Staff Report with Final Results: Texas State Board of Pharmacy Page: 12
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Sunset Advisory Commission
Texas Pharmacist Usage of the
Prescription Monitoring Program - FY 201519
Number of searches by pharmacists.......................833,654
Total controlled substances dispensed.......38,562,564
Percent of controlled substance prescriptions
searched by pharmacists before dispensing.................2.1%
Pharmacists using the database at least once......8,279
Percent of total pharmacists using the
database at least once...................................................26%Mandating use
of the database
has greatly
reduced doctor
and pharmacy
shopping in
other states.such as a new controlled substance prescription, a prescriber or patient
outside of the pharmacy's geographic area, or a patient exhibiting signs
of obtaining the drugs for illegal purposes.21 Tennessee similarly requires
pharmacists to check the system if they have reason to believe a prescription
is fraudulent or medically unnecessary.22 In Texas, the board has identified
"red flags" for pharmacists that indicate a prescription may be invalid, but
these do not trigger a requirement to check the database.23
In both Ohio and Tennessee, mandatory use requirements for both
prescribers and pharmacists have helped reduce the number of patients
who shop for doctors or pharmacies to obtain additional prescriptions. In
Ohio, the number of patients receiving prescriptions from five or more
prescribers in one month declined by 77 percent between 2009 and 2015
since the mandatory use requirement was put into effect.24 In Tennessee,
patients receiving prescriptions from more than five doctors or pharmacies
in a three-month-period declined by 50 percent between 2011 and 2015.25
Texas law already singles out certain controlled substances as posing the
greatest risk for abuse or addiction, and imposes increased scrutiny on pain
clinics that prescribe these medications. Medical facilities that primarily
prescribe opioids, benzodiazepines, barbiturates, and carisoprodol must
register as pain clinics with the Texas Medical Board, triggering additional
regulatory requirements such as searching the database before prescribing
drugs to treat chronic pain.26 Requiring pharmacists to also place increased
scrutiny on these drugs would better ensure informed decisions for safe
dispensing. Mandating use of the database by pharmacists would also
ensure the state's significant investment in this program can achieve its
intended purpose. As the board is currently working to make the new
system more user friendly, this requirement could easily be phased in to
give time for pharmacists to adjust their practices." No delegate accounts. Pharmacists often work in busy, fast-paced settings.
The Center of Excellence encourages states to make the database easier to
use through the creation of delegate accounts for pharmacy technicians,
who perform much of the day-to-day work in pharmacies under the
1 2 Texas State Board of Pharmacy Staff Report with Final Results
Issue 1June 2017
of thousands of Texans obtained prescriptions
for addictive, potentially harmful drugs without
a pharmacist using the best tool available to
check the validity of the prescription.
Other states mandate use of prescription
monitoring programs with positive results.
Currently, 11 states require pharmacists to check
the database before dispensing a controlled
substance in certain circumstances.20 Ohio
requires pharmacists to check the system when
a prescription has certain "red flag" indicatorsU
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Ogle, Steven; Schiff, Tamara; Hartley, Cee & Teleki, Katharine. Staff Report with Final Results: Texas State Board of Pharmacy, report, June 2017; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1033475/m1/36/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.