Illinois Prescription Monitoring Program

Sandeep D. Amin, MD


Asokumar Buvanendran, MD 

ISMS Members Making it Work: Sandeep D. Amin, MD and Asokumar Buvanendran, MD
May 2017

Two ISMS members are using a powerful free resource to make a difference in combating prescription drug abuse. As pain physicians, Sandeep D. Amin, MD, and Asokumar Buvanendran, MD, evaluate several patients a day in their office. Routinely, they use the Illinois Prescription Monitoring Program to check that opioid pain medication is not being overprescribed.  

The Illinois Prescription Monitoring Program (PMP) is an electronic database that collects information on controlled substance prescriptions. Prescribers and dispensers of controlled substances can search information on this system, which is updated weekly. The PMP is designed to help stop "doctor shopping," i.e., patients going from one doctor to another to get multiple prescriptions for powerful and addictive pain medications.

Value of the PMP

For Dr. Amin, the PMP has become an essential tool. "Before the PMP we were blind, as physicians, to a patient's prescription history. The only way to find out if a patient was abusing medications was by calling the pharmacy or performing a urine drug test. The PMP gave doctors a blueprint, so that prescribers can now know where patients are getting prescriptions and how much they are getting," said Dr. Amin.

"Almost every time I prescribe a Schedule II narcotic I use the PMP," says Dr. Buvanendran. "It allows me to see whether the patient has multiple prescriptions for narcotics or they've never had a narcotics prescription before. What I see in the PMP helps me in my conversation with a patient as well as in setting their dosage."

"Overall, the PMP is a very useful tool that keeps patients safer and should make physicians more comfortable when prescribing these medications," said Dr. Amin. "The use of the PMP has become a routine part of our practice."

Routine use of the PMP has prevented numerous cases of doctor shopping in their offices. "We have had patients come in for first-time consultations for pain who have said they are not on any pain medications or their prescription has run out," said Dr. Amin. "When we pull their information in the PMP we see they just had a script filled for 180 OxyContin the week before. We print that out and show it to the patient and ask them about it," says Dr. Amin. "The patient will give some excuse or explanation. A lot of them don't realize this tool exists. Typically we won't see that patient again."

Why Use the PMP

With all the administrative work and thousands of computer clicks a physician executes on a daily basis, it may be easy to overlook the PMP. That would be an important missed opportunity as far as these physicians are concerned. "Opioid abuse is a huge epidemic and all physicians should be part of the solution," comments Dr. Buvanendran. "We cannot ignore the problem and allow other entities to dictate how we tackle this issue. It does require more of an effort, but physicians must take the lead. At the end of the day it is about patient safety."

For Dr. Amin, the value of the PMP can be recognized by all physicians, regardless of specialty. "The PMP is underutilized currently, especially in areas like primary care where I see the PMP as a very useful tool. There is often uneasiness and discomfort when prescribing these types of drugs, and accessing patient information in the PMP can ease that discomfort," says Dr. Amin. "There is also patient discomfort when talking about pain medications, and fear they will be stigmatized for using opioid pain medications. Having the information in the PMP helps me to validate the patient's story and allows for better patient care."

Improvements to the PMP

While an excellent tool for physicians, the PMP is not without its challenges. Drs. Amin and Buvanendran believe a national database would improve the system. Currently, 49 states have their own PMPs, and while physicians can access information from other states, getting to that information requires further steps. "There are patients who live on the border and get a prescription filled in Indiana," says Dr. Amin. "We aren't able to see that information without clicking to another screen. It isn't always intuitive to look to another state like that. Having all of a patient's prescription history on one screen would increase the PMP's effectiveness. A federal prescription monitoring program that encompasses all states would go a long way in helping physicians and patients fight the growing epidemic of opioid abuse."

The only state that doesn’t have a PMP is Missouri, which has become a popular destination for patients seeking to game the system. The lack of a PMP puts physicians near the Missouri border at an extreme disadvantage when prescribing these powerful medications, leaving them unable to verify a patient's prescription history.