More than half of health providers surveyed said they only use the database when they suspect a patient may misuse the medication.
Despite Florida's availability of a statewide database that aims to reduce opiate abuse and diversion, just 3% of emergency medicine providers reported using the database every time they prescribed opioid pain relievers, according to researchers at University of Florida Health.
Instead, 51% of health providers surveyed said they only use the database when they suspect a patient may misuse the medication.
That response was the study's "biggest surprise," Henry Young II, MD, the study's lead researcher, said in a statement. He is an assistant professor in the UF College of Medicine's department of emergency medicine and a National Institute on Drug Abuse research fellow.
It also raised questions about the possible biases providers may act on when deciding whether they suspect opioid abuse, but this angle angle wasn't addressed in this research.
The study did reveal that 70% of the respondents reported receiving no formal education on identifying individuals at increased risk of opioid misuse. In addition, 73% said they feel pressured to prescribe opioids.
The study, published April 18 in the International Journal of Emergency Medicine, gathered survey results from 88 respondents throughout Florida who answered a 25-question survey distributed within the Florida College of Emergency Physicians' newsletter for five weeks in late 2015 and early 2016.
Related: Electronic-Florida Online Reporting of Controlled Substance Evaluation Program
Nearly all (99%) of the respondents were aware of the Electronic-Florida Online Reporting of Controlled Substance Evaluation Program, and 84% had registered accounts.
In addition to the 3% who said they always use the database, the survey showed that 21% of providers said they rarely use the database and 9% reported never using it when prescribing opioids.
Barriers to Database Access
Young said it was important to understand why the database isn't accessed more often and what can be done to change that.
"We found that there are quite a few barriers to access that slow the use of the database. Half of medical residents said they rarely use the database, which Young attributed to being very busy and learning how to be an emergency room physician.
Poor usability also seemed to be a factor in the database's underutilization, even though the database has been available for nearly seven years and there is a huge public health imperative for using it, with officials reporting 2,530 prescription drug overdose deaths in Florida in 2015.
The researchers found that among providers overall, most common complaints about the database were that it "timed out" too often and required frequent password changes. More than half said the system is too difficult to access and 45% said getting information takes too long.
Recommendations
The researchers call for decreasing the frequency of mandatory password changes, reducing system timeouts, and integrating the prescription database into EHR systems.
They point to Indiana, where a study showed that after patients' prescription drug information was integrated into medical records, it was used much more frequently. Young said he will work with the database developers to suggest revisions.
"The motive isn't to just catch people who are abusing the system," he said. "It's also a way to inform everyone who is involved in a patient's treatment and to promote conversations. You may well find someone who needs help with an addiction."
Alexandra Wilson Pecci is an editor for HealthLeaders.
