Table 2.
Reporting barriers to PMP use identified from included studies
| Study IDs and Frequency of Barrier Reporting |
||||
|---|---|---|---|---|
| Barrier Group | Minor (Reported by <50% of Study Sample) | Major (Reported by ≥50% of Study Sample) | General (No Frequency Reported) | Examples of Barrier Group |
| Not seeing value in PMP data | Rutkow 2015 (23), Perrone 2012 (47), McCauley 2016 (45), Lin 2017 (44), Feldman 2012 (58), Barrett 2005 (45), Hernandez-Meier 2017 (41), Blum 2016 (56), Green 2012 (28), Ulbrich 2010 (79) | NA | Warren 2016 (71), Carnes 2017 (72), Homant 2006 (42), Deyo 2015 (74) | Feel it would not impact or change clinical practice, did not want to use PMP, feel they can rely on their own instinct. |
| Availability of technology | Perrone 2012 (47), Hernandez-Meier 2017 (41), Green 2012 (28), Green 2013 (27), Wixson 2015 (25) | Ulbrich 2010 (79) | Pugliese 2018 (77), Hildebran 2014 (64) | Limited access to phone, internet, or computers at work, not having access to PMP during all hours of the dazy. |
| Usability issues | Rutkow 2015 (23), Blum 2016 (56), Perrone 2012 (47), McAllister 2015 (67), Fazio 2017 (75), Hernandez-Meier 2017 (41), Green 2012 (28), McCauley 2016 (45), Kelley 2013 (43), Barrett 2005 (55) | Deyo 2015 (74), Wang 2017 (54) | Pugliese 2018 (77), Poon 2016 (49), Worley 2015 (80), Click 2017 (73) , Carnes 2017 (72), Smith 2015 (78), Hildebran 2014 (64) | Difficulty interpreting PMP data, difficulty accessing and navigating the PMP, format of information is not easy to use, lack of confidence in performing PMP tasks. |
| Time constraints to using PMP data | McCauley 2016 (45), McAllister 2015 (67), Hernandez-Meier 2017 (41), Blum 2016 (56), Green 2013 (27), Young 2017 (24), Wang 2017 (54), Barrett 2005 (55) | Rutkow 2015 (23), Perrone 2012 (47), Norwood 2016 (46), Kelley 2013 (43), Deyo 2015 (74) | Radomski 2018 (50), Hildebran 2014 (64), Worley 2015 (80), Warren 2016 (71), Smith 2015 (78) | Time consuming to log in, to retrieve information, increase in burden or workload. |
| Lack of awareness of PMP | Perrone 2012 (47), Feldman 2011 (59), Ulbrich 2010 (79), Lin 2017 (44) | McCauley 2016 (45), Green 2012 (28), Green 2013 (27) | NA | Unaware of PMP or availability of PMP data among non-users. |
| System slowness | Young 2017 (24), Barrett 2005 (55), Green 2013 (27), Lin 2017∗ (44), Hernandez-Meier 2017 (41) | Ulbrich 2010 (79), Lin 2017∗ (44), Deyo 2015 (74) | Radomski 2018 (50), Carnes 2017 (72), Naiman 2013 (76), Hildebran 2014 (64), Worley 2015 (80), Warren 2016 (71), Smith 2015 (78) | Delay in receiving requested reports, lag time in system updates from when a prescription is dispensed to when it shows up in the PMP, delays in reporting to the system, inability to directly query the system in real time, requests not processing or timing out, system slowness. |
| Concerns with privacy, monitoring, and autonomy | LeMire 2012 (66), Kelley 2013 (43), Blum 2016 (56), Feldman 2012 (58), Barrett 2005 (55), Norwood 2016 (46) | NA | Hildebran 2014 (64), Carnes 2017 (72) | Concerns with patient privacy, feel they are being policed, feel they are being inhibited in prescribing, fear of legal ramifications. |
| Lack of training/education or policies/guidelines | Ulbrich 2010 (79) | Deyo 2015 (74) | Hildebran 2014 (64), Homant 2006 (42), Warren 2016 (71) | Lack of training on how to use PMP or interpret findings, no guidance on how to integrate PMP into workflow, lack of knowledge on PMP policies or laws. |
| Inability to delegate access | Green 2012 (28), Green 2013 (27), Deyo 2015 (74) | NA | Carnes 2017 (72), Smith 2015 (78), Click 2017 (73) | Lack of staff available to access the system, inability of residents to query the system, unable to share account or delegate access. |
| Lack of integration and data sharing (between systems and jurisdictions) | Blum 2016 (56), Deyo 2015 (74) | NA | Radomski 2018 (50), Naiman 2013 (76), Worley 2015 (80), Carnes 2017 (72), Click 2017 (73) | No interstate data sharing, no integration with electronic health/medical record, inability to search outside of one’s jurisdiction. |
| Patient satisfaction concerns | Kelley 2013 (43), Ulbrich 2010 (79) | NA | Hildebran 2014 (64), Smith 2015 (78) | Worried about patient satisfaction rating (which may impact salary), concern with confronting patients, detracting from patient flow. |
| PMP does not meet provider data needs | Blum 2016 (56), Barrett 2005 (55) | NA | Radomski 2018, (50) Carnes 2017 (72), Homant 2006 (42) | Does not cover certain populations such as Veteran's Affairs or homeless, does not monitor drugs of interest, inability to access information on ones own prescribing history. |
| Problems with log-in credentials | Perrone 2012 (47), Hernandez-Meier 2017 (41), Blum 2016 (56), Young 2017 (24) | NA | Poon 2016 (49), Naiman 2013 (76), Hildebran 2014 (64), Click 2017 (73) | Difficulty remembering login credentials, frequent password changes required. |
| Problems with registration process | Perrone 2012 (47), Norwood 2016 (46), McAllister 2015 (67), Lin 2017 (44), Hernandez-Meier 2017 (41), Green 2012, Blum 2016 (56), Green 2013 (27) | Ulbrich 2010 (79) | Hildebran 2014 (64), Smith 2015 (78) | Too time consuming to register, do not know how to register, having to register on each new computer. |
| No incentive to use PMP | Perrone 2012 (47) | NA | Hildebran 2014 (64), Smith 2015 (78) | No reimbursement for task or incentive (financial or otherwise) to use PMP data. |
| Data not reliable | Lin 2017∗ (44), Blum 2016 (44) | Lin 2017 ∗ (44) | Hildebran 2014 (64), Click 2017 (73) | Patient reports filed under more than one ID, missing data, inaccurate data or errors in the system, not all clinicians use the system so patient history may not be comprehensive.. |
| Lack of support from administration | Green 2012 (28), Green 2013 (27), Kelley 2013 (43) | NA | NA | PMP not required or promoted by administration, or PMP use is discouraged by administration. |
| Potential for under-treatment | Blum 2016 (56) | NA | Carnes 2017 (72) | Restrictions in providing opioids to patients who patients feel really need them (i.e. cancer, palliative care, surgery, etc.). |
*
Identifies studies that have reported barriers within the barrier group for more than one category of frequency of reporting.