Missouri became the final state in the country to form a statewide prescription drug monitoring program.
The new statewide program was established during the 2021 legislative session and went into effect on Dec. 13.
The registry program aims to reduce the misuse of controlled substances, like opioids, by making prescription information available to pharmacies, prescribers and health care providers.
Pharmacies in Missouri are required to submit information to the statewide registry when they fill prescriptions for specific controlled substances.
With the absence of a statewide registry, 75 cities and counties across the state participated in a PDMP operated by the St. Louis County Department of Public Health.
In 2017, after about nine months of debate, the Jefferson County Council voted against joining the St. Louis County registry.
The Jefferson County Health Department, an independent government agency, then voted to join it.
“I think in the end, the (St. Louis County) database served its purpose,” said Kelley Vollmar, executive director of the Jefferson County Health Department. “Health providers were able to provide more informed care to their patients because of the registry.”
Vollmar said when COVID-19 hit, a lot of public health attention was diverted to the pandemic, so reports on substance abuse trends that could be generated by the registry were put aside.
“We all really lost a couple of years of understanding some of the aspects of substance abuse during that time,” she said.
With the start of the statewide registry, the one operated by St. Louis County has been dissolved.
The records for Jefferson County residents compiled since 2017 in the St. Louis County database have been transferred to the statewide registry.
“I’m excited to see the state pick up the registry,” Vollmar said.
According to information from the Mercy health system, a couple of differences between the state registry and the one St. Louis County had maintained is that information about prescriptions filled in neighboring states will not be available and information about Missourians’ prescriptions can no longer be accessed by out-of-state pharmacies and doctors.
Another difference is that unlicensed health care professionals, including medical assistants, office managers and pharmacy assistants, will not be able to access the statewide database.
“While I don’t see that as a big problem – that unlicensed people were probably entering data into the database rather than getting data out, I think it’s a good thing that only the people who need to see this information on individuals will be able to have access to it,” Vollmar said. “Anytime you can restrict access to those who need it, that’s a positive.”
Also, pharmacies will be required to update when a prescription is filled for the specified medications in real time. Under the St. Louis County list, pharmacies updated that information daily.
Vollmar said another change is that individuals’ information will be purged from the registry after three years.
However, Vollmar said she is glad Jefferson County residents’ information from the St. Louis County database will be transferred to the state registry.
“That means doctors and pharmacists aren’t looking at a blank slate when they’re trying to decide the best avenues of care for their patients,” she said.
The legislation also creates a Missouri Joint Oversight Task Force for Prescription Drug Monitoring, which includes six medical professionals.
The task force is to oversee the collection and use of patient dispensation information submitted to the statewide registry.
It also chose Bamboo Health as the vendor to run the database. The Kentucky-based firm is involved with 40 other statewide PDMPs, according to the state website.