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Prescribers registered with the NC Controlled Substances Reporting System (NC CSRS) can now obtain prescription drug histories from other states. The Forum asked the director of Duke Health’s Medical Pain Service, Steven D. Prakken, MD, his thoughts on how this new capability fits in to clinical practice.

What factors would cause you to look at a patient’s prescription history in another state?
If about 50 miles or less from the border then I would check it regularly. I would check at intake, then at least every 6-12 months. I would even suggest that anyone you give C2 meds to should have the neighboring states scanned once a year. If someone travels frequently to another state, if they have family in another state, I would check multi-state data regularly.

When would you not run out-of-state histories?
As I’ve indicated, there’s no reason to run multi-state queries for every patient, every visit. I don’t think there is anything that would make me “not” run out of state, if the situation fit the parameters stated above. Maybe if it was a script for someone in a nursing facility I could be convinced not to run one.

How do you see the availability of multistate prescription drug data fitting in to your practice and current NC CSRS use?
This is something I have looked forward to for a few years. There are situations every week where I wish I had easy access to surrounding state medication records. This is something I will check commonly for about 25% of my patients. This also is something that staff can be assigned to do.