A Monash University survey of community pharmacists in Victoria, Australia, found that the share who said they always used the state’s real-time PDMP roughly doubled after a mandate, from about one in four to about one in two. Pharmacists outside Melbourne and those with more than 15 years in practice were less likely to check every time.

By PDMPNews Staff

Source: Picco et al., International Journal of Clinical Pharmacy, April 2023 (online Dec. 17, 2022) (DOI)

What happened

Victoria rolled out its real-time PDMP in stages in 2019, starting with voluntary use. In April 2020, checking became mandatory for community-based prescribers and pharmacists. For pharmacists, the system is built into dispensing software. When a monitored medicine is dispensed, a “traffic light” pop-up appears. Red and amber notifications require a PDMP check, and they flag multiple prescriber or pharmacist episodes, high doses, and high-risk drug combinations based on the past 90 days of history.

Researchers at the Monash Addiction Research Centre drew a random, location-stratified sample of 700 Victorian community pharmacies and phoned the pharmacist in charge between October and November 2020. The anonymous online survey asked how often pharmacists used the PDMP before and after the mandate, and what pharmacist and pharmacy characteristics went along with regular use. Data collection took place about six months after the mandate began.

Key numbers

  • 265 pharmacists took part, a 47% response rate.
  • Voluntary period: 24.9% used the PDMP all the time and 37.7% most of the time.
  • After the mandate: 51.7% used it all the time and 38.9% most of the time.
  • Regular voluntary use was more likely in pharmacies that stocked naloxone (OR 1.96, 95% CI 1.11 to 3.45) and among pharmacists who had attended formal PDMP training (OR 1.78, 95% CI 1.05 to 3.05).
  • Under the mandate, pharmacists in regional and rural areas had lower odds of always checking (OR 0.35, 95% CI 0.20 to 0.63), as did those with more than 15 years of experience (OR 0.24, 95% CI 0.11 to 0.51). Stocking naloxone was still linked to higher odds (OR 1.88, 95% CI 1.06 to 3.34).
  • Only 37.7% of the pharmacies stocked naloxone, and 56.2% of pharmacists had attended PDMP training.

Why it matters for PDMPs

A mandate is often treated as the finish line. This survey suggests it is closer to the halfway mark. Even with the PDMP built into dispensing software and alerts that pop up on their own, roughly half of pharmacists said they did not check every time once it was required.

The authors give two possible reasons for the rural gap. Rural pharmacists may know their patients well and feel less need to look up a familiar face, and rural pharmacies often run with heavier workloads and fewer staff. For U.S. programs, both points carry over. Outreach that treats every pharmacy the same will miss the settings where use lags, and training appears to matter. Pharmacists who had attended formal training were more likely to be regular users before the mandate, although under the mandate the training link fell just short of statistical significance (OR 1.73, 95% CI 0.99 to 3.00).

The study also points to a timing problem any new program should expect. Victoria’s mandate began in April 2020, at the same time as Australia’s first COVID-19 outbreak, and the authors note that use was not actively monitored or enforced by government authorities. That may explain some of the shortfall.

What has happened since

This paper first appeared in late 2022 and was reposted by aggregators afterward, so newer work by some of the same authors is worth reading alongside it. A 2025 study in the Journal of the American Pharmacists Association surveyed 690 pharmacists in New South Wales, Queensland, Victoria and Western Australia. Pharmacists in states without a mandate more often reported being unsure what to do with PDMP information and that the PDMP was not integrated into their dispensing software. Those in mandated states more often reported that not all prescriptions appear in the PDMP and that some information was inaccurate.

A nationwide study published in July 2026 in Drug and Alcohol Review surveyed 730 community pharmacists. Use “all the time” was reported by 74.1% in mandated states and territories and 45.7% in non-mandated ones. Working in a mandated jurisdiction (aOR 3.64), in a capital city (aOR 1.90), or in a chain or banner pharmacy (aOR 1.49) was linked to always checking. A similar location gap appeared nationally, with pharmacists in capital cities more likely to check every time. PDMPNews has also covered consumer awareness of the program in New South Wales in a survey that found two-thirds had not heard of it.

Analysis

One detail in the methods matters for anyone citing the headline numbers. The two outcomes were not measured the same way. Before the mandate, “regular use” meant most of the time or all of the time. After the mandate, it meant all of the time only. The odds ratios for the two periods therefore answer slightly different questions and should not be compared directly. The figures are also self-reported and collected from the pharmacist in charge, not from system logs.

For PDMP administrators, the takeaway is that compliance data from the system itself is the better measure, and that it should be broken out by location and pharmacy type. Taken together, the Australian surveys point to groups that may need more support: pharmacies outside major cities and independent pharmacies in the national data, and long-practicing pharmacists in the Victoria data. Targeted training and refresher sessions are low-cost places to start.

Read the full study: PubMed Central PMC9759276