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Prescription Drug Monitoring Programs

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https://www.readbyqxmd.com/read/29330240/structured-management-of-chronic-nonmalignant-pain-with-opioids-in-a-rural-primary-care-office
#1
Kevin S McCann, Shawndra Barker, Raymond Cousins, Adam Franks, Clinton McDaniel, Stephen Petrany, Eric Riley
INTRODUCTION: The use of opioid medication for nonmalignant chronic pain (NMCP) increased dramatically during the last 20 years. There have been regulatory changes implemented to reduce the risk of harm to both patients and society. Much of the burden of monitoring these patients is falling on primary care physicians (PCPs), who do not have the time or resources to handle what is entailed in a best-practice approach to NMCP. METHODS: A retrospective study was conducted with all patients on opioid medication for NMCP who were enrolled onto an individual PCP's practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#2
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29323819/the-use-of-a-statewide-prescription-drug-monitoring-program-by-emergency-department-physicians
#3
Jennifer L Hernandez-Meier, Rachel Muscott, Amy Zosel
BACKGROUND: Little is known about how emergency physicians have used Wisconsin's Prescription Drug Monitoring Program (PDMP). OBJECTIVE: To characterize emergency physician knowledge and utilization of the program and how it modifies practice. METHODS: Online survey data were collected 1 year after program implementation. Descriptive statistics were generated and qualitative responses were grouped by content. RESULTS: Of the 63 respondents, 64...
June 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29321043/what-is-in-your-wallet-a-cluster-randomized-trial-of-the-effects-of-showing-comparative-patient-out-of-pocket-costs-on-primary-care-prescribing-for-uncomplicated-hypertension
#4
Robyn Tamblyn, Nancy Winslade, Christina J Qian, Teresa Moraga, Allen Huang
BACKGROUND: Drug expenditures are responsible for an increasing proportion of health costs, accounting for $1.1 trillion in annual expenditure worldwide. As hundreds of billions of dollars are being spent each year on overtreatment with prescribed medications that are either unnecessary or are in excess of lowest cost-effective therapy, programs are needed that optimize fiscally appropriate use. We evaluated whether providing physicians with information on the patient out-of-pocket payment consequences of prescribing decisions that were in excess of lowest cost-effective therapy would alter prescribing decisions using the treatment of uncomplicated hypertension as an exemplar...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#5
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29297725/prescription-drug-monitoring-programs-and-pharmacist-orientation-toward-dispensing-controlled-substances
#6
Michael Fendrich, Janelle K Bryan, Katinka Hooyer
OBJECTIVES: We sought to understand how pharmacists viewed and used a newly implemented prescription drug monitoring program (PDMP). We also sought to understand pharmacist orientation toward dispensing of controlled substances and the people who obtain them. METHODS: We conducted three mini focus groups. The focus group findings were used to inform the design of a structured survey. We emailed a survey to 160 pharmacists who were employed in one statewide community chain store; we obtained 48 survey responses...
January 3, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29275945/the-supply-of-prescription-opioids-contributions-of-episodic-care-prescribers-and-high-quantity%C3%A2-prescribers
#7
Todd Schneberk, Brian Raffetto, David Kim, David L Schriger
STUDY OBJECTIVE: We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. METHODS: This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program...
December 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29248915/using-controlled-substance-receipt-patterns-to-predict-prescription-overdose-death
#8
Christina T Holt, Kenneth L McCall, Gary Cattabriga, Chunhao Tu, Elenna K Smalley, Stephanie D Nichols
BACKGROUND: This study evaluates complete state data from controlled substance prescribing trends in the prescription monitoring program (PMP) database and their association with the risk of prescription drug overdose death. SUMMARY: Maine PMP records of individuals who died of prescription overdose deaths between 2006 and 2010 were selected (n = 690). For each subject, an age, gender, and residence matched cohort of PMP users in a 50: 1 ratio was identified (n = 34,500)...
December 14, 2017: Pharmacology
https://www.readbyqxmd.com/read/29248333/effect-of-automated-prescription-drug-monitoring-program-queries-on-emergency-department-opioid-prescribing
#9
Benjamin C Sun, Christina J Charlesworth, Nicoleta Lupulescu-Mann, Jenny I Young, Hyunjee Kim, Daniel M Hartung, Richard A Deyo, K John McConnell
STUDY OBJECTIVE: We assess whether an automated prescription drug monitoring program intervention in emergency department (ED) settings is associated with reductions in opioid prescribing and quantities. METHODS: We performed a retrospective cohort study of ED visits by Medicaid beneficiaries. We assessed the staggered implementation (pre-post) of automated prescription drug monitoring program queries at 86 EDs in Washington State from January 1, 2013, to September 30, 2015...
December 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29241835/the-impact-of-a-statewide-mandatory-prescription-drug-monitoring-program-on-opioid-prescribing-by-emergency-medicine-providers-across-15-hospitals-in-a-single-health-system
#10
Brian Suffoletto, Michael Lynch, Charissa B Pacella, Donald M Yealy, Clifton W Callaway
Prescription drug monitoring programs (PDMP) enable registered prescribers to obtain real-time information on patients' prescription history of controlled medications. We sought to describe the impact of a state-mandated PDMP on opioid prescribing by Emergency Medicine providers. We retrospectively analyzed electronic medical records of 122,732 adult patients discharged with an opioid prescription from 15 Emergency Departments in a single health system in Pennsylvania from July 2015 to March, 2017. We used an interrupted time-series design to evaluate the percentage of patients discharged each month with an opioid prescription before and after state law mandated PDMP use on August 25th, 2016...
December 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29206984/rational-urine-drug-monitoring-in-patients-receiving-opioids-for-chronic-pain-consensus-recommendations
#11
Charles E Argoff, Daniel P Alford, Jeffrey Fudin, Jeremy A Adler, Matthew J Bair, Richard C Dart, Roy Gandolfi, Bill H McCarberg, Steven P Stanos, Jeffrey A Gudin, Rosemary C Polomano, Lynn R Webster
Objective: To develop consensus recommendations on urine drug monitoring (UDM) in patients with chronic pain who are prescribed opioids. Methods: An interdisciplinary group of clinicians with expertise in pain, substance use disorders, and primary care conducted virtual meetings to review relevant literature and existing guidelines and share their clinical experience in UDM before reaching consensus recommendations. Results: Definitive (e...
December 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29199394/trends-in-florida-s-prescription-drug-monitoring-program-registration-and-utilization-implications-for-increasing-voluntary-use
#12
Chris Delcher, Yanning Wang, Henry W Young, Bruce A Goldberger, Siegfried Schmidt, Gary M Reisfield
OBJECTIVE: Effective use of state prescription drug monitoring programs (PDMPs) to track controlled substance prescribing and dispensing may help mitigate the current opioid crisis. Our objective was to examine trends in registration for and use of Florida's PDMP by physicians and pharmacists, from 2013 to 2016. We discuss implications for PDMP uptake and policy. DESIGN: Key measures, such as cumulative number of registrants per license type and monthly utilization intensity, are presented...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29183067/prescription-drug-monitoring-programs-and-opioid-death-rates-reply
#13
Anne Schuchat, Gery P Guy, Deborah Dowell
No abstract text is available yet for this article.
November 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29183062/prescription-drug-monitoring-programs-and-opioid-death-rates
#14
LETTER
William Rudman, Peter Corcoran, Kimberly Elliot
No abstract text is available yet for this article.
November 28, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29177439/attitudes-beliefs-practices-and-concerns-among-clinicians-prescribing-opioids-in-a-large-academic-institution
#15
Jon O Ebbert, Lindsey M Philpot, Casey M Clements, Jenna K Lovely, Wayne T Nicholson, Sarah M Jenkins, Tim J Lamer, Halena M Gazelka
Objectives: Opioid treatment of chronic noncancer pain (CNCP) adds complexity and uncertainty to patient interactions. We sought to assess clinician attitudes, beliefs, practice styles, and concerns around opioid prescribing following the release of the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain. Methods: E-mailed electronic survey to clinicians at a large academic medical institution. Results: A total of 961 clinicians responded to the survey (response rate = 40%), 720 of whom prescribed opioids and were not in training...
June 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29165853/past-year-prescription-drug-monitoring-program-opioid-prescriptions-and-self-reported-opioid-use-in-an-emergency-department-population-with-opioid-use-disorder
#16
Kathryn Hawk, Gail D'Onofrio, David A Fiellin, Marek C Chawarski, Patrick G O'Connor, Patricia H Owens, Michael V Pantalon, Steven L Bernstein
BACKGROUND: Despite increasing reliance on Prescription Drug Monitoring Programs (PDMPs) as a response to the opioid epidemic, the relationship between aberrant drug-related behaviors captured by the PDMP and opioid use disorder is incompletely understood. How PDMP data should guide Emergency Department (ED) assessment has not been studied. STUDY OBJECTIVE: To evaluate a relationship between PDMP opioid prescription records and self-reported non-medical opioid use of prescription opioids in a cohort of opioid dependent ED patients enrolled in a treatment trial...
November 22, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29155988/opioid-prescribing-patterns-and-patient-outcomes-by-prescriber-type-in-the-oregon-prescription-drug-monitoring-program
#17
Patrick B Fink, Richard A Deyo, Sara E Hallvik, Christi Hildebran
Objective: Prescription drug monitoring programs (PDMPs) were created to facilitate responsible use of controlled substances. In Oregon, physicians, physician's assistants (MDs/DOs/PAs), dentists, nurse practitioners (NPs), and naturopathic physicians (NDs) may prescribe opioids, but differences in prescribing practices, patient mix, and patient outcomes among prescriber types have not been characterized. Methods: De-identified Oregon PDMP data from October 2011 through October 2014 were linked with vital records and a statewide hospital discharge registry...
November 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29150151/evaluating-short-and-long-term-impacts-of-a-medicaid-lock-in-program-on-opioid-and-benzodiazepine-prescriptions-dispensed-to-beneficiaries
#18
Rebecca B Naumann, Stephen W Marshall, Jennifer L Lund, Nisha C Gottfredson, Christopher L Ringwalt, Asheley C Skinner
BACKGROUND: Insurance-based "lock-in" programs (LIPs) have become a popular strategy to address controlled substance (CS) (e.g., opioid) misuse. However, little is known about their impacts. We examined changes in CS dispensing to beneficiaries in the 12-month North Carolina Medicaid LIP. METHODS: We analyzed Medicaid claims linked to Prescription Drug Monitoring Program (PDMP) records for beneficiaries enrolled in the LIP between October 2010 and September 2012 (n=2702)...
November 6, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#19
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29143401/assessment-of-risk-behaviors-in-patients-with-opioid-prescriptions-a-study-of-indiana-s-inspect-data
#20
Marion S Greene, Robert Andrew Chambers, Constantin T Yiannoutsos, Eric R Wright, Gregory K Steele, Terrell W Zollinger
BACKGROUND AND OBJECTIVES: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients' likelihood to engage in opioid-related risk behaviors. METHODS: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines...
November 16, 2017: American Journal on Addictions
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