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Prescription Drug Monitoring Programs

Jenna L McCauley, Renata S Leite, Valeria V Gordan, Roger B Fillingim, Gregg H Gilbert, Cyril Meyerowitz, David Cochran, D Brad Rindal, Kathleen T Brady
BACKGROUND: Minimal information exists regarding the consistency and correlates of dentists' implementation of risk mitigation strategies when prescribing opioids, including risk screening, prescription drug monitoring program (PDMP) use, and patient education. METHODS: The authors conducted a Web-based, cross-sectional survey among practicing dentist members of The National Dental Practice-Based Research Network. The authors used the survey to assess pain management prescribing practices and risk mitigation implementation...
March 14, 2018: Journal of the American Dental Association
Nathaniel M Rickles, Amy L Huang, Michelle B Gunther, Winney J Chan
BACKGROUND: Prescription opioid abuse has rapidly increased in recent years and is now considered a national epidemic by the United States government. Community pharmacies are at the forefront of opioid abuse, given their role in dispensing opioid prescriptions. Despite this role, however, there are few known guidelines to help community pharmacists navigate the process of detecting and managing prescription opioid abuse. OBJECTIVES: To develop and evaluate a candidate guideline, based on clinical experience and existing literature, to help community pharmacists monitor and manage potential opioid prescription abuse...
February 21, 2018: Research in Social & Administrative Pharmacy: RSAP
Richard A Deyo, Sara E Hallvik, Christi Hildebran, Miguel Marino, Nicole OʼKane, Jody Carson, Joshua Van Otterloo, Dagan A Wright, Lisa M Millet, Wayne Wakeland
Lumbar fusion surgery is usually prompted by chronic back pain, and many patients receive long-term preoperative opioid analgesics. Many expect surgery to eliminate the need for opioids. We sought to determine what fraction of long-term preoperative opioid users discontinue or reduce dosage postoperatively; what fraction of patients with little preoperative use initiate long-term use; and what predicts long-term postoperative use. This retrospective cohort study included 2,491 adults undergoing lumbar fusion surgery for degenerative conditions, using Oregon's prescription drug monitoring program to quantify opioid use before and after hospitalization...
March 6, 2018: Pain
Thomas R Radomski, Felicia R Bixler, Susan L Zickmund, KatieLynn M Roman, Carolyn T Thorpe, Jennifer A Hale, Florentina E Sileanu, Leslie R M Hausmann, Joshua M Thorpe, Katie J Suda, Kevin T Stroupe, Adam J Gordon, Chester B Good, Michael J Fine, Walid F Gellad
BACKGROUND: The Department of Veterans Affairs (VA) has implemented robust strategies to monitor prescription opioid dispensing, but these strategies have not accounted for opioids prescribed by non-VA providers. State-based prescription drug monitoring programs (PDMPs) are a potential tool to identify VA patients' receipt of opioids from non-VA prescribers, and recent legislation requires their use within VA. OBJECTIVE: To evaluate VA physicians' perspectives and experiences regarding use of PDMPs to monitor Veterans' receipt of opioids from non-VA prescribers...
March 8, 2018: Journal of General Internal Medicine
María José Fernández-Megía, Isabel Font Noguera, Matilde Merino Sanjuán, José Luis Poveda Andrés
OBJECTIVE: To analyze the results of sentinel patient program to monitoring the  quality pharmacoterapeutic process in the hospitalized patient through  medication errors. METHOD: Design: Observational, prospective and transversal study. Ambit: General hospital of 1,000 beds. PERIOD: From May 2011 to June 2016.  Sample: Patients with treatment prescribe within 24 hours of being admitted  with 4 or more medications. VARIABLES: Medication error, drugs prescribed,  medications and doses dispensing, drugs administered...
March 1, 2018: Farmacia Hospitalaria
Linda S Young, Robert S Crausman, John P Fulton
In the U.S. in 2015, the proportion of people dependent on opioids approached one percent, and opioid overdose rivaled auto accidents as the leading cause of accidental death. The literature suggests a credible link between increased opioid prescribing and increased opioid addiction. Accordingly, some have suggested that limiting the number of opioid prescriptions (and the number of doses per prescription) might be effective in reducing the number of opioid-related deaths. Toward this end, we designed and piloted an evidence-based quality-improvement project in four urgent care clinics...
March 1, 2018: Rhode Island Medical Journal
Hsien-Yen Chang, Irene Murimi, Mark Faul, Lainie Rutkow, G Caleb Alexander
PURPOSE: We quantified the effects of Florida's prescription drug monitoring program and pill mill law on high-risk patients. METHODS: We used QuintilesIMS LRx Lifelink data to identify patients receiving prescription opioids in Florida (intervention state, N: 1.13 million) and Georgia (control state, N: 0.54 million). The preintervention, intervention, and postintervention periods were July 2010 to June 2011, July 2011 to September 2011, and October 2011 to September 2012...
February 28, 2018: Pharmacoepidemiology and Drug Safety
Hilary Aroke, Ashley Buchanan, Xuerong Wen, Peter Ragosta, Jennifer Koziol, Stephen Kogut
BACKGROUND: Overuse and misuse of prescription opioids is associated with increased morbidity and mortality and places a significant cost burden on health systems. OBJECTIVE: To estimate annual statewide spending for prescription opioids in Rhode Island. METHODS: A cross-sectional study of opioids dispensed from retail pharmacies using data from the Rhode Island Prescription Drug Monitoring Program (PDMP) was performed. The study sample consisted of 651,227 opioid prescriptions dispensed to 197,062 patients between January 1, 2015, and December 31, 2015...
March 2018: Journal of Managed Care & Specialty Pharmacy
Emma E McGinty, Elizabeth A Stuart, G Caleb Alexander, Colleen L Barry, Mark C Bicket, Lainie Rutkow
BACKGROUND: The U.S. opioid epidemic has been driven by the high volume of opioids prescribed by healthcare providers. U.S. states have recently enacted four types of laws designed to curb high-risk prescribing practices, such as high-dose and long-term opioid prescribing, associated with opioid-related mortality: (1) mandatory Prescription Drug Monitoring Program (PDMP) enrollment laws, which require prescribers to enroll in their state's PDMP, an electronic database of patients' controlled substance prescriptions, (2) mandatory PDMP query laws, which require prescribers to query the PDMP prior to prescribing an opioid, (3) opioid prescribing cap laws, which limit the dose and/or duration of opioid prescriptions, and (4) pill mill laws, which strictly regulate pain clinics to prevent nonmedical opioid prescribing...
February 26, 2018: Implementation Science: IS
Naveed Zafar Janjua, Nazrul Islam, Margot Kuo, Amanda Yu, Stanley Wong, Zahid A Butt, Mark Gilbert, Jane Buxton, Nuria Chapinal, Hasina Samji, Mei Chong, Maria Alvarez, Jason Wong, Mark W Tyndall, Mel Krajden
BACKGROUND: Large linked healthcare administrative datasets could be used to monitor programs providing prevention and treatment services to people who inject drugs (PWID). However, diagnostic codes in administrative datasets do not differentiate non-injection from injection drug use (IDU). We validated algorithms based on diagnostic codes and prescription records representing IDU in administrative datasets against interview-based IDU data. METHODS: The British Columbia Hepatitis Testers Cohort (BC-HTC) includes ∼1...
February 23, 2018: International Journal on Drug Policy
Emilie Jouanjus, Grégory Guernec, Maryse Lapeyre-Mestre
Diversion of prescription drugs is difficult to assess in quality and quantity. This study aimed to characterize diversion of prescription drugs in France through a comparative analysis of falsified prescriptions collected during three periods from 2001 to 2012. The data recorded in a national program which records all falsified prescriptions presented to community pharmacies were studied. Included data regarded: subjects, prescription forms and drugs. Description of the dataset in 3 periods (2001-2004, 2005-2008, and 2009-2012) was completed with clustering analyses to characterize profiles of prescriptions and subjects associated with the most reported drugs...
February 13, 2018: Fundamental & Clinical Pharmacology
Sergio I Prada
Background: The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed...
December 2017: American Health & Drug Benefits
N J Pauly, S Slavova, C Delcher, P R Freeman, J Talbert
BACKGROUND: The United States is in the midst of an opioid epidemic. In addition to other system-level interventions, all states have responded during the crisis by implementing prescription drug monitoring programs (PDMPs). This study examines associations between specific administrative features of PDMPs and changes in the risk of prescription opioid-related poisoning (RxORP) over time. METHODS: This longitudinal, observational study utilized a 'natural experiment' design to assess associations between PDMP features and risk of RxORP in a nationally-representative population of privately-insured adults from 2004 to 2014...
January 11, 2018: Drug and Alcohol Dependence
Harlan Matusow, Andrew Rosenblum, Mark Parrino
No abstract text is available yet for this article.
January 20, 2018: Journal of Substance Abuse Treatment
Ira Byock
BACKGROUND: Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically supervised and monitored approach. A single or brief series of sessions often results in substantial and sustained improvement among people with treatment-resistant depression and anxiety, including those with serious medical conditions...
January 22, 2018: Journal of Palliative Medicine
Morhaf Al Achkar, Shaun Grannis, Debra Revere, Palmer MacKie, Meredith Howard, Sumedha Gupta
BACKGROUND: Prescription opioids have been linked to over half of the 28,000 opioid overdose deaths in 2014. High rates of prescription opioid non-medical use have continued despite nearly all states implementing large-scale prescription drug monitoring programs (PDMP), which points to the need to examine the impact of state PDMP's on curbing inappropriate opioid prescribing. In the short-term, PDMPs have been associated with short-term prescribing declines. Yet little is known about how such policies differentially impact patient subgroups or are interpreted by prescribing providers...
January 18, 2018: BMC Health Services Research
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
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
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
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
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