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Prescription Drug Monitoring Programs

Erin A Ferries, Aaron M Gilson, Rajendar R Aparasu, Hua Chen, Michael L Johnson, Marc L Fleming
OBJECTIVE:  Prescription drug abuse has reached epidemic levels, leading to overdose-related morbidity and mortality. Patient and regional-level factors are believed to contribute to higher rates of prescription drug abuse. The objective of this study was to determine the prevalence and factors associated with multiple provider episodes (MPEs) in Texas. METHODS:  This was a retrospective cohort analysis of data from the Texas Prescription Drug Monitoring Program (PDMP) database, linked with Texas county census data...
October 15, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Andrew W Roberts, Joel F Farley, G Mark Holmes, Christine U Oramasionwu, Chris Ringwalt, Betsy Sleath, Asheley C Skinner
Controlled substance lock-in programs are garnering increased attention from payers and policy makers seeking to combat the epidemic of opioid misuse. These programs require high-risk patients to visit a single prescriber and pharmacy for coverage of controlled substance medication services. Despite high prevalence of the programs in Medicaid, we know little about their effects on patients' behavior and outcomes aside from reducing controlled substance-related claims. Our study was the first rigorous investigation of lock-in programs' effects on out-of-pocket controlled substance prescription fills, which circumvent the programs' restrictions and mitigate their potential public health benefits...
October 1, 2016: Health Affairs
Deborah Dowell, Kun Zhang, Rita K Noonan, Jason M Hockenberry
To address the opioid overdose epidemic in the United States, states have implemented policies to reduce inappropriate opioid prescribing. These policies could affect the coincident heroin overdose epidemic by either driving the substitution of heroin for opioids or reducing simultaneous use of both substances. We used IMS Health's National Prescription Audit and government mortality data to examine the effect of these policies on opioid prescribing and on prescription opioid and heroin overdose death rates in the United States during 2006-13...
October 1, 2016: Health Affairs
Cary J Blum, Lewis S Nelson, Robert S Hoffman
BACKGROUND: Prescription drug monitoring programs (PDMPs) have emerged as one tool to combat prescription drug misuse and diversion. New York State mandates that prescribers use its PDMP (called ISTOP) before prescribing controlled substances. We surveyed physicians to assess their experiences with mandatory PDMP use. METHODS: Electronic survey of attending physicians, from multiple clinical specialties, at one large urban academic medical center. RESULTS: Of 207 responding physicians, 89...
November 2016: Journal of Substance Abuse Treatment
(no author information available yet)
No abstract text is available yet for this article.
October 2016: American Journal of Nursing
Francis P Lagattuta, Jason Williford, Physician Assistant
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Dora Lin, Eleanor Lucas, Irene B Murimi, Katherine Jackson, Michael Baier, Shannon Frattaroli, Andrea Gielen, Patience Moyo, Linda Simoni-Wastilla, G Caleb Alexander
AIMS: Physicians' use of Prescription Drug Monitoring Programs (PDMPs) varies by state. Among Maryland physicians, we sought to (1) estimate the PDMP impact on changes in opioid prescribing, (2) approximate the scope of PDMP utility and (3) determine the barriers to PDMP use after its 2013 implementation. DESIGN: Cross-sectional postal survey linking responses to state records of PDMP registration and use; randomly sampling physicians within specialty and registration strata...
September 23, 2016: Addiction
Ayesha Sajid, Aaron Whiteman, Richard L Bell, Marion S Greene, Eric A Engleman, R Andrew Chambers
BACKGROUND AND OBJECTIVES: Fourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university-affiliated integrated mental health-addiction treatment clinic. METHODS: Repeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long-acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders...
October 2016: American Journal on Addictions
Rana F Hamdy, Theoklis E Zaoutis, Susan K Seo
Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida...
September 2, 2016: Virulence
Sarah L Gold, Kristen Gilmore Powell, Michael H Eversman, N Andrew Peterson, Suzanne Borys, Donald K Hallcom
OBJECTIVES: To explore the high-risk ways in which older adults obtain prescription opioids and to identify predictors of obtaining prescription opioids from high-risk sources, such as obtaining the same drug from multiple doctors, sharing drugs, and stealing prescription pads. DESIGN: Logistic regression analyses of cross-sectional survey data from the New Jersey Older Adult Survey on Drug Use and Health, a representative random-sample survey. PARTICIPANTS: Adults aged 60 and older (N = 725)...
August 26, 2016: Journal of the American Geriatrics Society
Nicola Principi, Susanna Esposito
BACKGROUND: Antibiotics are among the drugs most commonly prescribed to children in hospitals and communities. Unfortunately, a great number of these prescriptions are unnecessary or inappropriate. Antibiotic abuse and misuse have several negative consequences, including drug-related adverse events, the emergence of multidrug resistant bacterial pathogens, the development of Clostridium difficile infection, the negative impact on microbiota, and undertreatment risks. In this paper, the principle of and strategies for paediatric antimicrobial stewardship (AS) programs, the effects of AS interventions and the common barriers to development and implementation of AS programs are discussed...
2016: BMC Infectious Diseases
Sonia Mendoza, Allyssa S Rivera-Cabrero, Helena Hansen
Growing nonmedical prescription opioid analgesic use among suburban and rural Whites has changed the public's perception of the nature of opioid addiction, and of appropriate interventions. Opioid addiction has been recast as a biological disorder in which patients are victims of their neurotransmitters and opioid prescribers are irresponsible purveyors of dangerous substances requiring controls. This framing has led to a different set of policy responses than the "War on Drugs" that has focused on heroin trade in poor urban communities; in response to prescription opioid addiction, prescription drug monitoring programs and tamper-resistant opioid formulations have arisen as primary interventions in place of law enforcement...
August 2016: Transcultural Psychiatry
Dominic DiPrinzio, Roopa Sethi
No abstract text is available yet for this article.
2016: Primary Care Companion to CNS Disorders
Stephen W Patrick, Carrie E Fry, Timothy F Jones, Melinda B Buntin
Over the past two decades the number of opioid pain relievers sold in the United States rose dramatically. This rise in sales was accompanied by an increase in opioid-related overdose deaths. In response, forty-nine states (all but Missouri) created prescription drug monitoring programs to detect high-risk prescribing and patient behaviors. Our objectives were to determine whether the implementation or particular characteristics of the programs were effective in reducing opioid-related overdose deaths. In adjusted analyses we found that a state's implementation of a program was associated with an average reduction of 1...
July 1, 2016: Health Affairs
Ellen Meara, Jill R Horwitz, Wilson Powell, Lynn McClelland, Weiping Zhou, A James O'Malley, Nancy E Morden
BACKGROUND: In response to rising rates of opioid abuse and overdose, U.S. states enacted laws to restrict the prescribing and dispensing of controlled substances. The effect of these laws on opioid use is unclear. METHODS: We tested associations between prescription-opioid receipt and state controlled-substances laws. Using Medicare administrative data for fee-for-service disabled beneficiaries 21 to 64 years of age who were alive throughout the calendar year (8...
July 7, 2016: New England Journal of Medicine
Ashley-Nicole Carmichael, Laura Morgan, Egidio Del Fabbro
BACKGROUND: The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. AIMS: To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer...
2016: Substance Abuse and Rehabilitation
Duy Q Nguyen, Brian Chung, Loryn L Osburn, Mark A Della Paolera, Benjamin Chavez
OBJECTIVE: This article aims to explore the statistics observed in the Pacific Northwest regarding substance abuse, as Oregon and Washington have been shown to be most affected given the increased treatment admissions for opioid utilization and mortality related to medication overdose. METHODS: Using PubMed and National Conference of State Legislatures database, articles detailing prescription drug abuse statistics, programs, and laws were collected and analyzed in order to identify possible solutions...
June 9, 2016: Journal of Pharmacy Practice
Nicole O'Kane, Sara E Hallvik, Miguel Marino, Joshua Van Otterloo, Christi Hildebran, Gillian Leichtling, Richard A Deyo
PURPOSE: To develop a complete and consistent prescription drug monitoring program (PDMP) data set for use by drug safety researchers in evaluating patterns of high-risk use and potential abuse of scheduled drugs. METHODS: Using publically available data references from the US Food and Drug Administration and the Centers for Disease Control and Prevention, we developed a strategic methodology to assign drug categories based on pharmaceutical class for the majority of prescriptions in the PDMP data set...
September 2016: Pharmacoepidemiology and Drug Safety
Yuhua Bao, Yijun Pan, Aryn Taylor, Sharmini Radakrishnan, Feijun Luo, Harold Alan Pincus, Bruce R Schackman
State prescription drug monitoring programs are promising tools to rein in the epidemic of prescription opioid overdose. We used data from a national survey to assess the effects of these programs on the prescribing of opioid analgesics and other pain medications in ambulatory care settings at the point of care in twenty-four states from 2001 to 2010. We found that the implementation of a prescription drug monitoring program was associated with more than a 30 percent reduction in the rate of prescribing of Schedule II opioids...
June 1, 2016: Health Affairs
(no author information available yet)
PURPOSE: Best practices and guidance are provided for improved electronic detection and alerting of inadvertent supratherapeutic cumulative doses of acetaminophen and other medications with narrow therapeutic ranges in inpatient settings. SUMMARY: Despite the use of medication safety technologies, overdosage and associated sentinel events continue to be serious problems in many inpatient settings. The tools needed to monitor and employ dose alerts, accumulators, and warning systems are available to reduce inadvertent overdose...
August 1, 2016: American Journal of Health-system Pharmacy: AJHP
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