Sunday, October 18, 2009

Tracking Controlled Substances

The State of California has unveiled a web-based prescription drug database to track all controlled substances (Schedule II, III, and IV) prescribed in the state. The tool gives doctors and law enforcement a way to combat prescription-drug abuse.

The state’s database known as the Controlled Substance Utilization Review and Evaluation System (CURES) contains more than 50 million entries for controlled substances dispensed in California. The password protected online system will help prevent so called “doctor shopping” among drug abusers by allowing providers to verify appropriate prescribing of medications.

Doctors, pharmacists, and investigators have access to the Department of Justice patient records under the state’s drug monitoring program and can access the information by fax and mail. However, the turnaround time for these requests typically takes days or weeks. The new California online system will provide information immediately and be helpful for the emergency department and all other physicians who need to treat patients with pain.

Previously in the last three years, Dr. Scott Fishman, Professor of Anesthesiology and Pain Medicine and Chief of the UC Davis Division of Pain Medicine, along with Barth Wilsey, a UC Davis Clinical Professor of Anesthesiology, worked on the largest study of a prescription monitoring program ever undertaken. The project was funded with a grant from the Robert Wood Johnson Foundation, and identified the need for the new database.

Dr. Fishman led a UC Davis study to demonstrate the benefits of the new database. In doing the study, Fishman collaborated with computer programmers and database experts in the Clinical and Translational Science Center (CTSC) and produced an application that was able to sift through over 50 million prescription records and identify potential problems with abuse.

To develop the database, the CTSC programmers created a complex algorithm so that researchers were able to link patient prescriptions in CURES. They found that the magnitude of patients with multiple provider episodes and visits to different doctors and pharmacies for the same controlled substances was significant and potentially represented serious medical and law enforcement problems.