Sunday, December 2, 2012

Monitoring Drug Misuse & Overdoses

The HHS Office of the National Coordinator is vitally concerned with prescription drug misuse causing the fastest growing health epidemics in the U.S. To address the prescription drug abuse problem, many states have established Prescription Drug Monitoring Programs (PDMP). These programs collect prescription data on medications that the federal government classifies as controlled substances and other non-controlled substance drugs.

PDMPs are not federally operated as they are statewide electronic databases that collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing physicians. PDMP information can be very useful to improve decision-making when prescribing and dispensing scheduled prescription drugs.

It has been shown that while most states have monitoring programs available to curb abuse and addiction, it is a fact that many states do not fully analyze or use the data they collect. Also, there are limitations on authorized users as current processes do not support clinical workflows, lack interoperability, and lack business agreements.

HHS initiated work groups with individuals from the healthcare community, industry, trade and advocacy groups, state, and the federal government to discuss the issues in using monitoring programs.  The work groups discussed the primary problems facing the transport and use of Prescription Drug Monitoring Program (PDMP) data. A final report “Enhancing Access to Prescription Drug Monitoring Programs Project Using Health Information Technology” has been prepared by the MITRE Corporation but is not yet approved for public release.

Also, experts from the “Prescription Drug Monitoring Program Center of Excellence at Brandeis University’s Heller School for Social Policy and Management have systematically assessed prescription drug monitoring programs and found a patchwork of strategies and standards.

Brandeis has issued a report outlining the best practices that all states and territories can use to improve the effectiveness of the monitoring programs. One of the primary conclusions is that prescription drug monitoring programs should shift from a reactive to a proactive approach.

“Being proactive is the key to success in the fight against prescription painkiller abuse,” said John L. Eadie, Director for the PDMP Center of Excellence at the Heller School for Social Policy and Management at the university. “While doctors may routinely collect and report data to a state program that signals where and when prescription painkillers are likely being misused, the program may not be sharing that information with others who can best use it.”

“State programs should analyze the data they collect”, said Peter Kreiner, Principal Investigator of Brandeis Center of Excellence. He continued to say “State programs should reach out to prescribers, pharmacists, insurers, law enforcement agents and others who can prevent powerful narcotics from falling into the wrong hands. For more information on the Brandeis study, go to www.pdmpexcellence.org.

In an effort to halt the use of the misuse of drugs, the National Governors Association is hosting a year-long project led by Governor Robert Bentley from Alabama and Governor John Hickenlooper from Colorado.

The year-long project “Prescription Drug Abuse Reduction Policy Academy” will work on strategic planning aimed at reducing prescription drug abuse. In addition to Alabama and Colorado, five other states such as Arkansas, Kentucky, New Mexico, Oregon, and Virginia will develop and implement comprehensive and coordinated strategies that will use all available tools and resources to address this growing problem.

NGA also released a new issue brief “Six Strategies for Reducing Prescription Drug Abuse” that highlights strategies and provides recommendations for governors looking to reduce prescription drug abuse in their state. For information on the issue brief, go to www.nga.org

NIH is going full force on researching prescription drug abuse. As a result, NIH’s National Institute on Drug Abuse has issued two companion funding opportunity notices to encourage applicants to develop innovative research applications as they apply to prescription drug abuse.

This research can include the factors contributing to prescription drug abuse, characterize the adverse consequences associated with prescription drug abuse, and develop effective prevention and service delivery approaches along with behavioral and pharmacological treatments.

The application for NIH funding is due by January 8, 2016. For more information on the companion funding notices PA-13-015 (Exploratory/Developmental Grant) and PA-13-016, (Research Project Grant), go to http://grants.nih.gov/grants/guide/pa-files/PA-13-015 and http://grants.nih.gov/grants/guide/pa-files/PA-13-016.