Using the Maine PMP to Improve Prescribing Practices for Potentially Addictive Prescription Medications Susan Payne, MPH, PhD Research Professor Institute.

Slides:



Advertisements
Similar presentations
MAPS Michigan Automated Prescription System. Exempt From Reporting Medications administered directly to patients. Dispensing of up to a 48 hour supply.
Advertisements

A Powerful Tool May, 2014 PDMP. pdmp No reportable financial interest.
National Prescription Drug Threat Assessment 2009 National Drug Intelligence Center Drug Enforcement Administration.
Preventing Prescription Drug Abuse: Laws and Legislation Hollie Hendrikson, MSc Policy Specialist, Health Program.
Achieving Better Care by Monitoring All Prescriptions (ABC-MAP) Act 191 of 2014 Board Meeting April 8, 2015.
A Growing Problem…. We Will Discuss Prescription vs. OTC medications Alarming trends Myths about prescription drug abuse Specific medications of abuse.
Controlled Substances Prescription Monitoring Program
Swinomish Wellness Program
Drug Utilization Review (DUR)
Team Care Department of Vermont Health Access. Revised 12/18/12 2 What is Team Care? The Team Care program is for beneficiaries with Vermont health care.
2008 International Symposium on Pharmaceuticals in the Home PMP/TDS Update Debra Brucker, M.P.A., Ph.D. Daniel Eccher, M.P.H. Maine Office of Substance.
Controlled Substance Prescribing Trends and Physician and Pharmacy Utilization Patterns: Epidemiological Analysis of the Maine Prescription Monitoring.
VIRGINIA PRESCRIPTION MONITORING PROGRAM C.A.R.E Presentation February 27, 2015 Ralph Orr Director, Virginia Prescription Monitoring Program.
Maine’s Prescription Monitoring Program Maine Benzodiazepine Study Group Conference 2007 UPDATE Daniel J. Eccher, MPH Project Coordinator.
Prescription Opioid Use and Opioid-Related Overdose Death — TN, 2009–2010 Jane A.G. Baumblatt, MD Centers for Disease Control and Prevention Epidemic Intelligence.
Prescription Drug Abuse Sharon Hertz, M.D. Medical Officer Division of Anesthetic, Critical Care and Addiction Drug Products Food and Drug Administration.
Quality Management Update March 18, New Performance Improvement Project (1) Title: Controlled Substance Prescription Monitoring Program Database.
Pharmaceutical Drug Abuse Counterfeit Drugs. Current State of Affairs National drug prevalence studies indicate a sharp increase in prescription drug.
California State Board of Pharmacy Continuing Education Program Senate Bill 151 (Burton)
Slide 1 Best Practices Working Group Chapter 244 Acts of 2012 Joint Policy Working Group Bureau of Health Care Safety and Quality Director Madeleine Biondolillo,
Prescription Drug Monitoring Programs: Analysis of State Level Usage Requirements Matthew Penn, JD, Carla Chen, JD Director, Public Health Law Program.
Opioid Risk Management Programs Celia Jaffe Winchell, M.D. Acting Deputy Division Director Division of Anesthetic, Critical Care, and Addiction Drug Products.
Wireless Password: NABP ® NEW TECHNOLOGY TO PREVENT DRUG DIVERSION AND DRUG ADMINISTRATION ERRORS NABP PERSPECTIVE Conference of Western Attorneys.
Rx for Success Next Steps to Prevent Prescription Drug Abuse Rebecca Hebner, MPH Substance Abuse Prevention Systems Coordinator.
Florida Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Florida Public Health Association - Medical Director’s.
1 Alcohol and Substance Abuse Council of Jefferson County, Inc. 167 Polk Street, Suite 320 Watertown, New York Voice: ; Fax: ;
An integrated approach to addressing opiate abuse in Maine Debra L. Brucker, MPA, PhD State of Maine Office of Substance Abuse October 2009.
Maine Prescription Monitoring Program Using the PMP to Improve Patient Care John Lipovsky, MPPM, AREM, PMM Prescription Monitoring Program Coordinator.
Maine Prescription Monitoring Program Using the PMP to Improve Patient Care John Lipovsky, MPPM, AREM, PMM Prescription Monitoring Program Coordinator.
Chapter 29 The PMP Not to be confused with 50 Cent’s song.
Buprenorphine Treatment for Opioid Dependence CESAR FAX U n i v e r s i t y o f M a r y l a n d, C o l l e g e P a r k A Weekly FAX from the Center for.
Maine’s Prescription Monitoring Program Daniel J. Eccher, MPH Project Coordinator Prescription Drug Misuse: A Community Challenge.
John Lipovsky, MPPM, AREM, PMM
State of Maine Prescription Monitoring Program (PMP) Maine's Prescription Monitoring Program (PMP) is a tool created to prevent and detect prescription.
Prevention, Identification and Treatment of Opioid Use Disorders: A Personal Perspective Leah Bauer, MD Medical Director, Addiction Resource Center, Mid.
Summary Report and Recommendations on Prescription Drugs: Misuse, Abuse and Dependency Presentation for the County Alcohol and Drug Program Administrators’
Ohio Automated Rx Reporting System (OARRS) Danna E. Droz, J.D., R.Ph. PMP Administrator Ohio State Board of Pharmacy Cuyahoga County Opiate Summit September.
Risk Management of Modified- Release Opiate Analgesics: Palladone Sharon Hertz, M.D. Medical Team Leader, Analgesics Division of Anesthetic, Critical Care,
Maine Prescription Monitoring Program Using the PMP to Improve Patient Care John Lipovsky, MPPM, AREM, PMM Prescription Monitoring Program Coordinator.
Maine Prescription Monitoring Program Using the PMP to Improve Patient Care John Lipovsky, MPP, AREM, PMM PMP Coordinator Eriko Farnsworth PMP Project.
Table of Contents.  Legal and Safety Issues Go Go  Prescriptions and Abbreviations Go Go.
Maine Prescription Monitoring Program Using the PMP to Improve Patient Care John Lipovsky, MPPM, AREM, PMM Prescription Monitoring Program Coordinator.
GB.DRO f, date of preparation: January 2010 Dartford and Gravesham NHS Trust Pharmacy Services in Hospital.
Drug Enforcement Administration Greater Kansas City Chapter American Society for Pain Management Nursing October 24, 2015 Judy R. Williams Group Supervisor.
Maine Prescription Monitoring Program Using the PMP to Improve Patient Care John Lipovsky, MPPM, AREM, PMM Prescription Monitoring Program Coordinator.
Sarah Thompson, PharmD, CDOE Director of Clinical Services, Coastal Medical.
Drug Utilization Review & Drug Utilization Evaluation: An Overview
A System to Manage Long Term Opioid Prescribing in the Primary Care Setting Joy Nassar, MD University Medicine Foundation November 16, 2015.
Achieving Better Care by Monitoring All Prescriptions (ABC-MAP) Act 191 of 2014 Pennsylvania's Prescription Drug Monitoring Program (PDMP) May 17, 2016.
ABC-MAP Act 191 of 2014 September 16, 2016 Pennsylvania’s Prescription Drug Monitoring Program (PA PDMP)
Oregon Prescription Drug Monitoring Program
Medication Assisted Treatment
New Mexico Prescription Monitoring Program
Medication-Assisted Therapy at Coleman Profession Services
Chapter 19 Mr. Pressman Freshman Health.
OPIOID SAFETY. Indiana Statistics In Summary… About 100 Hoosiers die from drug overdoses every month, many from opioids such as heroin and prescription.
An Overview of the ePDMP
Buccaneers SAIL Safe Accountable In Control Lead by Example.
Complete a legally valid prescription.
Differentiating Drug-Seeking Behavior From Poorly Controlled Pain
Barbara Allison-Bryan, MD
PRESCRIPTION MONITORING PROGRAMS
Opiate Roundtable March 29, 2018 Karen Burgess, MD
Prescription Drug Monitoring Program
Prescription Drug Monitoring Program
2019 Medicare Part D Rule Opioid-related Provisions
Prescription Drug Monitoring Program
Do Well by Doing Good: Expand the Connecticut Prescription Monitoring and Reporting System (CPMRS) Amy C. Justice MD, PhD Professor of Medicine and Public.
Illinois Prescription Monitoring Program
PMP Advisory Committee
Presentation transcript:

Using the Maine PMP to Improve Prescribing Practices for Potentially Addictive Prescription Medications Susan Payne, MPH, PhD Research Professor Institute for Health Policy, Muskie School of Public Service, University of Southern Maine Patricia Lapera, MPH Prescription Monitoring Program Coordinator, Office of Substance Abuse, DHHS State of Maine

Objectives of the session  Provide an overview of the misuse and abuse of potentially addictive prescription medications in Maine  Describe the Maine Prescription Monitoring Program (PMP)  Describe how health care providers use the PMP to improve prescribing  Provide contact information on the PMP

Potentially addictive or “controlled” prescription medications  “Controlled” medications include pain relievers, stimulants, sedatives, tranquilizers, sleep aids, and hormone supplements (Oxycodone, Vicodin, Alprazolam).  They are commonly prescribed.  They have legitimate therapeutic uses and can be used safely with medical oversight.  They also have the potential to be addictive.

Maine has serious problems with the use of controlled medications Source: Office of the Chief Medical Examiner; Marcella Sorg, UMaine/Smith Pol. Center

Use of controlled medications is increasing in Maine  From , the number of prescriptions for controlled medications in Maine increased by 24%.  Use of Schedule II medications (with highest potential for addiction) grew faster than Schedule III or IV (with lower potential).  Use of pain relievers is growing fast; they are often used for non-medical reasons and are most commonly obtained by diversion.

Source: Epidemiologic Study , Dr. Susan Payne Prescriptions filled in Maine Age and Year,

Admissions to substance abuse treatment for opiate abuse Maine:

“Doctor shopping” & “pharmacy hopping”  Most patients get their controlled medications from only 1 or 2 prescribers.  However, some people use many prescribers or pharmacies, so that it is harder to monitor and control their medication use.  For example, in 2008, 1% of the people with prescriptions for controlled medications in Maine used 5 or more prescribers. Some individuals used 50 or more prescribers.

The Maine Prescription Monitoring Program (PMP)  What is the Maine PMP?  What are the PMP goals?  How does the PMP work?

What is the Maine PMP?  The Maine PMP provides information to prescribers and pharmacists to identify suspicious activity related to prescribing and dispensing controlled substances.  It is under the Maine Office of Substance Abuse (OSA).  It collects information from all pharmacies for all prescriptions filled in Maine for medications In US DEA Schedules II -IV. 10

 Prescribers and pharmacists can access the information, after appropriate registration processes are completed, through a secure, password-protected PMP website.  They can verify patients’ reports on their use of PMP-tracked medications and identify questionable activity.

 PMP legislation passed in Maine in There are PMPs in more than 30 US states  Data collection began July  Data are submitted once per week from over 600 pharmacies  All information is saved in a centralized database, available online to data requesters/sub-account users.

13 What are the goals of the PMP?  To improve patient care by giving health care providers comprehensive information  To curb misuse of prescription drugs  To ensure that those who do need prescription medications still receive them  To get those who are addicted into appropriate treatment  To help stop prescription drug overdoses and overdose deaths  To educate the public on the dangers of prescription drug misuse and abuse

How does the PMP work? Who has access to the data? Prescribers, other licensed providers and medical office assistants (new) Pharmacists Licensing boards Patients OSA staff members Law enforcement- through grand jury subpoena Office of MaineCare Services Office of the Chief Medical Examiner 14

Two useful PMP reports Requested reports  Health care professionals can register with the PMP to request online patient history or prescriber history reports for their patients.  Prescribers, dispensers, licensed providers and medical office assistants (new) can register.

Notification (threshold) reports  Sent automatically to prescribers and dispensers  Monthly patient threshold reports  Monthly buprenorphine/narcotics concurrent usage reports  Monthly acetaminophen threshold reports

Examples of how prescribers are using the PMP  Summary of results from a study of the PMP conducted by the Muskie School in 2010

 Prescribers and pharmacists can play a key role in monitoring medication use, reducing the chance of diversion and misuse, assuring patient safety, and improving quality of care.  To do this, they need information on their patients’ medication use.  We asked health care professionals registered with the PMP about when and how they use it to improve prescribing and patient care.

When do prescribers use the PMP?  With new patients  With unfamiliar or unknown patients (drop ins)  With patients with suspicious behavior (aggressive or belligerent, “lost prescription,” needs emergency refill)  With patients seeking pain relievers  With patients already prescribed pain relievers or Suboxone® (to avoid potential drug-drug interactions)

What do they do with the information if they see a potential problem?  Counsel the patient  Discuss the patient with other health care professionals  Modify the treatment plan  Contact the police

Examples of steps taken to improve prescribing  Conduct substance abuse (SA) screening and brief intervention  Refer patient to a pain specialist  Establish a controlled substances agreement (“narcotics contract”) with patient  Refer the patient to an substance abuse professional  Discharge patient from the practice

“Best practices” to institutionalize use of the PMP Standardize use: Access the PMP for all patients meeting certain criteria, such as having a prescription for a pain reliever or suboxone This de-stigmatizes the PMP use – patients don’t feel singled out. Pre-visit planning: Access the PMP prescribing history for patients before the visit and put it in the chart, so information is available to provider during the visit

“Best practices” Communication: Use the PMP information to initiate conversations about possible dependency, addiction, or clinically inappropriate medication usage New patients: Compare patient’s reported medication use to PMP information, to test veracity and begin honest conversation about medication use

Conclusions  There is a significant prescription drug misuse problem in Maine.  The PMP is a tool to prevent and detect prescription drug abuse.  The PMP can be used to effectively enhance patient care.  EVERYONE is at risk! 24

Contact information  PMP registration: requester-forms.html requester-forms.html  Patricia Lapera: or or  Susan Payne: 