6/11/2013 PDMP Training & Technical Assistance Center Status of - - PDF document

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6/11/2013 PDMP Training & Technical Assistance Center Status of - - PDF document

6/11/2013 PDMP Training & Technical Assistance Center Status of Prescription Drug Monitoring Programs (PDMPs) * To view PDMP Contact information, hover the mouse pointer over the state abbreviation VT ME NH WA MA MT ND MN NY RI OR


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Arkansas Department of Health 4815 West Markham Street ● Little Rock, Arkansas 72205-3867 ● Telephone (501) 661-2000 Governor Mike Beebe Nathaniel Smith, MD, MPH, Interim Director and State Health Officer

Status of Prescription Drug Monitoring Programs (PDMPs)

Research is current as of April 10, 2013

AK AL AR CA CO ID IL IN IA MN MO MT NE NV ND OH OK OR TN UT WA AZ SD NM VA WY MI GA KS HI TX ME MS WI NY PA LA KY NC SC FL VT WV

Operational PDMPs Enacted PDMP legislation, but program not yet operational Legislation Pending

G U

NH MA RI CT NJ DE MD DC

PDMP Training & Technical Assistance Center

* To view PDMP Contact information, hover the mouse pointer over the state abbreviation

 National Vital Statistics System (CDC)

 Released January 14, 2007: Drug-induced deaths had become

more common than alcohol-induced or firearm-related deaths in the U.S.

 Released November 4, 2011: Drug overdose deaths surpassed

traffic accident deaths in the U.S.

 Arkansas ranked among the second highest group of states

nationally in overall drug overdose deaths in 2008, 38% of which were due to nonmedical use of opioid pain relievers.

 In 2010, Arkansas was among the highest group nationally in

the rate of kilograms of opioid pain relievers sold per 10,000 people.

CDC, Morbidity and Mortality Weekly Report, 60(43): 1490,2011 CDC, Morbidity and Mortality Weekly Report, 60(43): 1490,2011

 National Survey on Drug Use and Health

(SAMHSA)

  • Released January 8, 2013: Prescription drug misuse is second
  • nly to marijuana as the nation’s most prevalent illicit drug

problem.

  • Arkansas ranked among the top five states for nonmedical use
  • f prescription pain relievers by persons aged 12 and older

from 2010 – 2011.

 Arkansas Crime Laboratory

  • In 2011, approximately 1250 autopsies were

performed in Arkansas. Drug intoxication, either from prescription or illicit drugs or a combination thereof, was the primary cause of death in 1 of 9 cases.

  • Drugs, including prescription drugs, were a

contributory cause of death in 1 of 4 cases.

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 Arkansas Prevention Network

  • 22% of Arkansas high school students say they have abused

prescription drugs by the time they are seniors.

  • 1 in 3 teens reports knowing someone who abuses prescription drugs.
  • 1 in 5 teens share their prescription drugs with friends.
  • Over 60% of teens believe that most teens get their drugs from their

parent’s medicine cabinet.

2010 Arkansas Prevention Needs Assessment Survey, April 2011

 A PMP is a program that keeps records of all

dispenser transactions of controlled substances.

 Schedule II – V are reported.  Reports are generated to aide prescribers and

dispensers in enhancing patient care.

 Data can assist in curtailing misuse and abuse

  • f controlled prescription drugs.

Alliance of States with Prescription Drug Monitoring Programs

 Education and information  Public health initiatives  Early intervention and prevention  Investigations and enforcement  Protection of confidentiality

Alliance of States with Prescription Monitoring Programs

 The Arkansas Prescription Monitoring Program

(AR PMP) was established by ACT 304 of 2011 in

  • rder to:

 Enhance patient care  Help curtail the misuse and abuse of controlled substances.  Assist in combating illegal trade and diversion of controlled

substances.

 Enable access to prescription information by authorized

individuals.

 Act 304 directed the Arkansas Department of

Health to seek funding and implement the AR PMP by March 1, 2013.

 Health Information Designs was contracted to

construct the AR PMP database in the fall of 2012.

 AR PMP Rules and Regulations Public Hearing

January 8, 2013

 Notification Letters sent to 1,140 Pharmacies

January 15, 2013

 AR PMP Final Rules and Regulations approved

by the Board of Health January 24, 2013

 AR PMP Website Operational February 14,

2013 for Dispenser Upload Accounts.

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 AR PMP Operational March 1, 2013 for Weekly

Reporting of Controlled Substances Dispensing Data.

 AR PMP Operational in May 2013 for direct

access by prescribers and pharmacists.

 AR PMP Operational in June 2013 for indirect

access by law enforcement and regulatory boards.

 Dispensers of Controlled Substances:

 In-state Pharmacies  Out-of-State Pharmacies  Practitioners dispensing controlled

substances

Alliance of States with Prescription Drug Monitoring Programs

Controlled substance dispensing data reporting is web-based. Information is sent securely online to the PMP central database.

Reporting to the PMP is required weekly for

the previous Sunday – Saturday dispensing period. Schedule II – V : including Tramadol and Nalbuphine plus solid dosage forms of ephedrine, pseudoephedrine and phenylpropanolamine dispensed by prescription.  Prescribers & Pharmacists - for their patients  Licensing boards – pursuant to an investigation  Law Enforcement – pursuant to a search

warrant

 Other State PMPs  Researchers and educators (de-identified

information)

Alliance of States with Prescription Drug Monitoring Programs

State PMP

Dispensers Prescribers Law Enforcement & Regulatory Boards Pharmacists *Alliance of States with Prescription Monitoring Programs

Registration with the PMP

Receive Login Credentials

Login to Secure Web Portal

Request Report

View Report Online

Print Report

Typical for Prescribers/Pharmacists

Alliance of States with Prescription Monitoring Programs

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▫ Patient history

  • Check previous use of controlled substances
  • Check for misuse via multiple prescribers or

pharmacies

  • Check for medication duplication
  • Check for drug interactions
  • Check for compliance with pain contracts

Alliance of States with Prescription Drug Monitoring Programs

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 Prescriber History

  • A physician can confirm the authenticity of

prescriptions attributed to his/her DEA number

  • Check his/her own prescribing history
  • Run monthly prescriber history reports
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 Administrative Reports

  • Threshold Reports
  • De-identified Reports for research
  • Specialized interest and needs reports

Prescriber (>180mg/day) Oxycodone IR 30mg tablet

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 Prescription history of a current or a new

patient

 Check for appearance of addiction or

undertreated pain

 Check for appearance of misuse, multiple

prescribers, multiple pharmacies

 Check for drug interactions or other harm  Check for compliance with pain contracts

Alliance of States with Prescriptions Drug Monitoring Programs

 24/7 access via web portal  Can be accessed before filling controlled

substance prescriptions

 Data is updated weekly  Covers all sources of payment  Covers all controlled substances

Alliance of States with Prescriptions Drug Monitoring Programs

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 Unsolicited or Threshold Reporting is

proactive

 The PMP analyzes collected data

according to selected parameters

 Reports/Alerts can be sent to

pharmacists and prescribers

 Automated in the future

Alliance of States with Prescriptions Drug Monitoring Programs

 To Fill or Not to Fill….THAT is the question!  Opportunity to counsel patient on proper use  Alert prescribers to access the PMP  Alert other pharmacies to access the PMP

 Pharmacy/Clinic signage advising

patients of your participation in the AR PMP.

 Frequently Asked Questions  Reports Section

 Narcotics Anonymous: www.na.org  Alcoholics Anonymous: www.aa.org  Al-Anon/Alateen: www.al-anon.alateen.org  Substance Abuse Treatment Facility Locator:

http://dasis3.samhsa.gov

 Interstate Data Sharing  Automated Unsolicited Reporting  Education Programs for:

 Prescribers  Pharmacists  Law Enforcement

Alliance of States with Prescription Drug Monitoring Programs

 As of May 20, 2013,

  • 4,272,925 controlled substance prescription records

were in the database.

  • 842,875 were for narcotic analgesics
  • Since January 1, 2013 -- 478,948 prescriptions for

Hydrocodone/Apap have been dispensed (28,114,520 tabs)

  • Since January 1, 2013 – 114,533 prescriptions for

Oxycodone have been dispensed (includes liquids, tabs and caps)

  • Since January 1, 2013 – 7,136 prescriptions for

Hydromorphone have been dispensed. (609,173 tabs)

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Denise Robertson, P.D. PMP Administrator 4815 West Markham Street Slot 25 Little Rock, Arkansas 72205-3867 501-683-3960 501-661-2769 denise.robertson@arkansas.gov