How far have we come? The Kansas Drug Monitoring Program (K-TRACS) - - PowerPoint PPT Presentation
How far have we come? The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic Jennifer Donnelly, MPH Assistant Director K-TRACS Kansas Board of Pharmacy Kansas Association of Osteopathic Medicine Wichita, Kansas
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Jennifer Donnelly, MPH Assistant Director K-TRACS Kansas Board of Pharmacy Kansas Association of Osteopathic Medicine Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Trump Declares Opioid Crisis a ‘Health Emergency’ but Requests No Funds
Congress searches for prescription to help fight growing opioid epidemic
Image Source: https://www.nytimes.com/interactive/2019/07/17/upshot/drug-overdose-deaths-fall.html
Crack-cocaine epidemic Beginning of the Opioid Crisis
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Image Source: Gregory Reid (https://www.aarp.org/health/drugs-supplements/info-2017/opiates- prescription-pain-medication-information.html
130 + 81,000 11.4
million
37 %
People died every day in 2017 from an
People used heroin for the first time in 2016 People misused prescription opioids in 2016
Increase in overdose Deaths involving psychostimulants between 2016 & 2017
Data Source: https://www.hhs.gov/opi1oids/about-the-epidemic/index.html
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
VOLUNTARY controlled substance registry that is available 24/7 through a web based portal. Primary goals are: ▪ Provide education and information to prescribers and pharmacies ▪ Monitor trends and address controlled substance prescribing and utilization for public health ▪ Prevent misuse, abuse and diversion of controlled substances ▪ Give prescribers and pharmacies access to controlled substance history at the patient level ▪ Alert prescribers to patients that may benefit from a referral to treatment for substance abuse disorders
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
72% of the controlled substances dispensed in Kansas are prescribed by K-TRACS registrants
5287 5724 6747 7755 8968 12823 1042 1272 1652 1976 2400 3099
2013 2014 2015 2016 2017 2018
REGISTERED K-TRACS USERS
Registered Prescribers Registered Dispensers
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
8.3% 27.6% 46.7% 69.6% 142.5%
0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 120.0% 140.0% 160.0%4,000 6,000 8,000 10,000 12,000 14,000 2013 2014 2015 2016 2017 2018 Number of Registered Prescribers
Total Number of Registered Prescribers Percent Change of Registered Prescribers
Prescriber Registration has increased by 142.5% since December 31, 2013 The total number of registered prescribers has increased by 142.5% between 2013 to 2018. The total number of prescribers registered in KTRACS as of 12/31/2018 is 12,823 compared to 5,287 in 12/31/2013.
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
22.1% 58.5% 89.6% 130.3% 197.4%
0.0% 50.0% 100.0% 150.0% 200.0% 250.0%1,000 1,500 2,000 2,500 3,000 3,500 2013 2014 2015 2016 2017 2018 Number of Registered Pharmacists Total Number of Registered Pharmacists Percent Change of Registered Pharmacists
Pharmacist Registration has increased by 197.4% since December 31, 2013 The total number of registered pharmacists has increased by 197.4% between 2013 to 2018. The total number of pharmacists registered in KTRACS as of 12/31/2018 is 3,099 compared to 1,042 in 12/31/2013.
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
14
PDMP Electronic Health Records (EHRs) Integration and Interoperability Expansion (PEHRIIE) project
2015 and provided access within their electronic medical record system through a single-sign on (SSO) for physicians in emergency department.
Kroger NARxCheck
collaborated with Appriss Health to connect their pharmacy management system (PMS) to a predictive algorithm and care management platform for controlled substances. Expanded integration/interoperability statewide to all EHRs and PMS.
Gateway connection cost with Center for Disease Control and Prevention (CDC) Data-Driven Prevention Initiative (DDPI) Grant.
Expand upon past successes to build a statewide project.
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Our vision is 'healthy Kansans living in safe and sustainable environments'. The state belongs to all of us - "Kansas Don't Spoil It"
U.S. and Kansas Opioid Prescribing Rate per 100 Persons
Source: CDC and IQVIA Xponent 2006–2017.
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Multiple Prescriber Episodes
Technical Note – These maps display opioid prescription dispensations as reported to IQVIA Xponent 2006–2017. IQVIA Xponent is based on a sample
initial or refill prescription dispensed at a retail pharmacy in the sample and paid for by commercial insurance, Medicaid, Medicare, or cash or its
Data Source: -APPRISS Health Data Dashboard – Dispensations by County
Data Source: https://www.cdc.gov/drugoverdose/maps/rxcounty2017.html
2,396,957 Opioid Prescriptions were dispensed to Kansas Residents in 2017 (84.0 per 100 population)
Technical Note – These maps display opioid prescription dispensations as reported to K-TRACS. Reporting to K- TRACS is voluntary. Rates are calculated using 2000 US census standard population.
Data Source: -APPRISS Health Data Dashboard – Dispensations by County
Prescriptions per Capita by Patient County
2,604,203 Opioid Prescriptions were dispensed to Kansas Residents in 2016 (91.3 per 100 population) 2,555,858 Opioid Prescriptions were dispensed to Kansas Residents in 2015 (89.6 per 100 population)
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
14.3% increase
Percent Change in Reported 12 Month-ending Count of Drug Overdose Deaths, by Jurisdiction: March 2018 – March 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
(per 100,000 population) Involving Opioids,
Any Opioid Commonly Prescribed Opioids Psychostimulants Heroin Other Synthetic Opioids (fentanyl, tramadol)
Age Adjusted Overdose Death Rates (per 100,000 population), by Drug Type, Kansas, 2005 – 2018
Note: Rates based on small cell counts are generally thought to be unstable. The Kansas Department of Health and Environment define small numbers as less than six. These rates are suppressed in this graphic.
0.0 1.0 2.0 3.0 4.0 5.0 6.0
Age Adjusted Rate per 100,000 Population
Unspecified Drug Toxicity
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
*Data Source: 2000-2018 Kansas Vital Statistics Mortality files, Bureau of Epidemiology and Public Health Informatics, Kansas Department of Health and Environment Death were computed based on underlying cause of death using the 2000-2009 revised intercensal bridged race population estimates for years 2000 -2009 and postcensal estimates for 2010-2018 years. Rates were age adjusted to the U.S. 2000 standard population.
4.3 5.7 6.5 7.0 8.4 9.0 9.5 9.9 9.3 10.9 9.5 9.9 10.5 11.8 11.6 11.8 10.9 11.5 12.5 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 50 100 150 200 250 300 350 400
Age-Adjusted All Drug Overdose Deaths per 100,000 Population Total Number of All Drug Overdose Deaths Year of Death
Age-adjusted All Drug Overdose Deaths per Population by Year, Kansas Residents, (2000-2018*)
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Figure 13. Average Age-Adjusted Rate (per 100,000 population) for All Drug Overdose Deaths by County, Kansas (2009-2018 combined)
This map displays age-adjusted rates for deaths attributed to any drug overdose per 100,000 Kansas residents for counties with at least 6 overdose events. The reference population used is the 2000 Census estimates for Kansas by county.
Note: Rates based on small cell counts are generally thought to be unstable. The Kansas Department of Health and Environment define small numbers as less than six. These rates are suppressed in this graphic.
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
In 2018:
Opioid prescriptions
Benzodiazepine
prescription
1.1 million Kansas
patients received an
received an average daily dose of greater than or
equal to 90 MME
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Source:https://www.cdc.gov/opioids/pdf/Strategic-Framework-Factsheet_Jan2019_508.pdf
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Image source: https://www.jhsph.edu/events/2017/americas-opioid-epidemic/report/2017-JohnsHopkins-Opioid-digital.pdf
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Advisory Committee
to build a comprehensive approach to address the opioid epidemic
primary, secondary, and tertiary prevention activities for prescription and illicit opioid abuse and overdose
reporting
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
– review and analyze data for purposes of identifying patterns and activity of concern – notify the prescribers and dispensers who prescribed or dispensed the prescriptions – notify law enforcement or appropriate regulatory board(s) for additional investigation
– December 2018 approved and reviewed 4 cases
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Kansas Department for Aging and Disability Services Kansas Department of Health and Environment DCCCA Kansas Board of Pharmacy Kansas Board of Healing Arts Kansas Hospital Association Kansas Foundation for Medical Care Kansas Department for Children and Families Kansas State Child Death Review Board Kansas Pharmacists Association Kansas Department of Corrections Kansas Attorney General’s Office Kansas Medical Society U.S. Department of Health and Human Services U.S. Attorney’s Office, District of Kansas U.S. Department of Agriculture Kansas Healthcare Collaborative Greenbush - Southeast Kansas Education Service Center University of Kansas Medical Center American Society of Addiction Medicine KU Center for Telemedicine & Telehealth Federal Bureau of Investigation KC Division University of Kansas School of Medicine - Wichita Kansas Bureau of Investigation Kansas Association of Chiefs of Police Kansas Sheriffs Association Kansas Poison Control Center Alliance for Drug Endangered Children Kansas State University University of Kansas Topeka Police Department Community Care Network of Kansas American Association of Oral & Maxillofacial Surgeons Johnson County Mental Health Center CKF Addiction Treatment Stormont Vail Health Four County Mental Health Center Kansas Health Institute Blue Valley School District Douglas County Health Department Washburn University Kansas State Board of Education Boys and Girls Club Topeka Sedgwick County Division of Health Teen Challenge SAMHSA
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019
Jennifer Donnelly, MPH Assistant Director Kansas Board of Pharmacy (785) 296-8717 Jennifer.Donnelly@ks.gov
The Kansas Drug Monitoring Program (K-TRACS) & the Impact on the Opioid Epidemic
Kansas Association of Osteopathic Medicine * Wichita, Kansas * November 8, 2019