EFFECTIVENESS OF PRESCRIPTION MONITORING PROGRAM USE IN EMERGENCY DEPARTMENTS

急诊科使用处方监测计划的有效性

基本信息

批准号：
8610195
负责人：
Benjamin C Sun
金额：
$ 46.24万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-03-01 至 2018-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8610195
关键词：
Accident and Emergency department Accounting Acute Pain Address Adoption Alcohol or Other Drugs use Centers for Disease Control and Prevention (U.S.)Cessation of life Cocaine Collaborations Congresses County Hospitals Data Data Set Diagnosis Effectiveness Emergency Care Epidemic Evaluation Future Goals Health Healthcare Heroin Hospitals Individual Information Systems Intervention Knowledge Link Medicaid Monitor National Institute of Drug Abuse Nature Opioid Outcome Overdose Patients Pharmaceutical Preparations Pharmacy facility Physician-Patient Relations Physicians Policies Population Provider Public Health Reporting Resources Source Time United States National Institutes of Health Vehicle crash Visit Washington authority beneficiary database design disorder prevention drug abuser effective intervention high risk improved meetings mortality novel operation opioid abuse opioid misuse overdose death prescription drug abuse prescription opioid prescription opioid abuse pressure programs trend

项目摘要

DESCRIPTION (provided by applicant): The ultimate goal of this proposal is to reduce prescription opioid related overdoses and deaths. The U.S. Congress, the National Institute on Drug Abuse, and the Centers for Disease Control and Prevention have identified prescription opioid abuse as a top public health problem. The 14,800 prescription opioid-related overdose deaths reported in 2008 have increased five-fold since 1999 and far surpass overdose deaths from cocaine and heroin. Emergency departments (ED) are the source of 39% of prescriptions for controlled substances and represent particularly high risk settings for doctor shopping and drug diversion. Contributing factors include the episodic and time-pressured nature of emergency care, lack of a long-term physician- patient relationship, and until recently, the absence of integrated data systems about prior controlled substance use. Prescription monitoring programs (PMPs) are statewide pharmacy databases designed to limit drug misuse by providing data on controlled medication dispensing. Despite the considerable expense of PMPs, the data on their impact to reduce opioid related harms are limited. A major challenge to the effectiveness and evaluation of PMPs is low rates of physician adoption; less than 6% of eligible providers will register for PMP access in the first year of operation. Washington State recently mandated that ED providers register for PMP access by July 2012; all 87 eligible hospitals have met this requirement. Although the policy does not require PMP use, it does create universal provider PMP access in a high risk setting. We capitalize on this opportunity to study a critical public health question: Does PMP use in emergency departments reduce opioid prescribing, overdoses, and deaths? In collaboration with the Washington State Health Care Authority and the Washington State Prescription Monitoring Program, we will create a unique dataset linking provider PMP use, opioid prescribing, and outcomes to accomplish the following Aims: Specific Aim 1. Identify predictors of PMP use by emergency department providers Specific Aim 2. Assess the impact of emergency department PMP use on total, inappropriate, and appropriate opioid prescribing Specific Aim 3. Assess the impact of emergency department PMP use on patient outcomes. To achieve these Aims, we will create a unique dataset of 2,400 providers and 1.4 million ED visits that links provider PMP use to patient claims and mortality files. Our proposal will result in novel and policy-relevant knowledge to address the public health epidemic of prescription opioid abuse.

描述（由申请人提供）：该提案的最终目标是减少处方阿片类药物相关的过量和死亡。美国国会，美国国家药物滥用研究所和疾病控制与预防中心已将阿片类药物滥用确定为公共卫生的主要问题。自1999年以来，2008年报道的14,800份处方阿片类药物相关的过量死亡人数增加了五倍，超过可卡因和海洛因的过量死亡。急诊科（ED）是受控物质处方的39％的来源，代表了购物和毒品转移的高风险环境。促成因素包括急诊护理的情节性和时间压力的性质，缺乏长期的医师关系，直到最近，还没有关于先前受控药物使用的综合数据系统。处方监测计划（PMP）是全州药房数据库，旨在通过提供对受控药物分配的数据来限制药物滥用。尽管PMP的费用相当大，但其影响减少阿片类药物相关危害的数据仍然有限。对PMP的有效性和评估的主要挑战是医师采用率低。在运营的第一年，不到6％的合格提供者将注册PMP访问。华盛顿州最近要求在2012年7月之前登记PMP访问权限；所有87家合格的医院都满足了这一要求。尽管该策略不需要PMP使用，但它确实在高风险设置中创建了通用提供商PMP访问。我们利用这一机会研究一个关键的公共卫生问题：PMP在急诊室中使用是否减少了阿片类药物的处方，过量服用和死亡？ In collaboration with the Washington State Health Care Authority and the Washington State Prescription Monitoring Program, we will create a unique dataset linking provider PMP use, opioid prescribing, and outcomes to accomplish the following Aims: Specific Aim 1. Identify predictors of PMP use by emergency department providers Specific Aim 2. Assess the impact of emergency department PMP use on total, inappropriate, and appropriate opioid prescribing Specific Aim 3. Assess the impact of emergency department PMP use on patient结果。为了实现这些目标，我们将创建一个独特的数据集，包括2,400个提供商和140万次ED访问，将提供商PMP与患者的索赔和死亡率文件联系起来。我们的建议将导致新颖和与政策相关的知识，以解决处方阿片类药物滥用的公共卫生流行。