Teaming Up for Safer Pain Management: Strategies for Effective Collaboration

Size: px
Start display at page:

Download "Teaming Up for Safer Pain Management: Strategies for Effective Collaboration"

Transcription

1 Teaming Up for Safer Pain Management: Strategies for Effective Collaboration Noah Nesin, MD, FAAFP, Vice President of Medical Affairs, Penobscot Community Health Care Felicity Homsted, PharmD, DPLA, Chief Pharmacy Officer, Penobscot Community Health Care

2 Target Audience: Pharmacists ACPE#: L04-P Activity Type: Knowledge-based

3 Teaming Up for Safer Pain Management: Strategies for Effective Collaboration Noah Nesin, MD, FAAFP, Vice President of Medical Affairs, Penobscot Community Health Care Felicity Homsted, PharmD, DPLA, Chief Pharmacy Officer, Penobscot Community Health Care

4 Disclosures: The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Noah Nesin: No relationships to disclose Felicity Homsted: No relationships to disclose The data presented is from a single health system

5 Session Objectives Identify mechanisms for collaboration between pharmacists and prescribers to minimize opioid misuse, while ensuring that patients with legitimate needs have access to opioids. Describe effective communication strategies between pharmacists and prescribers to optimize care and minimize patient risk. Describe policies around PDMP use and other mechanisms being used to manage risk and diversion and support appropriate medication use.

6 1. Assessment Question 1. Which of the following is not an example of how pharmacists and prescribers can collaborate to minimize opioid misuse. A. Develop interdisciplinary teams to review challenging cases B. Create community prescribing and monitoring guidelines C. Establish formal communication process between community pharmacist and prescribers to address prescribing concerns D. Construct a punitive based process for giving providers feedback

7 2. Assessment Question 2. Which of the following is not an effective way for pharmacists to improve communication to ensure safe prescribing practices and address community needs. A. Provide evidence base education to prescribers B. Counsel that state laws are the reason for opioid tapers C. Establish relationships with key prescriber stakeholders and leadership D. Reinforce safe-prescribing messaging in pharmacy

8 3. Assessment Question 3. Which of the follow is not optimal in mitigating diversion and supporting appropriate medication use. A. Reviewing prescription monitoring program data B. Utilization of urine drug screens C. Performing scheduled pill counts D. Requiring patient contracts for chronic opioids

9 Overview Established in 1998 Federally Qualified Health Center Patients: 65,000+ patients in 2017 Majority lower incomes Thousands uninsured Four integrated pharmacies, 1 rural dispensary, and 3 pharmacy residency programs 150,000 prescriptions dispensed annually

10 PCHC Integration Model

11 Primary Care Pharmacy Services Diabetes management Anticoagulation management Comprehensive medication management Chronic care management Hepatitis C management Controlled substance stewardship

12 Interdisciplinary Committee Structure Controlled Substance Stewardship (CSS) Committee Chief medical officer, chief psychiatrist, pharmacists, prescribers, social workers, & care managers Provider-patient agreements Policies with oversight Proactive case reviews Homsted F, Magee C, Nesin N. Population health management in a small health system: Impact of controlled substance stewardship in a patient-centered medical home. Am J Health-Syst Pharm. 2017;74: M8

13 Slide 12 M8 quality assurance/improvement reports? Magee,Chelsea, 3/15/2016

14 Impact Analysis: First 90 Days Retrospective chart review: 93 cases involving opioids reviewed in a 90-day period Dose reductions suggested in 78 cases At three-month follow-up, 76% of dose reductions implemented 32% of patients had the prescription eliminated completely Gernant SA, Bastien R, Lai A, et al. Development evaluation of a multidisciplinary controlled substances committee within a patient-centered medical home. JAPhA. 2015;55(6):

15 Annual Compliance Monitoring to Support Appropriate Use Informed consent & patient provider agreement Urine drug screens (UDS) - Prior to prescribing & random Pill Counts Also as needed at points of concern, random Prescription Drug Monitoring Program (PDMP) review - Prior to prescribing & scheduled by prescriber Opportunities for pharmacists to support

16 Informed Consent and Provider/Patient Agreement Provider reviews informed consent and patient/provider agreement with patient, ensuing patient understands all aspects Patient and Provider both sign, placed in medical record, copy for patient Designates single filling pharmacy Opportunity: Pharmacists support in drafting

17 Informed Consent: Opioids for Chronic Pain Goal is Improved 35% of people No proven function, not may develop benefit for total pain relief addiction chronic pain Higher risk of injury, falls, car accidents, breathing problems, heart disease, accidental overdose & death Bangor Area Controlled Substance Work Group. Controlled substance clinical documents resource informed consent for opioids for chronic pain Boscarino JA, Rukstalis MR, Hoffman SN, et al. (2011) Prevalence of Prescription Opioid-Use Disorder Among Chronic Pain Patients: Comparison of the DSM-5 vs. DSM-4 Diagnostic Criteria, Journal of Addictive Diseases. 2011;30(3):

18 Partnership Approaches to Ensure Legitimate Access to Opioids Begin with evidence based medicine Collaborate to develop consistent practices Identify strategies for managing inappropriate practices and utilize them Continuously educate Wiedemer NL, Harden PS, Arndt IO, Gallagher RM. The opioid renewal clinic: a primary care, managed approach to opioid therapy in chronic pain patients at risk for substance abuse. Pain Med. 2007;8(7):

19 Where is the evidence? Trauma informed care Eye movement desensitization & reprocessing (EMDR) Cognitive behavioral therapy (CBT) Antidepressants Anticonvulsants Physical therapy Support groups Weight loss Acupuncture Massage Chiropractic CDC guideline for prescribing opioids for chronic pain - United States, MMWR Recomm Rep. 2016; 65(RR-1): 1-49.

20 Communication Methods to Optimize Care and Minimize Patient Risk Consistent process evaluation and improvement Reinforce deprescribing messaging Increase consumer awareness Have difficult conversations

21 Non-Reassuring Behaviors Requests for early refills Lost or stolen medications Inability to reach for pill counts or UDS Failure to make scheduled appointments Reports of suspected diversion

22 PCHC Experience: Provider impact Practice security New addiction focus Awareness of suffering

23 Pill Counts % 90.00% 80.00% 70.00% Data from PCHC Clinical Tracking Scorecard. Goal 80.00% 67.14% 65.78% 60.00% 50.00% 40.00% 30.00% 20.00% 35.97% 31.28% 10.00% 0.00% Oct-13 Nov-13 Apr-14 Jun-14 Sep-14 Dec-15 Mar-15 Jun-15 Oct-15 Mar-16 May-16 Oct-16 Dec-16 Mar-17 May-17 Jun-17 Oct-17 Opportunity: Perform pill counts

24 Collaboration Strategies to Support Safe & Effective Pain Management Start small Build a team Develop a process Maximize interdisciplinary expertise Expect challenges and adapt

25 Patients On Chronic Opioid Prescriptions % Reduction Overall Homsted F, Magee C, Nesin N. Population health management in a small health system: Impact of controlled substance stewardship in a patient-centered medical home. Am J Health-Syst Pharm. 2017;74:

26 Community Pharmacy Based Intervention 1010 patients, 1062 prescriptions review Addressed only >100 MMEs* daily Study sample (n) = 84 patients *100 MMEs selected in accordance with Maine law

27 Community Pharmacy Based Intervention Informed providers of patients exceeding dose limits Distributed provider and patient education handouts Provided pharmacists patient lists & intervention forms Interventions included recommending tapering for those prescriptions greater than 100MME and not having medical exceptions stated in the law.

28 Community Pharmacist Intervention Taper Results Change in Opioid Prescribing at 6 months Tapering 18% No change 14% Discontinued 11% Tapered < 100 MMEs 57% MMEs Average MMEs Daily Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Nair, S. Evaluating the impact of the new opioid dose limits mandated by the state of Maine on provider specific treatment plans for pain management. ASHP Poster Presentation

29 Conclusion Community pharmacist have an important role to play in safer pain management Evidence-based practices should be used to inform collaboration with prescribers to prevent diversion and promote better pain control Strong pharmacist-prescriber communication channels are key to improving medication safety in pain management

30 1. Assessment Question 1. Which of the following is not an example of how pharmacists and prescribers can collaborate to minimize opioid misuse. A. Develop interdisciplinary teams to review challenging cases B. Create community prescribing and monitoring guidelines C. Establish formal communication process between community pharmacist and prescribers to address prescribing concerns D. Construct a punitive based process for giving providers feedback

31 2. Assessment Question 2. Which of the following is not an effective way for pharmacists to improve communication to ensure safe prescribing practices and address community needs. A. Provide evidence base education to prescribers B. Counsel that state laws are the reason for opioid tapers C. Establish relationships with key prescriber stakeholders and leadership D. Reinforce safe-prescribing messaging in pharmacy

32 3. Assessment Question 3. Which of the follow is not optimal in mitigating diversion and supporting appropriate medication use. A. Reviewing prescription monitoring program data B. Utilization of urine drug screens C. Performing scheduled pill counts D. Requiring patient contracts for chronic opioids

Approved Procedures for Prescribing and Monitoring Controlled Substances in South Carolina

Approved Procedures for Prescribing and Monitoring Controlled Substances in South Carolina Approved Procedures for Prescribing and Monitoring Controlled Substances in South Carolina Robert B. Hanlin, M.D., FAAFP Vice Chair, Medical Staff Affairs Greenville Health System Greenville, SC Disclosures

More information

North Dakota Board of Pharmacy

North Dakota Board of Pharmacy North Dakota Board of Pharmacy Updates on Drug Abuse Trends, the PDMP and Medical Marijuana Mark J. Hardy, Pharm D Executive Director Disclosure Statement I have no conflict of interests to report Objectives

More information

Chronic Disease Management for Pain: It CAN be done in primary care!

Chronic Disease Management for Pain: It CAN be done in primary care! Chronic Disease Management for Pain: It CAN be done in primary care! Sondra Adkinson, PharmD, DAAPM, CPE Thomas B. Gregory, Pharm.D., BCPS, DASPE, CPE Chris Herndon, PharmD, BCPS, CPE Disclosures Adkinson:

More information

Prescription Monitoring Program (PMP)

Prescription Monitoring Program (PMP) 06/15/2018 FACT SHEET Implementation of Enacted Prescribing Limits and Requirements and Relevant Opioid Prescribing Laws and Rules Background: The 2016 law (Chapter 488) makes five major changes to opioid

More information

Monitoring Protocol for Clozapine-induced Myocarditis. Copyright 2017, CAMH

Monitoring Protocol for Clozapine-induced Myocarditis. Copyright 2017, CAMH 1 Monitoring Protocol for Clozapine-induced Myocarditis 1 Agenda Problem Identification / Identification Importance / Importance Baseline Workflow Baseline Workflow Baseline Data Baseline Data Objectives

More information

The Oregon Opioid Initiative. State Pain & Opioid Conference Prescription Drug Monitoring May 2018 Lisa Millet, Public Health Division

The Oregon Opioid Initiative. State Pain & Opioid Conference Prescription Drug Monitoring May 2018 Lisa Millet, Public Health Division The Oregon Opioid Initiative State Pain & Opioid Conference Prescription Drug Monitoring May 2018 Lisa Millet, Public Health Division Disclosure No disclosures 2 Learning Objectives Learner will be able

More information

Opioids in the Management of Chronic Pain: An Overview

Opioids in the Management of Chronic Pain: An Overview Opioids in the Management of Chronic Pain: An Overview Appropriate treatment of chronic pain may include both pharmacologic and non-pharmacologic modalities. The Board realizes that controlled substances,

More information

Nurse Practitioner Practice Guideline Treatment Agreements

Nurse Practitioner Practice Guideline Treatment Agreements Nurse Practitioner Practice Guideline Treatment Agreements In November 2012, the New Classes of Practitioners Regulations (NCPR) under Canada s Controlled Drug and Substances Act (CDSA) came into force,

More information

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Andrew Kolodny, MD Co-Director, Opioid Policy Research Collaborative Heller School for Social Policy and Management Brandeis

More information

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Andrew Kolodny, MD Co-Director, Opioid Policy Research Collaborative Heller School for Social Policy and Management Brandeis

More information

Evaluation of National Academic Detailing Service on Naloxone Kit Prescription Rates in the Veterans Health Administration

Evaluation of National Academic Detailing Service on Naloxone Kit Prescription Rates in the Veterans Health Administration Evaluation of National Academic Detailing Service on Naloxone Kit Prescription Rates in the Veterans Health Administration Melissa LD Christopher, PharmD National Director Academic Detailing Program Office

More information

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Andrew Kolodny, MD Co-Director, Opioid Policy Research Collaborative Heller School for Social Policy and Management Brandeis

More information

Prescription Opioid Overdose in Oregon: A public health perspective

Prescription Opioid Overdose in Oregon: A public health perspective Prescription Opioid Overdose in Oregon: A public health perspective Katrina Hedberg, MD, MPH Health Officer & State Epidemiologist Oregon Public Health Division Oregon Health Authority All-Cause Mortality,

More information

September 22, National Association of Attorneys General 1850 M Street, NW, 12 th Floor Washington, DC Prescription Opioid Epidemic

September 22, National Association of Attorneys General 1850 M Street, NW, 12 th Floor Washington, DC Prescription Opioid Epidemic National Association of Attorneys General 1850 M Street, NW, 12 th Floor Washington, DC 20036 RE: Prescription Opioid Epidemic On behalf of America s Health Insurance Plans (AHIP), thank you for your leadership

More information

4/24/15. New Mexico s Prescription Monitoring Program. Carl Flansbaum, RPh. PMP Director New Mexico Board of Pharmacy. New Mexico and the PMP

4/24/15. New Mexico s Prescription Monitoring Program. Carl Flansbaum, RPh. PMP Director New Mexico Board of Pharmacy. New Mexico and the PMP New Mexico s Carl Flansbaum, RPh. PMP Director New Mexico Board of Pharmacy New Mexico and the PMP In 2012, New Mexico had the 3 nd Highest Overdose Death Rate in Nation.! 492 Deaths or a rate of 23.6

More information

MOA: Practice Managers Program. Presented by: Kimber Debelak, CMC, CMOM, CMIS. May 17, zpain Management. & New Opioid Laws

MOA: Practice Managers Program. Presented by: Kimber Debelak, CMC, CMOM, CMIS. May 17, zpain Management. & New Opioid Laws MOA: Practice Managers Program Presented by: Kimber Debelak, CMC, CMOM, CMIS May 17, 2018 Pain Management & New Opioid Laws Objectives and Educational Statement Objectives To understand the need for new

More information

SUBHEAD GOES HERE. Addressing Tennessee s Opioid Crisis. Natalie A. Tate, PharmD Vice President, Pharmacy

SUBHEAD GOES HERE. Addressing Tennessee s Opioid Crisis. Natalie A. Tate, PharmD Vice President, Pharmacy SUBHEAD GOES HERE Addressing Tennessee s Opioid Crisis Natalie A. Tate, PharmD Vice President, Pharmacy Our opioids story Our approach Our response to neonatal abstinence syndrome Facts and faces of opioid

More information

Managing Opioid Overutilization Challenges

Managing Opioid Overutilization Challenges One Source. Lower Cost. Better Care. Managing Opioid Overutilization Challenges A LOOK AT REDUCING OPIOID OVERUTILIZATION BY 36 PERCENT Copyright 2017 MedImpact Healthcare Systems, Inc. All rights reserved.

More information

Implementation: Public Hearing: Request for Comments (FDA-2017-N-6502)

Implementation: Public Hearing: Request for Comments (FDA-2017-N-6502) March 16, 2018 via online submission: www.regulations.gov The Honorable Scott Gottlieb Commissioner Food and Drug Administration 5630 Fishers Lane, Room 1061 Rockville, MD 20852 Re: Opioid Policy Steering

More information

The Opioid Crisis in Kentucky. Doug Oyler, PharmD Director, Office of Opioid Safety UK HealthCare

The Opioid Crisis in Kentucky. Doug Oyler, PharmD Director, Office of Opioid Safety UK HealthCare The Opioid Crisis in Kentucky Doug Oyler, PharmD Director, Office of Opioid Safety UK HealthCare Discuss the role of opioid prescribing in creating and sustaining the crisis Describe components and initiatives

More information

A Rural Primary Care Clinic s Successful Response to the Opioid Epidemic. Dr. Kurt DeVine Dr. Heather Bell

A Rural Primary Care Clinic s Successful Response to the Opioid Epidemic. Dr. Kurt DeVine Dr. Heather Bell A Rural Primary Care Clinic s Successful Response to the Opioid Epidemic Dr. Kurt DeVine Dr. Heather Bell A Call to Action / 3 A Call to Action The number of emergency room visits attributable to pharmaceuticals

More information

Welcome - we will begin the webinar shortly Please read the participation tips below:

Welcome - we will begin the webinar shortly Please read the participation tips below: Welcome - we will begin the webinar shortly Please read the participation tips below: All guest phones have been muted: Background noises, conversations, white noise etc., can be disruptive to a webinar.

More information

Patient Agreement for the use of Opioid Medications

Patient Agreement for the use of Opioid Medications today s date Patient Name date of birth Patient Agreement for the use of Opioid Medications The purpose of this agreement is to give you information about the medications that may be part of your treatment

More information

Opioid Review and MAT Clinic CDC Guidelines

Opioid Review and MAT Clinic CDC Guidelines 1 Opioid Review and MAT Clinic CDC Guidelines January 10, 2018 Housekeeping Use chat feature to inform everyone who s at your clinic Click chat on Zoom option bar Chat Everyone the names of those who are

More information

Disclosures 6/5/2017. Dr. Franklin has no disclosures Dr. Ngo has no disclosures

Disclosures 6/5/2017. Dr. Franklin has no disclosures Dr. Ngo has no disclosures Tu Ngo, PhD, MPH Julie Franklin, MD, MPH International Conference on Opioids Boston, MA June 11, 2017 1 Disclosures Dr. Franklin has no disclosures Dr. Ngo has no disclosures 2 Objectives Identify areas

More information

Department of Veterans Affairs Network Policy No.: VA Desert Pacific Healthcare Network (VISN 22) Date: September 23, 2014 Long Beach, CA

Department of Veterans Affairs Network Policy No.: VA Desert Pacific Healthcare Network (VISN 22) Date: September 23, 2014 Long Beach, CA Department of Veterans Affairs Network Policy No.: 2014-01 VA Desert Pacific Healthcare Network (VISN 22) Date: September 23, 2014 Long Beach, CA CHRONIC OPIOID USE FOR NON-MALIGNANT PAIN 1. PURPOSE: To

More information

Resources Encouraging Safe Prescription Opioid & Naloxone Dispensing: Results from the RESPOND Study

Resources Encouraging Safe Prescription Opioid & Naloxone Dispensing: Results from the RESPOND Study Resources Encouraging Safe Prescription Opioid & Naloxone Dispensing: Results from the RESPOND Study Nicole O Kane, PharmD, Clinical Director Daniel Hartung, PharmD, MPH, Associate Professor Disclosure

More information

Oregon s PDMP: An epidemiological assist tool

Oregon s PDMP: An epidemiological assist tool Oregon s PDMP: An epidemiological assist tool Todd Beran Center for Prevention and Health Promotion Oregon Health Authority PDMP TTAC Webinar February 13, 2013 1 Acknowledgements Lisa Millet, MSH, Section

More information

New Medicare Part D Prescription Opioid Policies for 2019 Information for Prescribers

New Medicare Part D Prescription Opioid Policies for 2019 Information for Prescribers CENTERS FOR MEDICARE & MEDICAID SERVICES New Medicare Part D Prescription Opioid Policies for 2019 Information for Prescribers Background CMS understands the magnitude of the nation s opioid epidemic and

More information

Section I. Short-acting opioid Prior Authorization Criteria

Section I. Short-acting opioid Prior Authorization Criteria Request for Prior Authorization for Opioid analgesics Website Form www.highmarkhealthoptions.com Submit request via: Fax - 1-855-476-4158 Requests for opioid analgesics may be subject to prior authorization

More information

It Takes A Village to Curb the Prescription Opioid Epidemic: Supply healthcare providers with resources to improve patient safety

It Takes A Village to Curb the Prescription Opioid Epidemic: Supply healthcare providers with resources to improve patient safety Session L6 This presenter has nothing to disclose It Takes A Village to Curb the Prescription Opioid Epidemic: CDC Efforts Jan Losby, PhD Team Lead, Overdose Prevention Health Systems Team Division of

More information

Legal Issues in Opioid Prescribing

Legal Issues in Opioid Prescribing Legal Issues in Opioid Prescribing Joanne L. Martin, J.D. Legal Counsel Mayo Clinic Rochester, Mn 2015 MFMER slide-1 Conflict of Interest I have no relevant financial relationships to disclose I will not

More information

Opioid Overdose Education and Naloxone Distribution

Opioid Overdose Education and Naloxone Distribution Opioid Overdose Education and Naloxone Distribution Emily Stoukides, PharmD PGY-2 Ambulatory Care Pharmacy Resident Nicole Brunet, PharmD, BCPP Clinical Pharmacy Specialist, Mental Health Disclosures Emily

More information

NBPDP Drug Utilization Review Process Update

NBPDP Drug Utilization Review Process Update Bulletin # 802 December 1, 2010 NBPDP Drug Utilization Review Process Update The New Brunswick Prescription Drug Program (NBPDP) employs a Drug Utilization Review (DUR) process which identifies, investigates

More information

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Andrew Kolodny, MD Co-Director, Opioid Policy Research Collaborative Institute for Behavioral Health Schneider Institutes

More information

September 1, The Honorable Tom Price, MD Secretary Department of Health and Human Services 200 Independence Avenue SW Washington, DC 20201

September 1, The Honorable Tom Price, MD Secretary Department of Health and Human Services 200 Independence Avenue SW Washington, DC 20201 September 1, 2017 The Honorable Tom Price, MD Secretary Department of Health and Human Services 200 Independence Avenue SW Washington, DC 20201 Dear Secretary Price: The National Association of County

More information

Addressing the Opioid Epidemic in Tennessee

Addressing the Opioid Epidemic in Tennessee Addressing the Opioid Epidemic in Tennessee A Multidisciplinary Approach Melissa McPheeters, PhD, MPH Director, Informatics and Public Health Analytics 26 108 733 *Source: CDC References Centers for

More information

There are no financial or other pertinent conflicts of interest to disclose. Learning Objectives: Key Questions To Ask 10/4/2014

There are no financial or other pertinent conflicts of interest to disclose. Learning Objectives: Key Questions To Ask 10/4/2014 Maintaining Patient Safety When Chronic Opioid Therapy Is Prescribed P. David Pacheco, Ph.C, PA-C, CAAAPM Pain Medication Management Specialist Southwest Interventional Pain Specialists, PC 4700 Jefferson

More information

WHAT YOU NEED TO KNOW TO ABOUT AB 474

WHAT YOU NEED TO KNOW TO ABOUT AB 474 WHAT YOU NEED TO KNOW TO ABOUT AB 474 PRESENTED BY: NEVADA STATE BOARD OF OSTEOPATHIC MEDICINE 2275 Corporate Circle, Suite 210 Henderson, NV 89074 702-732-2147 Fax 702-732-2079 Web Site: www.bom.nv.gov

More information

Opioid Management of Chronic (Non- Cancer) Pain

Opioid Management of Chronic (Non- Cancer) Pain Optima Health Opioid Management of Chronic (Non- Cancer) Pain Guideline History Original Approve Date 5/08 Review/Revise Dates 11/09, 9/11, 9/13, 09/15, 9/17 Next Review Date 9/19 These Guidelines are

More information

This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved. Re-purposing Anticoagulation Clinics: Expanding Access to Opioid Agonist Therapy in Primary Care Settings Pooja Lagisetty, MD, MSc 1,2, Michele Heisler, MD, MPA 2.3, and Amy Bohnert, PhD, MHS 3,4 1 Robert

More information

VIRGINIA S OPIOID & HEROIN OVERDOSE EPIDEMIC

VIRGINIA S OPIOID & HEROIN OVERDOSE EPIDEMIC 1 VIRGINIA S OPIOID & HEROIN OVERDOSE EPIDEMIC Virginia Association of Counties November 14, 2016 The Honorable William A. Hazel, Jr., M.D. Secretary of Health and Human Resources 1999 - Estimated drug

More information

D. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine

D. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine D. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine Financial Disclosure I have no relevant financial relationships

More information

Innovations in Complex Chronic Pain Care: An Interdisciplinary Model in Primary Care

Innovations in Complex Chronic Pain Care: An Interdisciplinary Model in Primary Care Innovations in Complex Chronic Pain Care: An Interdisciplinary Model in Primary Care Caitlin Garvey, RN, MS, AGNP-bc Christina Tat, PharmD, BCPS, CPE Jenny Tighe, MSPH Erin Watson, PsyD Pain Day September

More information

Oregon Prescription Drug Monitoring Program

Oregon Prescription Drug Monitoring Program Oregon Prescription Drug Monitoring Program 2013 Annual Report to the PDMP Advisory Commission PUBLIC HEALTH DIVISION Prescription Drug Monitoring Program Oregon Prescription Drug Monitoring Program 2013

More information

Taking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain

Taking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain Taking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain Department of Veterans Affairs (VA) and Department of Defense

More information

ANNUAL REPORT

ANNUAL REPORT ANNUAL REPORT - 2015 New Hampshire Prescription Drug Monitoring Program Report for July 1, 2014 June 30, 2015 Published October 2015 Table of Contents Executive Summary... 3-4 NH PDMP Background Information

More information

Data-Driven Multidisciplinary Approaches to Reduce Prescription Drug Abuse in Kentucky

Data-Driven Multidisciplinary Approaches to Reduce Prescription Drug Abuse in Kentucky Data-Driven Multidisciplinary Approaches to Reduce Prescription Drug Abuse in Kentucky http://uknow.uky.edu/content/kentucky-awarded-grant-prescription-drugabuse-prevention-program Data-Driven Multidisciplinary

More information

Oregon Opioid Overdose Prevention Initiative

Oregon Opioid Overdose Prevention Initiative Oregon Opioid Overdose Prevention Initiative Katrina Hedberg, MD, MPH Health Officer & State Epidemiologist Oregon Public Health Division Oregon Association of Hospitals & Health Systems February 2017

More information

CDC Guideline for Prescribing Opioids for Chronic Pain. Centers for Disease Control and Prevention National Center for Injury Prevention and Control

CDC Guideline for Prescribing Opioids for Chronic Pain. Centers for Disease Control and Prevention National Center for Injury Prevention and Control CDC Guideline for Prescribing Opioids for Chronic Pain Centers for Disease Control and Prevention National Center for Injury Prevention and Control THE EPIDEMIC Chronic Pain and Prescription Opioids 11%

More information

Rule Governing the Prescribing of Opioids for Pain

Rule Governing the Prescribing of Opioids for Pain Rule Governing the Prescribing of Opioids for Pain 1.0 Authority This rule is adopted pursuant to Sections 14(e) and 11(e) of Act 75 (2013) and Sections 2(e) and 2a of Act 173 (2016). 2.0 Purpose This

More information

6/6/2017. First Do No Harm SECTION 1 THE OPIOID CRISIS. Implementing an Opioid Stewardship Program in a HealthCare System OBJECTIVES

6/6/2017. First Do No Harm SECTION 1 THE OPIOID CRISIS. Implementing an Opioid Stewardship Program in a HealthCare System OBJECTIVES First Do No Harm Implementing an Opioid Stewardship Program in a HealthCare System Phil Chang, MD Kristy Deep, MD Doug Oyler, PharmD June 12, 2017 OBJECTIVES Explain the role of opioid stewardship as a

More information

Table of Contents Interim Report of the OxyContin Task Force, Newfoundland & Labrador, January 30, 2004

Table of Contents Interim Report of the OxyContin Task Force, Newfoundland & Labrador, January 30, 2004 OXYCONTIN TASK FORCE INTERIM REPORT January 30, 2004 Submitted to Hon. Elizabeth Marshall, Minister of Health & Community Services, Government of Newfoundland and Labrador Table of Contents INTRODUCTION

More information

Texas Vendor Drug Program Specialty Drug List Process. February 2019

Texas Vendor Drug Program Specialty Drug List Process. February 2019 Texas Vendor Drug Program Specialty Drug List Process February 2019 Table of Contents Table of Contents...1 1 About the Specialty Drug List...2 1.1 Information for Pharmacies... 2 1.2 Information for Managed

More information

TITLE AUTHORS. Lucas G. Hill, PharmD The University of Texas at Austin College of Pharmacy

TITLE AUTHORS. Lucas G. Hill, PharmD The University of Texas at Austin College of Pharmacy TITLE Naloxone Counseling for Harm Reduction and Patient Engagement AUTHORS Lucas G. Hill, PharmD The University of Texas at Austin College of Pharmacy Marianne E. Koenig, PharmD UPMC St. Margaret Family

More information

Submitted to the House Energy and Commerce Committee. Federal Efforts to Combat the Opioid Crisis

Submitted to the House Energy and Commerce Committee. Federal Efforts to Combat the Opioid Crisis STATEMENT FOR THE RECORD Submitted to the House Energy and Commerce Committee Federal Efforts to Combat the Opioid Crisis October 25, 2017 America s Health Insurance Plans 601 Pennsylvania Avenue, NW Suite

More information

Behavioral Health in PACE: Substance Abuse

Behavioral Health in PACE: Substance Abuse Behavioral Health in PACE: Substance Abuse NPA s Quality Symposium 2017 June 9th, 2017 Bharati Srivastava MD MBA FACP AGSF Mercy LIFE Sharon Hill Mercy LIFE Southeastern PA Trinity Health Inc. Objectives

More information

Pharmacist s Role In Pain Management. Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017

Pharmacist s Role In Pain Management. Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017 Pharmacist s Role In Pain Management Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017 1 Presentation Objectives Briefly discuss Geisinger Health System and the use of Pain Management Pharmacists

More information

Pain Management and Safe use of opioids in hospitals. Kyoung-Sil Kang, PharmD, BCPS Scott Tam, PharmD Lauve Casimir, RN, MSN

Pain Management and Safe use of opioids in hospitals. Kyoung-Sil Kang, PharmD, BCPS Scott Tam, PharmD Lauve Casimir, RN, MSN Pain Management and Safe use of opioids in hospitals Kyoung-Sil Kang, PharmD, BCPS Scott Tam, PharmD Lauve Casimir, RN, MSN Bronx Care Health System Bronx Lebanon Hospital Concourse/ Fulton division, Nursing

More information

Central Oregon Pain Standards Task Force

Central Oregon Pain Standards Task Force Central Oregon Pain Standards Task Force For 2018 Oregon Pain + Addiction Treatment Conference KIM SWANSON, PH.D. CHAIR PAIN STANDARDS TASK FORCE Disclosures Kim Swanson, Ph.D. is a full time salaried

More information

Best Practices for Prescribing Controlled Substances

Best Practices for Prescribing Controlled Substances Best Practices for Prescribing Controlled Substances Dr. Merrill Norton Pharm.D., D.Ph, ICCDP-D Clinical Associate Professor University of Georgia College of Pharmacy mernort@uga.edu Georgia Composite

More information

Ontario s Narcotics Strategy

Ontario s Narcotics Strategy Ontario s Narcotics Strategy Ontario Public Drug Programs Ministry of Health and Long-Term Care January 31, 2012 Ontario Harm Reduction Distribution Program Conference 2012 1 Background The Need for Action

More information

HEALTH INFORMATION TECHNOLOGY: A POWERFUL TOOL IN ATTACKING THE OPIOID CRISIS PAUL L. UHRIG CHIEF ADMINISTRATIVE, LEGAL & PRIVACY OFFICER

HEALTH INFORMATION TECHNOLOGY: A POWERFUL TOOL IN ATTACKING THE OPIOID CRISIS PAUL L. UHRIG CHIEF ADMINISTRATIVE, LEGAL & PRIVACY OFFICER HEALTH INFORMATION TECHNOLOGY: A POWERFUL TOOL IN ATTACKING THE OPIOID CRISIS PAUL L. UHRIG CHIEF ADMINISTRATIVE, LEGAL & PRIVACY OFFICER Copyright 2018 2017 by by Surescripts, LLC. All All rights reserved.

More information

Safe Medication Practices

Safe Medication Practices Safe medication practices for life. Slide 1 Safe Medication Practices Facilitator Talking Points Welcome to today s program, Generation Rx: Safe Medication Practices for Life. You may be asking yourself,

More information

Prescribing Opioids in the Opioid Epidemic. Scott Woffinden, PA-C Jason Chapman, JD

Prescribing Opioids in the Opioid Epidemic. Scott Woffinden, PA-C Jason Chapman, JD Prescribing Opioids in the Opioid Epidemic Scott Woffinden, PA-C Jason Chapman, JD What's the Problem? http://www.zdoggmd.com/blank-script-taylor-swift-parody/ What's the Problem? CDC 115 Americans die

More information

Implementing Pain and Opioid Management Guidelines in Primary Care Practice

Implementing Pain and Opioid Management Guidelines in Primary Care Practice Implementing Pain and Opioid Management Guidelines in Primary Care Practice Objectives 1. What is the issue? 2. Why use a dedicated dissemination & implementation process? a. Historical perspective Cooperative

More information

House of Pain? A Standardized Approach to Chronic Pain In the Patient-Centered Medical Home. MAJ Meghan Raleigh, MD 17 MAR 2014

House of Pain? A Standardized Approach to Chronic Pain In the Patient-Centered Medical Home. MAJ Meghan Raleigh, MD 17 MAR 2014 House of Pain? A Standardized Approach to Chronic Pain In the Patient-Centered Medical Home MAJ Meghan Raleigh, MD 17 MAR 2014 Make this house your own! Objectives Review key components in PCMH Identify

More information

Reducing Opioid Over- Prescribing in a Large Integrated Health Care System

Reducing Opioid Over- Prescribing in a Large Integrated Health Care System Session L6 This presenter has nothing to disclose It Takes a Village to Curb the Prescription Opioid Epidemic: Reducing Opioid Over- Prescribing in a Large Integrated Health Care System Joel D. Hyatt,

More information

Medicare Part D Prescription Opioid Policies for 2019 Information for Pharmacists

Medicare Part D Prescription Opioid Policies for 2019 Information for Pharmacists CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Part D Prescription Opioid Policies for 2019 Information for Pharmacists Background Opioid medications are effective at treating certain types of pain,

More information

Drug Diversion Recognition and Prevention in a Hospital Setting. Natalie Tuttle PharmD, BCPS, DPLA University of Toledo Medical Center

Drug Diversion Recognition and Prevention in a Hospital Setting. Natalie Tuttle PharmD, BCPS, DPLA University of Toledo Medical Center Drug Diversion Recognition and Prevention in a Hospital Setting Natalie Tuttle PharmD, BCPS, DPLA University of Toledo Medical Center 1 Disclosure I have no actual or potential conflict of interest in

More information

PDMP Tools to Identify Red Flag Situations

PDMP Tools to Identify Red Flag Situations PDMP Tools to Identify Red Flag Situations Prescription Drug Monitoring Programs CBI Baltimore, MD February 7, 2017 Grant Carrow, Ph.D. Project Consultant The Heller School for Social Policy and Management

More information

Opiate Use Disorder and Opiate Overdose

Opiate Use Disorder and Opiate Overdose Opiate Use Disorder and Opiate Overdose Irene Ortiz, MD Medical Director Molina Healthcare of New Mexico and South Carolina Clinical Professor University of New Mexico School of Medicine Objectives DSM-5

More information

U.S. Counties Vulnerability to Rapid Dissemination of HIV/HCV Infections Among People Who Inject Drugs

U.S. Counties Vulnerability to Rapid Dissemination of HIV/HCV Infections Among People Who Inject Drugs U.S. Counties Vulnerability to Rapid Dissemination of HIV/HCV Infections Among People Who Inject Drugs Michelle Van Handel, MPH Health Scientist National Center for HIV/AIDS, Viral Hepatitis, STDs and

More information

ScO.S. Academic Detailing for Safer Prescribing

ScO.S. Academic Detailing for Safer Prescribing ScO.S. Academic Detailing for Safer Prescribing Sarah Ball, PharmD Research Assistant Professor MUSC College of Medicine September 6, 2017 Megan Pruitt, PharmD SCORxE Clinical Pharmacy Consultant MUSC

More information

Outline. Decreasing total opioid prescriptions Decreasing benzodiazepine and opioid co-prescription. Increasing community awareness of opioid risks

Outline. Decreasing total opioid prescriptions Decreasing benzodiazepine and opioid co-prescription. Increasing community awareness of opioid risks RxSafe Marin overview Outline Safe Prescribing Guidelines Decreasing total opioid prescriptions Decreasing benzodiazepine and opioid co-prescription Increasing community awareness of opioid risks Increasing

More information

Legal Considerations for. Immunizations

Legal Considerations for. Immunizations Legal Considerations for Pharamcists Providing Immunizations Gary G. Cacciatore, Pharm.D., J.D. Vice President of Regulatory Affairs and Associate Chief Regulatory Counsel Cardinal Health, Inc. 1 1 Outline

More information

California. Prescribing and Dispensing Profile. Research current through November 2015.

California. Prescribing and Dispensing Profile. Research current through November 2015. Prescribing and Dispensing Profile California Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points

More information

Opioid Overdose in Oregon Report to the Legislature

Opioid Overdose in Oregon Report to the Legislature SEPTEMBER 2018 Opioid Overdose in Oregon Report to the Legislature This report summarizes the burden of opioid overdose among Oregonians as required by ORS 432.141. It describes Oregon s progress in reducing

More information

Overview of ASHP Opioid Efforts

Overview of ASHP Opioid Efforts Overview of ASHP Opioid Efforts Deborah A Pasko, Pharm.D, MHA Director, Medication Safety & Quality Nicholas Gentile Director, State Grassroots Advocacy and Political Action Presenter My educational background

More information

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction

Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Responding to the Prescription Opioid and Heroin Crisis: An Epidemic of Addiction Andrew Kolodny, M.D.. Executive Director, Physicians for Responsible Opioid Prescribing Senior Scientist, Heller School

More information

Vermont. Prescribing and Dispensing Profile. Research current through November 2015.

Vermont. Prescribing and Dispensing Profile. Research current through November 2015. Prescribing and Dispensing Profile Vermont Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points of

More information

EMERGENCY DEPARTMENT MODEL PRACTICES DEALING WITH THE PRESCRIPTION OPIOID EPIDEMIC

EMERGENCY DEPARTMENT MODEL PRACTICES DEALING WITH THE PRESCRIPTION OPIOID EPIDEMIC EMERGENCY DEPARTMENT MODEL PRACTICES DEALING WITH THE PRESCRIPTION OPIOID EPIDEMIC RAMI R KHOURY, MD, FACEP ASSISTANT MEDICAL DIRECTOR EMERGENCY CARE ALLEGIANCE HEALTH ADVERTISING AT ITS BEST! OVERDOSE

More information

Arkansas Prescription Monitoring Program

Arkansas Prescription Monitoring Program Arkansas Prescription Monitoring Program FY 2017 Second Quarter Report October December 2016 Arkansas Prescription Monitoring Program Quarterly Report October December, Fiscal year 2017 Act 304 of 2011

More information

Tri-County Opioid Safety Coalition Data Brief December 2017 Clackamas, Multnomah, and Washington Counties

Tri-County Opioid Safety Coalition Data Brief December 2017 Clackamas, Multnomah, and Washington Counties Medicaid-Funded Alternative Treatment for Back Pain in the Tri-County Region Key Findings The percentage of members with a back pain diagnosis who received an alternative treatment increased from 29% in

More information

Rhode Island. Prescribing and Dispensing Profile. Research current through November 2015.

Rhode Island. Prescribing and Dispensing Profile. Research current through November 2015. Prescribing and Dispensing Profile Rhode Island Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points

More information

Navigating Pain Management during the Opioid Epidemic: Focus Group Findings

Navigating Pain Management during the Opioid Epidemic: Focus Group Findings Navigating Pain Management during the Opioid Epidemic: Focus Group Findings David Cameron Oregon Health & Science University Department of Family Medicine, Portland, OR Funding received from AHRQ (5R18HS024227-02)

More information

The Dark Art. Of Supervising & Managing Controlled Substances

The Dark Art. Of Supervising & Managing Controlled Substances The Dark Art Of Supervising & Managing Controlled Substances David A. Frenz, M.D. Vice President & Executive Medical Director North Memorial Health Care Robbinsdale, Minn. 27 October 2016 www.doctorfrenz.com

More information

TREATING OPIOID ADDICTION IN HOMELESS POPULATIONS

TREATING OPIOID ADDICTION IN HOMELESS POPULATIONS TREATING OPIOID ADDICTION IN HOMELESS POPULATIONS Challenges and Opportunities Providing Medication Assisted Treatment (Buprenorphine) August 18, 2016 SPEAKERS TODAY Nilesh Kalyanaraman, MD, Chief Health

More information

Clinical Policy: Opioid Analgesics Reference Number: CP.PMN.97 Effective Date: Last Review Date: 02.19

Clinical Policy: Opioid Analgesics Reference Number: CP.PMN.97 Effective Date: Last Review Date: 02.19 Clinical Policy: Reference Number: CP.PMN.97 Effective Date: 02.11 Last Review Date: 02.19 Line of Business: Medicaid Revision Log See Important Reminder at the end of this policy for important regulatory

More information

The Wisconsin Prescription Drug Monitoring Program. WI PDMP Timeline. PDMP Overview. What is a PDMP? PDMPs Across the Nation. Wisconsin.

The Wisconsin Prescription Drug Monitoring Program. WI PDMP Timeline. PDMP Overview. What is a PDMP? PDMPs Across the Nation. Wisconsin. The Wisconsin Prescription Drug Monitoring Program Wisconsin Nurses Association Jail Health Care Conference May 21, 2018 WI PDMP Timeline PDMP Overview January 2013 WI PDMP operational April 2017 WI epdmp

More information

Oklahoma. Prescribing and Dispensing Profile. Research current through November 2015.

Oklahoma. Prescribing and Dispensing Profile. Research current through November 2015. Prescribing and Dispensing Profile Oklahoma Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points

More information

Arkansas Prescription Monitoring Program

Arkansas Prescription Monitoring Program Arkansas Prescription Monitoring Program ONE YEAR UPDATE Scott Pace, Pharm.D., Esq. Special Thanks Thanks to Denise Robertson at the Arkansas Department of Health for supplying the PMP data for this presentation

More information

US H.R.6 of the 115 th Congress of the United States Session

US H.R.6 of the 115 th Congress of the United States Session US H.R.6 of the 115 th Congress of the United States 2017-2018 Session This Act may be cited as the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities

More information

About Your Pain Management

About Your Pain Management UW MEDICINE PATIENT EDUCATION About Your Pain Management Answers to common questions This handout outlines the goals of pain management treatment. It also reviews the guidelines that you are expected to

More information

Association of State and Territorial Health Officials (ASTHO)

Association of State and Territorial Health Officials (ASTHO) Association of State and Territorial Health Officials (ASTHO) Strategy Session on Prescription Drug Misuse and Abuse Prepared by: August 13-14, 2013 Table of Contents Introduction... 1 Setting Future Direction

More information

Virginia. Prescribing and Dispensing Profile. Research current through November 2015.

Virginia. Prescribing and Dispensing Profile. Research current through November 2015. Prescribing and Dispensing Profile Virginia Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points

More information

Preparing for Electronic Prescribing of Controlled Substances (EPCS) in New York

Preparing for Electronic Prescribing of Controlled Substances (EPCS) in New York Preparing for Electronic Prescribing of Controlled Substances (EPCS) in New York Ken Whittemore, Jr. R.Ph., MBA Senior VP, Professional & Regulatory Affairs Copyright Copyright 2015 by 2015 Surescripts,

More information

IMPLEMENTATION OF A SHARED MEDICAL APPOINTMENT FOR OPIOID OVERDOSE EDUCATION AND NALOXONE KIT TRAINING FOR VETERANS Kristin A. Tallman, Pharm.

IMPLEMENTATION OF A SHARED MEDICAL APPOINTMENT FOR OPIOID OVERDOSE EDUCATION AND NALOXONE KIT TRAINING FOR VETERANS Kristin A. Tallman, Pharm. IMPLEMENTATION OF A SHARED MEDICAL APPOINTMENT FOR OPIOID OVERDOSE EDUCATION AND NALOXONE KIT TRAINING FOR VETERANS Kristin A. Tallman, Pharm.D, BCPS Clinical Pharmacy Specialist Providence Medical Group

More information

Ahsan U. Rashid, M.D., F.A.C.P.

Ahsan U. Rashid, M.D., F.A.C.P. Ahsan U. Rashid, M.D., F.A.C.P. OPIOID MAINTENANCE AND CONSENT Instructions: Review this document before signing. This document will help both the patient and caregivers in establishing a medical program

More information