CAPT Webinar February 16, 2016 Collaborating with Prescription Drug Monitoring Programs Opportunities and Challenges State Presenters Neal Traven & Jennifer Sabel, Epidemiologists, Washington Jessica Hawkins, Senior Director of Prevention, Oklahoma Ralph Orr, PDMP Director, Virginia
Facilitator Sarah Ivan Project Associate SAMHSA s CAPT 2
Technical Information This webinar is being recorded and archived, and will be available to all webinar participants. Please contact the webinar facilitator if you have any concerns or questions. This training was developed under the Substance Abuse and Mental Health Services Administration s Center for the Application of Prevention Technologies task order. Reference #HHSS283201200024I/HHSS28342002T. For training use only. 3
Learning Objectives Describe approaches Grantees are using to integrate Prescription Drug Monitoring Program (PDMP) data into their efforts to prevent the nonmedical use of prescription drugs (NMUPD) Identify challenges to collaborating with PDMPs and using PDMP data to support prevention efforts Describe best practices for collaborating with PDMPs, as identified by prevention practitioners 4
State Presenters Neal Traven Epidemiologist Washington Jennifer Sabel Epidemiologist Washington Jessica Hawkins Senior Director of Prevention Oklahoma Ralph Orr PDMP Director Virginia 5
Discussion Facilitators Thomas Clark CAPT Associate Institute for Behavioral Health Brandeis University Meelee Kim CAPT Associate Institute for Behavioral Health Brandeis University Sandeep Kasat Associate Director of Epidemiology SAMHSA s CAPT Victoria LeGarde Epidemiology T/TA Specialist SAMHSA s CAPT 6
PDMP Webinar Series Part 1. An Introduction to PDMPs Completed January 10 Part 2: Using PDMPs Across SAMHSA s Strategic Prevention Framework Completed January 26 Part 3: Collaborating with Prescription Drug Monitoring Programs: Opportunities and Challenges Webinar recordings and transcripts are available on CAPT Connect, in the SPF Rx and PDO portal: https://captconnect.edc.org 7
Using PDMP Data Across SAMHSA s Strategic Prevention Framework Step 1: Assessment Step 2: Capacity Building Step 3: Planning Step 4: Implementation Identify and/or refine prescription drug priorities and populations at increased risk for non-medical use of prescription drugs Raise awareness of NMUPD at the state or community levels; encourage collaboration across agencies; generate reports and data summaries to educate stakeholders about how PDMPs function and their role in prevention Identify factors that place individuals at increased or decreased risk for NMUPD Support the development and implementation of strategies to reduce NMUPD Step 5: Evaluation Measure the effectiveness of prevention interventions using PDMP-tracked outcomes 8
Example of PDMP Data Use Across the SPF Assessment State XYZ collects PDMP data on doctor shopping rates Evaluation Capacity Shares PDMP data to engage prescribers in prevention efforts Implementation Planning 9 Identifies doctor shopping as a risk factor influencing rising opioid misuse rates
Example of PDMP Data Use Across the SPF Assessment Evaluation Capacity Selects desired outcomes Implementation Planning Implements education programs for pharmacists and prescribers 10 State XYZ prioritizes doctor shopping as a risk factor
Example of PDMP Data Use Across the SPF Assessment Re-collects PDMP data to determine current problems and behaviors Evaluation Capacity Using PDMP data, state XYZ finds that rates of doctor shopping decline after intervention Implementation Planning 11
Common Challenges to Using PDMP Data: Examples Assessment Implementation PDMP functionality may limit data use Capacity Implementation Potential partners, such as prescribers, may be unwilling to work with patients who have been identified as drug-misusing 12
Best Practices for Using PDMP Data: Examples Capacity Evaluation Engage partners who understand PDMPs to help you negotiate relationships and assess the utility of the data for local planning Capacity Implementation Educate prescribers on utilizing PDMPs appropriately 13
PDMP Collaborations in Action Examples from the Field Opioid Use and Misuse 14
Washington Invited county health departments to join an advisory workgroup with prescription monitoring program staff Currently developing county data profiles on controlled substance prescriptions (including age and gender patterns, most commonly prescribed drugs, and geographic locations of high-risk prescribing) Up next: Adding prescription monitoring program to a public data portal 15
Washington Anticipate that county health departments will use county data profiles to: o Inform strategic planning for prevention and treatment programs o Educate community members about the rates of controlled substances prescribed o Encourage collaboration with local prescribers and dispensers 16
Oxycodone by County, 2014 Recipients per 1,000 Residents 83 98 74 82 60 73 33 58 San Juan 65 70 Whatcom Skagit 83 Okanogan 58 Ferry 58 Pend Oreille 61 Clallam Jefferson Grays Harbor 92 98 78 91 Mason 79 Kitsap 82 76 Thurston Island 93 Snohomish 92 King 73 Pierce Chelan 76 Kittitas 66 Douglas 76 66 Grant 60 Lincoln Adams 42 61 Stevens 49 Spokane 35 Whitman 74 Pacific 86 Wahkiakum Lewis Cowlitz 97 94 Skamania 71 Yakima 74 77 Benton Franklin Garfield 71 48 Columbia 38 47 54 Asotin Walla Walla Clark 77 33 Klickitat Statewide Rate = 75 17
Challenges & Best Practices 18
Questions for Washington 19
Virginia Maps Charts Policy Impact Education Other www.dhp.virginia.gov 20
Virginia www.dhp.virginia.gov 21
Virginia www.dhp.virginia.gov 22
Percent opioid naive patients Morphine milligram equivalents Virginia Virginia: Opioid Naive Patients and Mean Daily LA/ER Opioid Dose, 2010-2015 45% 40% 35% 30% 25% 20% 15% 10% 5% 140 130 120 110 100 90 80 70 0% 60 2010 2011 2012 2013 2014 2015 Data Source: Brandeis University-PBSS VA PMP 10/16 % receiving LA/ER that were opioid naïve mean daily dose for LA/ER Rx www.dhp.virginia.gov 23
Challenges and Best Practices 24
Questions for Virginia 25
Oklahoma Convened a prescription drug monitoring (PMP) advisory committee which includes representation across state agencies Utilized PMP data, along with other data, to identify and prioritize sub-recipient communities for the SPF Rx and PDO grants 26
Oklahoma PMP data is being used to: o Develop county-level heat maps to identify geographic areas where multiple provider episodes are occurring (then provide targeted interventions in these areas) o Identify provider practices that may be contributing to prescription misuse (then provide practice facilitation to health care providers) o Identify individual patients at risk to provide interventions 27
Oklahoma Heat Map Example 28
Questions for Oklahoma 29
Next Steps for Prevention Practitioners Opioid Use and Misuse 30
Based on today s discussion, what is one step you might take to make better use of PDMP data to support your prevention efforts? 31
A Look Back: PDMP Webinar Series An Introduction to PDMPs (completed January 10) Defined PDMPs Discussed strengths and limitations of PDMP data Shared PDMP resources 32
A Look Back: PDMP Webinar Series (cont.) Using PDMPs Across SAMHSA s SPF (completed January 25) Reviewed steps to take prior to using PDMP data Shared examples of opportunities for using PDMP data across the SPF 33
Discussion and Poll After participating in this webinar series, where would you rate your level of readiness to use PDMP data to inform your prevention planning? 34
Final Thoughts and Questions? 35
Evaluation Please take the time to complete a brief feedback form: https://www.surveymonkey.com/r/feedback- CAPT-1692 Thank you for sharing your thoughts! 36