maine’s prescription monitoring program maine benzodiazepine study group conference 2007 update...
Post on 22-Dec-2015
217 views
TRANSCRIPT
Maine’s Prescription Monitoring Program
Maine Benzodiazepine Study Group Conference
2007 UPDATE
Daniel J. Eccher, MPHProject Coordinator
Outline for Presentation
Program overview Aggregate PMP data PMP data on benzodiazepines How health care providers can use patient-
specific PMP data Time for questions at the end?
PMP Description
Data collection since July 1, 2004 Data submission from over 300 pharmacies
(100%) dispensing controlled substances in Maine (including out-of-state mail order and Internet pharmacies, and the VA-Togus Med. Cnt.)
Schedules II-IV Data stored in centralized, relational
database
OSA’s Goals for PMP
Improve patient care by giving health care providers comprehensive information
Curb prescription drug misuse Get those who are addicted into appropriate
treatment
OSA’s Goals for PMP
Help stop prescription drug overdoses Educate the public on the dangers of
prescription drug abuse Ensure that those who do need prescription
medications still receive them
PMP Database Description
Patient identifiers: Name, DOB, Address(es) Prescriber identifiers: DEA number (from which
we derive name) Drug identifiers: NDC Code, Name, dosage,
days supply Pharmacy identifiers: Pharmacy DEA number,
pharmacy address Possible to derive other info (e.g. patient
county)
Drug Type Proportions (State of Maine, PMP Data, SFY07)
Drug Type as Percent of State Total: 2,106,901
Others1%
Stimulants10%
Tranquilizers35%
Narcotics54%
Drug Types Per Age Group(State of Maine: PMP Data, SFY07)
21,402
69,593
142,296
213,463
368,883
323,979
114,188
24,409 23,495 22,509 28,234
7,721 10,598 23,907
70,750
127,036
246,997 250,027
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
Age: 0 - 18 Age: 19 - 25 Age: 26 - 35 Age: 36 - 45 Age: 46 - 60 Age: 61 & Up
AGE GROUP
PR
ES
CR
IPT
ION
CO
UN
T
Narcotics Stimulants Tranquilizers
Maine’s PMP “Top 10” List(SFY 2007)
DRUG COUNT RX % OF TOTAL
HYDROCODONE/ACETAMINOPHEN 448,430 20.73
LORAZEPAM 173,228 8.01
CLONAZEPAM 149,815 6.92
ALPRAZOLAM 136,729 6.32
OXYCODONE HCL 127,541 5.89
OXYCODONE/ACETAMINOPHEN 124,483 5.75
PROPOXYPHENE-N/ACETAMINOP 100,546 4.65
AMBIEN 73,966 3.42
DIAZEPAM 73,945 3.42
CONCERTA 63,411 2.93
TOTAL (for “Top 10”) 1,472,094 68.04
Prescriptions per Person by County (Maine PMP Data, SFY07)
1.40
1.79
1.63
1.67
1.591.70
1.56
1.81
1.60
1.40
1.56
1.621.51
1.54 1.701.83
State Average:State Average:1.60 Scripts/Person
Benzodiazepines
PMP Data
Benzodiazepines (PMP SFY 2006)Drug Name Rx Count % Total Benzos
Alprazolam 132,612 24.09%
Chlordiazepoxide HCl 4,198 0.76%
Clonazepam 139,009 25.25%
Clorazepate Dipotassium 4,428 0.80%
Diazepam 70,855 12.87%
Diazepam (Anticonvulsant) 608 0.11%
Estazolam 383 0.07%
Flurazepam HCl 1,663 0.30%
Lorazepam 162,999 29.61%
Midazolam HCl 52 0.01%
Oxazepam 6,197 1.13%
Quazepam 39 0.01%
Temazepam 22,649 4.11%
Triazolam 4,882 0.89%
Total Benzo's 550,574 100%
Benzodiazepines (PMP SFY 2006)
39
52
383
608
1663
4198
4428
4882
6197
22649
70855
132612
139009
162999
0 20000 40000 60000 80000 100000 120000 140000 160000 180000
Quazepam
Midazolam HCl
Estazolam
Diazepam (Anticonvulsant)
Flurazepam HCl
Chlordiazepoxide HCl
Clorazepate Dipotassium
Triazolam
Oxazepam
Temazepam
Diazepam
Alprazolam
Clonazepam
Lorazepam
Rx Count
Benzodiazepines - Percent of Total (PMP SFY 2006)
Alprazolam24.09%
Chlordiazepoxide HCl0.76%
Clonazepam25.25%
Clorazepate Dipotassium0.80%
Diazepam12.87%Diazepam (Anticonvulsant)
0.11%
Estazolam0.07%
Flurazepam HCl0.30%
Lorazepam29.61%
Oxazepam1.13%
Temazepam4.11%
Triazolam0.89%
Quazepam0.01%
Midazolam HCl0.01%
Benzodiazepines (PMP SFY 2007)Drug Name Rx Count % Total Benzos
Alprazolam 136193 23.76%
Chlordiazepoxide HCl 4026 0.70%
Clonazepam 148082 25.84%
Clorazepate Dipotassium 4047 0.71%
Diazepam 73085 12.75%
Diazepam (Anticonvulsant) 787 0.14%
Estazolam 353 0.06%
Flurazepam HCl 1541 0.27%
Lorazepam 171290 29.89%
Midazolam HCl 49 0.01%
Oxazepam 6089 1.06%
Quazepam 14 0.00%
Temazepam 22895 3.99%
Triazolam 4675 0.82%
Total Benzo's 573126 100.00%
Benzodiazepines (PMP SFY 2007)
14
49
353
787
1541
4026
4047
4675
6089
22895
73085
136193
148082
171290
0 20000 40000 60000 80000 100000 120000 140000 160000 180000
Quazepam
Midazolam HCl
Estazolam
Diazepam (Anticonvulsant)
Flurazepam HCl
Chlordiazepoxide HCl
Clorazepate Dipotassium
Triazolam
Oxazepam
Temazepam
Diazepam
Alprazolam
Clonazepam
Lorazepam
Rx Count
Benzodiazepines - Percent of Total (PMP SFY 2007)
Alprazolam, 23.76%
Chlordiazepoxide HCl, 0.70%
Clonazepam, 25.84%
Clorazepate Dipotassium, 0.71%Diazepam, 12.75%
Diazepam (Anticonvulsant), 0.14%
Estazolam, 0.06%
Flurazepam HCl, 0.27%
Lorazepam, 29.89%
Oxazepam, 1.06%
Quazepam, 0.00%
Temazepam, 3.99%
Triazolam, 0.82%
Midazolam HCl, 0.01%
Trend in Counts of Top 4 Benzos(SFY’s 2005 – 2007)
70,855
145960
128403
69288
129586
162,999
132,612 139,009
171290
148082
73085
136193
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
Diazepam Alprazolam Clonazepam Lorazepam
DRUG
CO
UN
T
SFY 05 SFY 06 SFY 07
Please analyze our data …
and then, publish the results.
Patient-specific PMP Data
Using PMP data in the healthcare setting
Patient History Reports
“Unsolicited” reports (automatically sent to prescribers)– Quarterly Patient Threshold Reports– Monthly Buprenorphine/Narcotics Reports (new)– Quarterly APAP Threshold Reports (in devlpmt.)
“Solicited” reports – registration for anyone with a DEA number, including pharmacists; data available online, through secure portal
Registraton as a “Requestor”
Go to: http://www.maine.gov/pmp Follow the “GHS Web Site” link. Scroll to the bottom and click the “Sign Up”
button in the “New Users” section. Fill in the required information on the
sequential forms. (Select “Requestor” in the User Type section; last step: entering DEA #.)
Wait for confirmation by fax. (The approval process takes about two business days.)
Prescription Data Portal
Patient History Report
Registration as Requestors
Free service Easy to use Immediate access to reports “Sub-accounts” allowed under prescriber
accounts Of 6200+ eligible prescribers, only 1557
registered (about 25%)
OSA’s Focus: Treatment
Addiction = disease (non-judgemental approach)
Helping people find treatment Office of Substance Abuse - questions about
PMP or how to find treatment options for a patient
OSA’s Treatment Resources
OSA’s Web Site: http://www.maine.gov/dhhs/osa
Treatment Directory: “Find Help” link Information and Resource Center:
Plethora of substance abuse literatureTreatment teamTreatment Data System
For more information about PMP, …
… log on to our web site:
http://www.maine.gov/dhhs/osa/data/pmp
Or contact me:
Phone: (207) 287-3363
Email: [email protected]
Any questions now?