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Oregon’s PDMP 101
Lisa Millet, MSH, Section ManagerInjury and Violence Prevention SectionCenter for Prevention and Health PromotionOregon Health AuthorityCoos Bay, Oregon PDO SummitOctober 27, 2016
1
Presentation Objectives
• Explain the purpose and goals of Oregon’s PDMP
• Identify how PDMPs can improve patient safety and health outcomes
• Resources
2
Why have a PDMP?
• Prescribers responsible for safety lack information they need
• An opioid prescription is dispensed to 1 in 4 Oregonians each year – a lot of opioids
• Overdose epidemic
• Patient safety concerns, drug efficacy questions
• Dependency and addiction concerns
• Over prescribing and co-prescribing concerns
3
Who has access to the PDMP?
• Licensed healthcare providers, pharmacists and their delegates authorized by the OHA
• PDMP staff administer the program
• Vendor personnel maintain the system
4
PDMP system accounts by discipline, Oregon: September 2011 to December 2015, n=12,142
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OD, 10PA, 755
RPh, 2,463
ND, 199
MD, 3,900DO, 513
DDS/DMD, 794
NP/CNS-PP, 1,365
Delegate, 2,143
Number and percentage of Oregon-licensed controlled substance (CS) prescribers with PDMP accounts by discipline, September 2011 through December 2015
Discipline
Prescribed at
least one
CS (Schedule II–
IV) in 2014
Prescribers
with system
accounts
Percentage of CS
prescribers with
PDMP accounts
NP/CNS-
PP
2,072 1,365 66%
DDS/DM
D
2,461 794 32%
DO 791 513 65%
MD 8,889 3,900 44%
ND 393 199 51%
PA 1,224 755 62%
OD 69 10 15%
TOTAL 15,881 7,536 48% 6
Percentage of Oregon-licensed controlled substance prescribers with PDMP accounts by most frequent prescribing cohort: Oregon, 2013–2015
Prescribing cohort 2013 2014 2015
2,000 most frequent
prescribers
66% 74% 80%
4,000 most frequent
prescribers
58% 66% 72%
All Oregon-licensed prescribers 37% 42% 48%
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Percentage of controlled substance prescriptions written by prescribing cohort: Oregon, 2015
8
59% of prescriptions were written
by 2,000 prescribers
19% of prescriptions were written by a second
cohort of 2,000 …
22% of prescriptions were written
by the remaining 42,279* …
72% of top 4,000 prescribers registered – top two cohorts79% of top 2,000 prescribers registered – top cohort
PDMP registration and resources
• Go to: www.orpdmp.com/health-care-provider/
• Read directions and FAQs please
• Create an electronic request
• Download and complete an enrollment form and send it and a photocopy of drivers license to PDMP
• Training videos available on the website
• Advisory Commission reports available on the website
• PDMP system metrics available on the website
10
PDMP collects data from all retail pharmacies dispensing to Oregonian
Patient information• First and last names, middle initial • Date of birth • Sex• Address • Drug code number • Date drug was prescribed • Date drug was dispensed • Quantity of drug dispensed
Pharmacy and practitioner information• Dispensing pharmacy • Prescriber
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Who is most at risk?
• Patients on doses >100 mg MEDD
• Patients on doses >40 mg Methadone
• Patients who are coprescribed benzos and opioids
• Patients on opioids >90 days
• Patients who have a history of mental illness
• Have a history of substance misuse are at highest risk for overdosing
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Sources: Policy Impact: Prescription Painkiller Overdoses: http://www.cdc.gov/homeandrecreationalsafety/rxbrief/ andIVPP unpublished data
Potential PDMP Enhancements
• Mandated enrollment to support integration of PDMP data into patient HER
17
Resources
PDMP website: http://www.orpdmp.com/
OHA website: www.healthoregon.org/opioidsReducing Opioid Overdose & Misuse
• State prevention plan• Data visualization, queriable, downloadable• Prescribing guidelines• Treatment directory• Pain management resources• Naloxone rescue protocols and training
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Lisa Millet, MSH, Section ManagerInjury and Violence Prevention Program
Center for Prevention and Health PromotionPublic Health Division
Oregon Health Authority
www.healthoregon.org/opioids
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www.orpdmp.com