184968 Illegal use of prescription drugs prior to the implementation of a population based pharmacy network

Sunday, October 26, 2008

Kayla Collins, MSc, PhD (c) , Newfoundland and Labrador Centre for Health Information, Research and Evaluation Department, St. John's, NF, Canada
Don MacDonald, MSc, PhD (c) , Newfoundland and Labrador Centre for Health Information, Research and Evaluation Department, St. John's, NF, Canada
Anas El Aneed, PhD , College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
Neil Gladney, MSc (C) , Newfoundland and Labrador Centre for Health Information, Research and Evaluation Department, St. John's, NF, Canada
Objective: To examine the expected impact of a population based pharmacy network on the illicit use of prescription drugs in Newfoundland and Labrador and establish baseline data for comparison following implementation of the pharmacy network.

Methods: The study is designed as the pre-implementation component of a pre-/post-implementation study. Multiple data sources were used in the study incorporating both quantitative and qualitative methodologies.

Data sources include:

1. focus groups and semi-structured interviews with policy, health, social and law-enforcement professionals;

2. questionnaires administered to all community pharmacists and physicians practicing within the province;

3. secondary analysis of administrative data to examine hospitalization rates for poisoning by prescription drugs; and

4. chart reviews at in-patient addiction services centres to determine admission rates related to prescription drugs.

Results: Preliminary survey findings indicate that 93% of pharmacists agree that the pharmacy network will have a positive impact on the issue of prescription drug abuse. However, a small percentage (16%) of pharmacists feels that there will be negative effects of the pharmacy network as it relates to prescription drug abuse. Similarly, focus group and interview findings show that key informants believe that the pharmacy network will decrease doctor shopping, prescription forgery and illegal prescribing. On the other hand, participants indicated that theft of prescription drugs, as well as the importation of prescription drugs from outside the province, may increase following the implementation of the pharmacy network.

The annual average hospitalization rate due to prescription drug poisoning was 37 per 100,000 population. A majority of hospitalizations (>50%) were related to benzodiazepine poisoning. Twenty three per cent of addictions centre admissions were related to prescription drugs abuse. The most commonly identified source of prescription drugs were street drug dealers, prescriptions shared by family/friends and doctor shopping (42%, 10% and 9% of admissions, respectively).

Conclusion: While a population based pharmacy network may not be able to address all aspects of prescription drug abuse, by enabling access to province-wide medication profiles in real-time, comprehensive decision support tools and e-prescribing capabilities, it is expected that it will have a positive impact on activities that result in diverting drugs to the illicit market. Findings of the pre-/post-implementation study can support public health decision-making related to the implementation of the pharmacy network and other appropriate intervention strategies to address the issue of prescription drug abuse.

Learning Objectives:
At the end of the session, participants will be able to: 1. Describe a multi-method approach to examining the impact of a population-based pharmacy network on prescription drug abuse; and 2. Describe the expected impact of a population based pharmacy network on prescription drug abuse.

Keywords: Prescription Drug Use Patterns, Health Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am involved in numerous studies related to the evaluation of health information system initiatives including several studies related to the potential impact of a province-wide drug information system. In addition to my work in health information systems evaluation, I have been Principal Investigator or co-investigator on numerous studies that involve the secondary use of administrative data. My research interests include health ifnromation systems evaluation, chronic disease epidemiology, primary health care and using administrative data for applied health research. I have presented my work in local, provincial, national and internation conferences. Since 2004, I have been the Manager of Research with the Research and Evaluation Department of the Newfoundland and Labrador Centre for Health Information. The Research and Evaluation Department, one of five departments at the Centre for Health Information, carries out applied health research that is relevant to health policy decision making by government, healthcare managers, and program planners. The Department also provides information to clinicians and the public to assist them in their decision making.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Medical Care Poster Session: Drug Policy/Pharmacy & Quality Improvement
See more of: Medical Care