142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

How Can Prescription Monitoring Programs Prevent Overdose?: A national survey of Prescription Monitoring and Injury Prevention Program Coordinators

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Traci Green, PhD, MSc , Inflexxion, Inc, Newton, MA
Sarah Bowman, MPH , Rhode Island Hospital, Providence, RI
Cristina Los , Inflexxion, Inc, Newton, MA
Kimberly McHugh , Inflexxion, Inc, Newton, MA
Peter Friedmann, MD, MPH , Division of General Internal Medicine, Rhode Island Hospital, Providence, RI
Background: Prescription monitoring programs (PMPs) can influence risks to patients associated with abuseable medications, especially prescription opioids.  The extent to which PMPs incorporate overdose prevention—explicitly or implicitly—in their goals, educational materials, and future applications is unknown.

Methods: Telephone interviews were conducted with PMP coordinators/directors and injury prevention or other public health program coordinators in states without active PMPs, whose PMP did not participate in the interview, or as supplemental data.  Interviews sought to enumerate existing efforts and future possibilities in PMP user training, public health impacts, and, specifically, prescription opioid overdose prevention.  Descriptive statistics and content synthesis methods summarized findings from closed and open-ended questions, respectively.

Results:  Interviews with 45 PMP coordinators/directors (44 of 45 active PMP programs) and 14 injury prevention coordinators indicated that ‘preventing overdose’ ranked third among named intended outcomes of the state PMP programs, above law enforcement use (fifth).  Although 97% of PMPs reported having educational materials for providers, 48% addressed interpreting the PMP report, and 24% provided information about responding to an unsolicited report of aberrant medication use.  19 PMPs directly addressed overdose or its prevention on their publicly available PMP website, primarily as justification for PMP existence (n=12) rather than in educational materials (n=3).  Innovative practices of PMP-based overdose prevention included PMP-embedded morphine equivalent daily dose calculators and drug treatment locators.

Conclusions: PMPs could be leveraged for large-scale opioid overdose prevention efforts, and examples from several states provide initial learning examples.  Future work should evaluate impacts of targeted, overdose prevention efforts undertaken with PMPs.

Learning Areas:

Public health or related public policy

Learning Objectives:
Discuss mechanisms for how Prescription monitoring programs (PMP) can alter opioid overdose risk in the community. Identify opportunities for public health initiatives undertaken by, or in conjunction with, PMPs. List 3 PMP-involved initiatives aimed directly to reduce overdose risk. Describe variability in public health, law enforcement, and data driven orientations of PMPs.

Keyword(s): Prescription Drug Abuse and Misuse, Public Health Infrastructure

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a drug abuse epidemiologist whose federally funded research focuses on prescription drug abuse and overdose prevention.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Inflexxion drug abuse research Employment (includes retainer)

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.