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

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Presentation Objectives

• Explain the purpose and goals of Oregon’s PDMP

• Identify how PDMPs can improve patient safety and health outcomes

• Resources

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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

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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

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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

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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 Enrollment by County, Q3, OR, 2016

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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

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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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PDMP Patient Report

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PDMP mapping function

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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

PDMP threshold report, p. 1

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PDMP threshold report, p. 2

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Potential PDMP Enhancements

• Mandated enrollment to support integration of PDMP data into patient HER

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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

lisa.m.millet@state.or.us

www.healthoregon.org/opioids

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www.orpdmp.com