July 30, 2018

CT regulators hone in on prescription tracking

Michelle Seagull Commissioner, Department of Consumer Protection

The deadly opioid crisis has weighed on state and federal lawmakers and regulators.

The situation has pushed the National Institutes of Health to nearly double its pain and addiction research funding this year, and here in Connecticut, where more than 1,000 people died from overdoses in 2017, the overdose reversal drug Naloxone has become more accessible.

Meanwhile, the legislature has enabled Connecticut's drug and pharmacy regulator, the Department of Consumer Protection, to boost its monitoring of opioid prescriptions in recent years.

This Q&A speaks with DCP Commissioner Michelle Seagull about the effort.

Q. What are the aims of the state's prescription monitoring program?

A. The Prescription Drug Monitoring Program (PDMP) is a database that contains information on controlled substances that are provided to patients in the state. It is an important tool that aims to assist prescribers and pharmacists in making the best medical decisions possible for patients.

With the information in the PDMP, practitioners have a more complete picture of their patient's medical condition and the other controlled substances the patient is taking.

Q. It's important to note that Connecticut has been increasing its efforts to track prescriptions of opioids, benzodiazepines and other controlled substances for years now. Can you briefly explain how these efforts have evolved between 2013 and the present?

A. While the PDMP has been collecting data since 2008, over the past several years, legislation has been passed to increase the usefulness of this tool by requiring that information be uploaded more quickly and utilized more regularly.

In 2013, legislation was passed that required prescribers to register in the system, and pharmacies to upload dispensing information, activity that was previously optional. In 2015, new legislation required prescribers to review a patient's PDMP record prior to prescribing greater than a 72-hour supply of any controlled substance.

In 2016, legislation required pharmacies to upload dispensing information by the next business day, rather than within a week as was previously required. In addition to legislation, DCP has launched a number of educational programs and engaged in outreach to practitioners to increase the medical community's understanding and use of the PDMP.

Q. While the number of controlled-substance prescriptions tracked by the monitoring system has grown by more than 700,000 over the past four years, the number of opioid and benzodiazepine prescriptions has fallen. To what do you attribute those declines?

A. There have been a lot of different efforts throughout the state to decrease opioid dependency. The declines in opioid and benzodiazepine prescriptions are in large part attributable to increased awareness in the prescriber and pharmacist community about the dangers of high-risk prescribing behavior.

In addition, the greater availability of information through the PDMP has made it easier for prescribers to track the amount of these products that a patient may already be receiving. The state, medical employers and nonprofits have all worked very hard to promote educational programs to address the opioid epidemic, and to make sure the PDMP is as easy as possible for practitioners to use.

Q. Recently, DCP announced that Walmart's pharmacies were the first to integrate their data systems with the state's drug monitoring program. What does that entail?

A. Integration of a pharmacy's software program or electronic health records and the monitoring program allows a healthcare professional to access PDMP information without leaving the software they are using for the rest of the patient interaction. This means pharmacists only need to log in to one program and can obtain a patient's controlled substance prescription history more rapidly. Ultimately, this should allow for more time to be spent focusing on the patient's healthcare needs.

Q. Is connecting to the drug monitoring program mandatory?

A. Connecting is not mandatory, but is a great step being taken by a number of facilities because it allows the information in the monitoring program system to become a seamless part of a patient's medical record. Many prescribers and pharmacies have been inquiring about integration so we anticipate seeing more in the near future, and are excited about those developments.

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