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Usage grows for opioid prescription database

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Since Pennsylvania's Prescription Drug Monitoring Program went live last summer, physicians and pharmacists have checked the online database 5.7 million times, according to the state's Department of Health.

The agency launched the database in response to the opioid pain pill and heroin epidemic, which is one of the largest public health crises in the history of Pennsylvania, department secretary Karen Murphy said.

The database helps doctors and pharmacists discover patients who may be doctor- or pill-shopping for controlled substances, such as opioid pain pills.

Physicians can then initiate a dialogue with patients. However, the number of patients identified as abusing controlled substances is not being tracked. That information is between the patient and the physician, Murphy said.

Anecdotally, the effort appears to be making an impact.

Dr. Robert Nielsen, president of PinnacleHealth Medical Group in Harrisburg, is finding the database a useful way to start talking with patients about the dangers of narcotics. He has discovered a few patients who are receiving prescriptions from multiple physicians, then getting them filled at different pharmacies.

PinnacleHealth requires patients to agree to receive controlled substances only from that physician and take them as directed. The database is one way PinnacleHealth providers can discover whether a patient is breaking that contract. Once an issue is identified, the patient and provider can work together to find a resolution.

“Sure it slows you down, but overall we have a major concern” with the opioid epidemic, Nielsen said.

Harrisburg-based Capital BlueCross, meanwhile, is seeing a decline in opioid prescriptions, according to spokeswoman Kirsten Page. There was an 11 percent drop in 2016, followed by a 4 percent reduction in the first quarter of 2017.

The monitoring program continues to evolve as additional needs are identified.

Last fall, for example, lawmakers passed legislation requiring physicians to check the database every time they prescribe controlled substances. When the program was initially launched, physicians had to check the database only when prescribing to a patient for the first time.

Legislation also updated the frequency with which pharmacists use the database. When the database first went live, pharmacy workers were required to report filled prescriptions every 48 hours. Now they have to enter into the database within 24 hours of dispensing a controlled substance.

About 86,000 physicians and dispensers are registered in the system overall, Murphy said.

The department plans to make additional improvements to the monitoring program, such as finding a way to help physicians identify available rehab facilities more easily. The department also wants to integrate the prescription drug database with the state’s electronic health record system, Murphy said.

Although the state had a tracking program before, it was operated through the Attorney General’s office, and it was limited in scope as to what drugs were tracked and how information was stored.

The new tracking system “is really designed to assist physicians,” Murphy said. “The purpose is really to identify those who need help.”

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