U.S. President Donald Trump earlier this month vowed to declare the U.S. opioid crisis a “national emergency,” pledging to commit more funding and attention to the issue. And, while President Trump has yet to officially declare a state of emergency, a move that could help remove barriers and would enable the federal government to devote more funding to address the drug epidemic, healthcare organization leaders have been trying to combat the worsening opioid epidemic for several years now.
According to the Drug Enforcement Administration (DEA), deaths from prescription drug abuse have outpaced those from cocaine and heroin combined in the last 14 years. According to the Centers for Disease Control (CDC), overdose deaths involving prescription opioids have quadrupled since 1999. Further, the CDC reports that, today, nearly half of all U.S. opioid overdose deaths involve a prescription opioid. In 2015, more than 15,000 people died from overdoses involving prescription opioids. What's more, each day, more than 1,000 people are treated in emergency departments for not using prescription opioids as directed.
Many healthcare and health IT organizations have called for increased use of prescription drug monitoring programs (PDMPs) and for federal leaders to ensure that PDMPs are interoperable across state lines, in order to reduce instances of prescription drug and opioid abuse and addiction. Last year, Health IT Now wrote a letter urging the U.S. Food and Drug Administration to leverage health IT tools, in combination with physician education and training, to combat the opioid crisis.
While education and training for healthcare providers is one tool that the FDA has, Health IT Now said that training will be “reinforced and exponentially more effective when that education is paired with comprehensive and real-time data of the patient’s controlled substance prescription history. “In order for those pieces to coordinate, PDMPs need to be interoperable across state lines, real-time and within the workflow of prescribers and dispensers.”
A report from Shatterproof, a national substance use disorder prevention organization, released a report back in March that found that PDMPs can be an effective and valuable tool to help identify and prevent prescription drug misuse. However, in most states, prescriber participation is very low, which compromises the effectiveness of the clinical tool. That report called on state legislatures to require doctors to use state-run databases to track patients’ history of opioid and sedative prescriptions in an effort to address the growing opioid abuse problem in the U.S.
Health information exchange (HIE) organizations throughout the country also are taking steps to enhance data exchange specifically in the area of prescription information to help providers address opioid misuse and abuse. As an example, the Nebraska Health Information Initiative (NeHII), a statewide HIE, and the Nebraska Department of Health and Human Services, are taking steps to capture state prescription information and deliver it to Nebraska’s enhanced PDMP. According to NeHII, the inclusion of complete prescription data in the PDMP database enhances patient safety and helps combat the abuse of opioids by giving providers and pharmacists a more complete picture of a patient’s medication history, allowing opioid use to be addressed in the overall context of the patient’s care plan while also highlighting diversion or other patterns of abuse.
Beyond PDMPs, many healthcare provider and payer organizations are looking to leverage advanced health IT tools, such as data analytics and predictive modeling, to identify risk factors that can put patients at high risk for a prescription opioid overdose or addiction in order to intervene before an adverse event occurs.
Virginia Premier Health Plan, a managed care insurance organization owned by VCU Health and based in Richmond, Va., plans to implement a newly developed predictive analytics tool that predicts a patient’s likelihood of experiencing an overdose. The tool, called the Venebio Opioid Advisor (VOA), was developed by Venebio, a Richmond-based life sciences consultancy.
The company conducted numerous published opioid studies, with the support of the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH), and, as a result of that research, researchers were able to identify the most common risk factors associated with an opioid overdose and developed predictive algorithms that can predict the likelihood of a patient experiencing an unintentional overdose from a prescription opioid.
Barbara Zedler, M.D., Venebio’s chief medical officer and a lead researcher on several of the studies, says many unintentional overdoses occur not because of excessive dosage, but from other factors like age, concomitant medications and pre-existing health conditions that can increase the risk of certain individuals treated with prescription opioids. The risk-screening tool analyzes these risk factors and predicts a patient’s likelihood of a life-threatening opioid overdose.