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Pa. offers database of patient prescriptions to end doctor shopping

Renatta Signorini
| Wednesday, Aug. 24, 2016, 9:39 p.m.
200 milligram pills of Pfizer Inc.'s Celebrex are viewed through a magnifying lens in a pharmacy in Cambridge, Mass., on Wednesday, October 17, 2006.
Medical Horizons
200 milligram pills of Pfizer Inc.'s Celebrex are viewed through a magnifying lens in a pharmacy in Cambridge, Mass., on Wednesday, October 17, 2006.

A few extra minutes and clicks of a computer mouse could make a difference for someone addicted to prescription medication.

A new state program aimed at ending doctor shopping will allow physicians to quickly check whether a patient has been prescribed painkillers before, which could open frank discussions between them, said Dr. Bill Jenkins, director of the emergency department at Excela Health Frick Hospital in Mt. Pleasant.

“There's a huge patient safety benefit to it,” Jenkins said.

Under the Prescription Drug Monitoring Program that starts Thursday, doctors and pharmacists can consult a centralized database at the Department of Health's website to check a patient's prescription history. Pharmacists are required to enter information into the database within 72 hours of dispensing prescription drugs that are considered controlled substances.

Authorities hope the program — it will monitor prescriptions for everything from morphine to prescription cough medicine — will enable physicians to identify patients who are at-risk and direct them to treatment, if necessary.

“It's a start,” said Tim Phillips, director of the Westmoreland County Drug Overdose Task Force. “It's something more than we've ever had in the past.”

“It takes time to change the environment,” he said. “I think it will take time and commitment on the doctors' part.”

The system is one way state and local officials are battling the growing opioid addiction crisis. In 2014 and 2015, overdoses killed 6,125 people in Pennsylvania, the Drug Enforcement Administration recently reported.

“Ensuring prescription drugs are not being overprescribed is a necessary first step to curb drug addiction and also reduce the supply of excess prescription drugs that can be used illicitly,” said Wes Culp, deputy press secretary for the Health Department.

Between 2012 and 2015, 377 people died of overdoses in Westmoreland County and 1,297 died in Allegheny, according to coroner statistics. In 2016, 64 fatal overdoses have been confirmed in Westmoreland and 66 in Allegheny.

“We'll be able to track doctor shopping across the state” with the new database, said Dr. Abraham Kabazie, division director of pain medication at Allegheny Health Network. “I think it's certainly going to be a work in progress.”

Nationwide effort

Similar programs are operating or in development nationwide, but Pennsylvania only recently inked a three-year, $1.48 million contract with Apriss of Kentucky, which operates systems in 24 other states.

Doctors and pharmacists or their staffs must first register with the program. Within 24 hours pharmacists are required to enter information about each dispensing of a prescription medication that is considered a controlled substance, such as oxycodone, methadone, diazepam and aspirin with codeine.

Starting Thursday, pharmacists and doctors can search the program for a patient's history, which state health officials hope will result in more informed decisions about future prescriptions.

The Allegheny County Medical Society has been pushing for creation of the database, Executive Director John Krah said.

“Most physicians are going to see this as a tool, but they also understand that it will impose cost to the practice” in the form of time spent querying the database, Krah said.

Doctors are required by law to check the database if they are prescribing a medication for a first-time patient or if they suspect the patient is abusing drugs. Doctors can direct patients to treatment options or discuss other means of pain management.

Precautions

A prescriber or dispenser could face civil or criminal penalties for misuse of the system, Culp said.

Dr. V. Hema Kumar, president of the Westmoreland County Medical Society, said the program will require more time of physicians and their staffs. But access to the patients' prescription histories is sorely needed, she added.

“It is a big problem with society,” said Kumar, whose practice is in South Greensburg. “We need to tackle it properly.”

In 2013, U.S. doctors wrote 207 million prescriptions for opioid painkillers, according to the government's national prescription audit.

Dean Matanin, director of pharmacy with Excela Health, said in the past year he has noticed doctors prescribing fewer quantities of prescription pills.

Pharmacists with the hospital system — they typically fill 2,000 prescriptions monthly — can easily spend a few minutes checking the database while the customer waits, Matanin said.

“It's another couple clicks on the computer,” he said. “We have a problem; hopefully this will help us wrap our hands around it.”

Problem areas

Still, there is some uncertainty the program will work as expected. Phillips worries that addicts will turn to street drugs like heroin.

“No one wants to go into withdrawal, so if they can't get their prescriptions,” they may go elsewhere, he said.

In the fast pace of hospital emergency departments, an added benefit is that some patients don't know or can't verbalize other medications they take, Jenkins said. A check through the program could prevent duplication or a bad drug combination, he said.

“The benefit of it far outweighs the downside,” he said. “I don't think it's going to unnecessarily burden any doctor.”

Renatta Signorini is a Tribune-Review staff writer. Reach her at 724-837-5374 or rsignorini@tribweb.com.

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