Marie Abate, Pharm.D., professor in the WVU School of Pharmacy and faculty affiliate with the WVU Injury Control Research Center, was part of a team of researchers who explored prescription and drug-related death data to determine how many subjects visited multiple doctors and pharmacies to obtain medications.
The study examined information from the West Virginia Controlled Substance Monitoring Program (WV CSMP) and drug-related death data compiled by the Forensic Drug Database from July 2005 through December 2007. Of the more than one million subjects 18 years and older, 698 were categorized as deceased. Doctor shoppers accounted for about 25 percent of deceased subjects, while nearly 17.5 percent of the deceased were pharmacy shoppers.
In addition, approximately 20 percent of doctor shoppers were also pharmacy shoppers, and 55.6 percent of pharmacy shoppers were doctor shoppers. Younger age and greater number of prescriptions dispensed also contributed to having greater odds of drug-related death.
The article reporting this research, “Doctor and Pharmacy Shopping for Controlled Substances,” appeared in the June 2012 issue of “Medical Care.” It concludes that prescription monitoring programs may be useful in identifying potential shoppers at the point of care.
“The WV CSMP compiles data for each controlled substance prescription filled in the state,” Dr. Abate said. “These programs currently exist in most states, and efforts are underway to create one large program that would compile the controlled substance prescription data from all participating states. Physicians can consult the CSMP to determine if a patient had recently filled other prescriptions, from different physicians, for the same drug or similar types of drugs.”
“Similarly, pharmacists should routinely consult the CSMP when patients come into the pharmacy with a new opioid or other controlled substance prescription,” she added. “This allows pharmacists to determine if patients had recently filled similar prescriptions at different pharmacies or from different physicians. While patients might appropriately see different physicians to treat a medical problem or condition, there should not be overlapping prescriptions for similar medications within the same time frame.”
The paper also emphasized collaboration and communication between doctors and pharmacists. Abate suggested that physicians contact other involved physicians and pharmacies if a patient had recently filled or is trying to fill similar prescriptions, and pharmacists should do likewise.
“Ways of tackling the problem at a broader level might be to hold periodic joint meetings of both local physician and local pharmacy organizations to specifically discuss possible strategies for reducing and detecting doctor and pharmacy shopping in their area,” Abate said. “Doctors and pharmacists could also collaborate to present community seminars to help educate the public about the dangers of misusing or abusing opioids and other potentially addicting medications.”
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