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Sowa EM, Fellers JC, Raisinghani RS, et al. Prevalence of substance misuse in new patients in an outpatient psychiatry clinic using a prescription monitoring program. Prim Care Companion CNS Disord. 2014;16(1)doi: 10.4088/PCC.13m01566.
Sowa, E. M., Fellers, J. C., Raisinghani, R. S., Santa Cruz, M. R., Hidalgo, P. C., Lee, M. S., Martinez, L. A., Keller, A. E., & Clayton, A. H. (2014). Prevalence of substance misuse in new patients in an outpatient psychiatry clinic using a prescription monitoring program. The primary care companion for CNS disorders, 16(1), . https://doi.org/10.4088/PCC.13m01566
Sowa, Elle M, et al. "Prevalence of substance misuse in new patients in an outpatient psychiatry clinic using a prescription monitoring program." The primary care companion for CNS disorders vol. 16,1 (2014). doi: https://doi.org/10.4088/PCC.13m01566
Sowa EM, Fellers JC, Raisinghani RS, Santa Cruz MR, Hidalgo PC, Lee MS, Martinez LA, Keller AE, Clayton AH. Prevalence of substance misuse in new patients in an outpatient psychiatry clinic using a prescription monitoring program. Prim Care Companion CNS Disord. 2014;16(1). doi: 10.4088/PCC.13m01566. Epub 2014 Jan 02. PMID: 24940523; PMCID: PMC4048139.
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Prim Care Companion CNS Disord. 2014;16(1). doi: 10.4088/PCC.13m01566. Epub 2014 Jan 02.

Prevalence of substance misuse in new patients in an outpatient psychiatry clinic using a prescription monitoring program.

The primary care companion for CNS disorders

Elle M Sowa, Jonathan C Fellers, Rachna S Raisinghani, Maria R Santa Cruz, Priscilla C Hidalgo, Meredith S Lee, Lady A Martinez, Adrienne E Keller, Anita H Clayton

Affiliations

  1. Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville (Drs Sowa, Santa Cruz, Hidalgo, Lee, and Clayton); Department of Addiction Psychiatry, Oregon Health and Science University, Portland (Dr Fellers); Psychosomatic Medicine, Virginia Commonwealth University Health System, West Hospital, Richmond (Dr Raisinghani); Child Psychiatry, University of Connecticut, West Hartford (Dr Martinez); and Public Health Sciences, The National Social Norms Institute at the University of Virginia, Charlottesville (Dr Keller).

PMID: 24940523 PMCID: PMC4048139 DOI: 10.4088/PCC.13m01566

Abstract

OBJECTIVE: To investigate the value of a prescription monitoring program in identifying prescription drug misuse among patients presenting to a resident physician outpatient psychiatry clinic at an academic medical center.

METHOD: Participants were 314 new patients aged 18 years or older presenting to the clinic from October 2011 to June 2012. Resident physicians completed a data collection form for each participant using information from the patient interview and from the prescription monitoring program report. Prescription drug misuse was defined as having any 1 of the following 5 criteria in the prescription monitoring program report: (1) filled prescriptions for 2 or more controlled substances, (2) obtained prescriptions from 2 or more providers, (3) obtained early refills, (4) used 3 or more pharmacies, and (5) the prescription monitoring program report conflicted with the patient's report.

RESULTS: At least 1 indicator of prescription drug misuse was found in 41.7% of patients. Over 69% of the patients that the residents believed were misusing prescription drugs actually met 1 of the criteria for prescription drug misuse. The prescription monitoring program report changed the management only 2.2% of the time. Patients with prior benzodiazepine use (χ(2) 1 = 17.68, P < .001), prior opioid use (χ(2) 1 = 19.98, P < .001), a personality disorder (χ(2) 1 = 7.22, P < .001), and chronic pain (χ(2) 1 = 14.31, P < .001) had a higher percentage of prescription drug misuse compared to patients without these factors.

CONCLUSION: Using the prescription monitoring program to screen patients with prior benzodiazepine and opioid use, with a personality disorder, and/or with chronic pain may be useful in confirming the suspicion of prescription drug misuse identified at the initial evaluation.

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