An 十大菠菜台子威廉博蒙特医学院 student project has identified problems with Michigan’s prescription-tracking database — and local officials hope it helps tackle the state’s devastating opioid addiction epidemic.
“A Survey of Barriers Between Prescribers and the 密歇根自动处方系统” is a project led by fourth-year OUWB student Chris Cooper.
The project won first place in the category of Public Health at the National Student 研究 Forum held at the University of Texas 医疗 Branch in Galveston, Texas.
库珀说，他的目的是发现和关注的问题 密歇根自动处方系统 (MAPS) — issues that he says limit the drug-tracking system’s effectiveness in battling the state’s ongoing opioid addiction crisis.
“The goal of our research was to identify the barriers that keep prescribers from using (MAPS) so that we can make suggestions to local health departments versus the state level, 让它对用户更友好, 希望能提高它的使用率,库珀说.
帕特里克Karabon, 欧文局生物统计学家，也是该项目的共同作者之一, 库珀的项目是同类项目中的首例.
“While other states have looked at barriers to implementing their own Prescription Drug Monitoring Programs (PDMPs), 到目前为止，密歇根州还没有进行任何评估,他说.
Karabon said the project benefited from the connection to the representatives from Oakland County and 奥克兰社区健康网络.
特别是, 他说, because they “were able to distribute the survey throughout the entire state of Michigan.”
丽莎McKay-Chiasson, 管理员, 奥克兰县卫生局, 还有Trisha Zizumbo, 培训总监, 奥克兰社区健康网络, 项目是否有共同作者. 在一份联合声明中，他们确认了这项工作的重要性.
“The data from (the project) can help us identify barriers and challenges unique to Oakland County prescribers and allows for the 奥克兰县卫生局, 奥克兰社区健康网络, and the Oakland County Prescription Drug Abuse Partners to continue to work together on combating the opioid epidemic happening in our communities,声明中写道.
识别问题
根据国家药物滥用研究所的数据, deaths in Michigan related to overdose from prescription opioids rose from 378 in 2012 to 633 in 2017. NIDA also reports that Michigan providers wrote 74 opioid prescriptions for every 100 people.
State law requiring use of MAPS (with some exceptions) went into effect in June 2018.
根据密歇根州的网站, MAPS is used to track controlled substances and “a tool used by prescribers and dispensers to assess patient risk and is also used to prevent drug abuse and diversion at the prescriber, 药店, 病人的水平.”
简单地说, MAPS旨在遏制“购证”,” or the practice of visiting multiple physicians to obtain multiple prescriptions.
Cooper said he first started to question the effectiveness of MAPS while working outside of medical school with a local emergency department. 库珀 最近引入 加入Alpha Omega Alpha荣誉医学协会(见右图), said that experience pushed him to pursue the issue further making it the focus of his OUWB 开始 学生研究项目.
开始 is an OUWB required scholarly concentration that provides a mentored introduction to research and scholarship. The four-year longitudinal curriculum consists of structured coursework in research design and implementation, 合规培训, 研究交流, 学术性的陈述, with protected time to develop mentored projects in a wide-range of community and health-related settings.
库珀说，他的项目表明MAPS“确实没有得到充分利用.”
库珀说:“在开麻醉品处方时，使用MAPS实际上是强制性的。. 但一些数据显示，这种情况实际上并没有发生.”
“我们需要弄清楚为什么它没有(被使用)，”他补充说.
Project findings were based on survey responses received from nearly 200 physicians, 医师助理, 护士从业人员.
答复者指出了定期使用MAPS的各种障碍, 包括一个复杂的注册过程, 用户界面不够友好, 以及对系统普遍缺乏了解.
然而, the biggest barrier respondents identified is lack of integration with electronic medical records (EMR) systems.
“缺乏与电子病历的整合是最大的障碍，”卡拉邦说.
展望未来
卡拉邦说，电子病历很大, 复杂的, and interwoven in everything that health care providers do throughout the day. EMRs are also large financial investments for any health care provider and require a team of specialists to maintain the system, 他说.
“While our clinical partner Beaumont has begun the integration of MAPS with its (system), this is a much more difficult challenge for many of the smaller community hospitals and physicians’ offices located throughout the state of Michigan,卡拉邦说.
Karabon said health care stakeholders need to be aware of the problems that impact use of MAPS, 尤其是电子病历问题.
“处方提供者每天大部分时间都在电子病历中, having to use a second system to check the patient against MAPS is something that is inefficient and might dissuade these providers from using MAPS all the time,卡拉邦说. “Hopefully this (project) will be a catalyst for health care systems and EMR providers to continue the discussion of integrating MAPS and other PDMPs with EMR systems.”
在他们的声明中, McKay-Chiasson and Zizumbo said the project was useful in identifying a need to improve the use of MAPS.
“(The project) assisted in determining the challenges and barriers associated with utilizing MAPS and directly aligns with the Oakland County Prescription Drug Abuse Partnership's priorities to ensure and advocate for safe and competent opioid prescribing practices,他们说.
除了库珀、麦凯-恰森、齐祖博和卡拉邦， 莎拉Lerchenfeldt,制药.D, OUWB assistant professor of Foundation 医疗 Studies in the discipline of pharmacology, 是作者之一.
For more information, contact Andrew Dietderich, marketing writer, OUWB, at (电子邮件保护).
