Data-Driven Responses to Prescription Drug Misuse in Kentucky

The Kentucky Injury Prevention and Research Center (KIPRC), a bona fide agent for the Kentucky Department for Public Health (DPH), Cabinet for Health and Family Services (CHFS), seeks funding under Category 6 to implement Data-Driven Responses to Prescription Drug Misuse in Kentucky. Kentucky had the nation’s third-highest 2015 drug overdose mortality rate. The proposed statewide project involves partnerships with the Kentucky All Schedule Prescription Electronic Reporting (KASPER), CHFS, Office of Drug Control Policy (ODCP), Administrative Office of the Courts (AOC), licensure boards, and other agencies. The project’s research component will be performed by action researchers from KIPRC, the Institute for Pharmaceutical Outcomes and Policy (IPOP), and the Center on Drug and Alcohol Research (CDAR), University of Kentucky, following the BJA Smart Suite initiative for practitioner-researcher partnership to use data, evidence-based practices, and rigorous methodologies to address the project’s aims cost-efficiently, leveraging key public health and public safety datasets made available under data-sharing agreements dating to the BJA FY2014 Category 3 grant (http://www.mc.uky.edu/kiprc/programs/data-driven-pdo.html). The project aims to: 1) evaluate the short-term impact of Kentucky’s 2017 SB32 on prescriber/dispenser behaviors (SB32 amended KRS 218A.202 to require the AOC to forward drug conviction data to CHFS for inclusion in KASPER); survey Kentucky prescribers and dispensers on awareness and understanding of the law (pre- and post-implementation); develop and provide continuing education for prescribers/dispensers on the content and interpretation of conviction data; 2) analyze gabapentin prescribing in Kentucky, where it will become a Schedule V controlled substance (CS) [902 KAR 55:035 §1(e)] on July 1, 2017, by identifying populations and regions with elevated rates of dispensed prescriptions/doses; describe patterns of concurrent prescribed CS and other medications; track changes in gabapentin prescribing and associated health outcomes among Medicaid and commercially insured populations in Kentucky and the US for which prescribing data before July 2017 are available; track changes in the prevalence of gabapentin in postmortem toxicology for Kentucky drug overdose decedents (2015 baseline: 36%); and estimate the prevalence of gabapentin diversion; and 3) hold quarterly action team meetings to review recent data (e.g., opioid prescribing rates, buprenorphine-naloxone prescribing, overdose mortality and morbidity) and solicit input on project implementation and deliverables. This strategy addresses priority considerations for strengthening multi-agency and practitioner-research collaborations, timely data-sharing, and prescriber/dispenser education. Kentucky is currently a CDC Prevention for States and a SAMHSA Medication Assisted Treatment- Prescription Drug and Opioid Addiction grantee; letters of support from these programs are provided.