Studies HB1 effects--KASPER

Purpose and Background HB1 made sweeping changes relative to the prescribing and monitoring of controlled prescription drugs in an effort to address the prescription drug abuse problem in Kentucky. In particular, the requirements for mandatory registration and utilization of the Kentucky All Schedule Prescription Reporting (KASPER) system should assist prescribers in making appropriate treatment decisions and identifying patients potentially in need of substance abuse treatment interventions. As with any policy change, unintended consequences that impact patients and providers may be associated with HB1 implementation. To maximize the effectiveness of HB1 and minimize unintended consequences, we propose to conduct a comprehensive assessment of HB1’s impact on patients, prescribers, and citizens in Kentucky utilizing a mixed-methods approach that includes both qualitative and quantitative components. Goals and Objectives The overall goals of the project are to: 1. Evaluate the impact of HB1 on reducing prescription drug abuse and diversion in Kentucky 2. Identify unintended consequences associated with implementation of HB1 that impact patients, providers and citizens of the Commonwealth 3. Develop recommendations to improve effectiveness of HB1 and mitigate identified unintended consequences Specific Aims Our quantitative analyses will rely on KASPER administrative data files to examine trends in KASPER utilization and prescribing, and whether those trends changed systematically after the introduction of HB1. Additionally, nationally available datasets will be used to assess impact of HB1 on morbidity and mortality associated with prescription drug overdoses. Our proposed qualitative component is designed to provide timely insights through a series of semi-structured interviews with key stakeholders and surveys of KASPER users to determine perceptions of HB1 effectiveness and to identify unintended consequences. To achieve the above goals, we propose using data available from the KASPER program and other readily available data sets to address the following specific aims: 1) Assess changes in KASPER utilization since implementation of HB1, including number of registrants, requests and geographic distribution of registrants 2) Assess changes in controlled substance (CS) prescribing patterns since implementation of HB1, including number of CS prescribed, demographics of prescribers and drugs prescribed 3) Assess KASPER user perceptions of the effectiveness of KASPER and the chilling effect of HB1utilizing surveys and stakeholder interviews 4) Assess changes in patient behavior/characteristics, including doctor shopping, since implementation of HB1 5) Assess changes in morbidity/mortality indices since implementation of HB1, including Emergency Department visits and hospital discharges for CS overdose, admission to substance abuse treatment facilities and deaths due to CS overdose