Dashboard to Monitor Opioid Prescriptions and Drug Overdose Related Morbidity and Mortality

Project Name: Dashboard to Monitor Opioid Prescriptions and Drug Overdose Related Morbidity and Mortality

Project Status: Proposed

Point of Contact: R. Matt Gladden

Center: National Center for Injury Prevention and Control

Keywords: Query System, Prescription drug overdose

Project Description: From 2000 to 2010, overdose deaths related to opioid pain relievers increased at a faster rate than any other major cause in the US. In 2011, there were over 40,000 drug overdose deaths; nearly 17,000 were related to opioid pain relievers. Similarly, emergency department (ED) visits related to opioids increased 183% from 2004 to 2011. Opioid related morbidity and mortality is higher in states with high rates of opioid prescribing and misuse. An array of policies and programs has been launched at the national and state level to reduce overdose deaths related to opioid pain relievers. For instance, policies addressing inappropriate prescribing practices by providers (e.g., providing pain relievers illegally to patient or prescribing in contrast to current guidelines) or reducing illegal behavior by patients (e.g., filling the same prescription at multiple pharmacies) have the potential to reduce opioid morbidity and mortality. Also, 49 states track controlled substance prescriptions through prescription drug monitoring programs (PDMP) to identify, monitor, and respond to inappropriate prescribing practices. PDMPs can provide clinicians access to patients’ full prescription history when considering controlled substance prescriptions and proactively inform law enforcement and medical licensure boards of aberrant prescribing patterns among doctors, pharmacies, and patients.

At the national level, CDC has funded five states to enhance their PDMPs, evaluate promising policy approaches, and use insurer mechanisms to reduce inappropriate prescription of opioid pain relievers. As the policy and program responses at the state and national level to the prescription drug overdose epidemic have increased, the need for timely data has increased to evaluate these initiatives, identify emerging patterns, and detect promising declines in inappropriate prescribing rates and drug overdose morbidity and mortality. This project proposal, the “Prescription Opioid Drug Overdose Data Dashboard,” will help address these data needs and advance efforts in the priorities of “strengthening surveillance, epidemiology, and laboratory services,” “Improving the ability to support state, tribal, local and territorial public health,” and “increasing policy impact.” The anticipated impact of this data dashboard will be to provide timely data to those who are acting promptly at the state and national-level to curb the epidemic of prescription drug overdoses.

Currently, there is no single surveillance system in place to track standard metrics on opioid prescription and consumer related risk factors and opioid related morbidity and mortality. Furthermore, no single surveillance system can compare states on these metrics to better evaluate the impact of state policies and programs. The “Prescription Opioid Drug Overdose Data Dashboard,” seeks to address these needs. With this funding, we will develop a proof of concept for a web query system that provides data on prominent risk factors for opioid overdoses (i.e., inappropriate opioid prescription patterns detected with PDMP data) and drug overdose mortality data across the United States. This data dashboard will also help track the progress of U.S. states implementing prevention programs and policies versus those that are not. Specifically, the dashboard would provide users timely metrics on three key pieces of information for as many US states as possible that have available data:

1. the policies and prevention programs that are being implemented to prevent inappropriate prescribing and use of opioids;
2. key metrics/indicators of inappropriate prescribing and use of opioids (e.g., updated with a time lag of only 6 months or less); and
3. indicators for drug overdose morbidity and mortality.

A strong public response to recent vital signs, MMWR reports, and NCHS publications detailing opioid prescriptions and mortality highlight the need for consistent reporting of these indicators. Publicly sharing this information in an easy to use format can assist policymakers, state and local public health officials, the media, and other interested members of the public in identifying, investigating, and responding to promising or problematic trends in opioid prescription patterns by states on a quarterly and biannual basis. This could help identify promising practices as well as speed the response to worrisome new trends. Finally, including a few indicators on state level drug overdose mortality will keep prevention efforts focused on the ultimate goal of saving lives.

Leveraging the WISQARS interactive site as a model (See https://www.cdc.gov/injury/wisqars/), this project would use the funding to develop a prototype system that has the structure/framework to accommodate key drug overdose mortality and PDMP indicators of inappropriate opioid prescription indicators selected from the work of expert panels. In addition, an implementation plan including a timetable and cost estimate would be created to fully implement the query system as part of WISQARS. The plan will include compliance with all relevant CDC regulations including the need to secure an authority to operate. This work would be a critical first step in developing an innovative query system tool that combines risk factors with mortality that could better inform a growing response to the epidemic of opioid pain reliever overdoses.

The approach is scalable in two ways. First, the infrastructure could be applied to develop other similar modules in NCIPC that take an in-depth looks at other injury problems and risk factors such as traumatic brain injury or child abuse and neglect. Second, the plan will help assess whether other indicators could be integrated on prescription drug overdose in the future such as emergency department visits related to drug overdoses.

For more information about this project, please contact the CHIIC at chiic@cdc.gov or Brian Lee at brian.lee@cdc.hhs.gov.