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Kentucky All Schedule Prescription Electronic Reporting

Cabinet for Health and Family Services. What is KASPER?. KASPER is Kentucky's Prescription Monitoring Program (PMP). KASPER tracks Schedule II

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Kentucky All Schedule Prescription Electronic Reporting

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    1. Kentucky All Schedule Prescription Electronic Reporting Trend Reporting Project

    2. Cabinet for Health and Family Services What is KASPER? KASPER is Kentucky’s Prescription Monitoring Program (PMP). KASPER tracks Schedule II – V controlled substance prescriptions dispensed within the state as reported by pharmacies and other dispensers. KASPER is a Web accessed database that provides a tool to help address one of the largest threats to patient safety in the Commonwealth of Kentucky; the misuse, abuse and diversion of controlled pharmaceutical substances.

    3. Cabinet for Health and Family Services Controlled Substance Schedules Schedule I – Illegal Drugs e.g. heroin, marijuana, etc. Schedule II – Most addictive legal drugs; high abuse potential e.g. oxycodone (Oxycontin, Percocet, Tylox). Schedule III – Less abuse potential than I or II e.g. hydrocodone combinations (Vicodin, Lortab). Schedule IV – Less abuse potential than III e.g. benzodiazepines (Xanax, Valium). Schedule V – least abuse potential e.g. codeine containing cough mixtures.

    4. Cabinet for Health and Family Services The Need for KASPER Health care professionals need a tool to help identify patient prescription drug problems and when intervention may be needed. Diversion of controlled substances is reaching epidemic proportions. Diverters cover large areas to obtain drugs. Agencies need efficiency and value in their investigative tools.

    5. Cabinet for Health and Family Services Misuse, Abuse, Diversion Misuse: When a schedule II – V substance is taken by an individual for a non-medical reason. Abuse: When an individual repeatedly takes a schedule II – V substance for a non-medical reason. Diversion: When a schedule II – V substance is acquired and/or taken by an individual for whom the medication was not prescribed.

    6. Cabinet for Health and Family Services The Scope of the Problem

    7. Cabinet for Health and Family Services Perspective From 1992 to 2003 the 15.1 million Americans abusing controlled prescription drugs exceeded the combined number abusing: Cocaine (5.9 million), Hallucinogens (4.0 million), Inhalants (2.1 million), and Heroin (.3 million).

    8. Cabinet for Health and Family Services Cough Syrup “Cocktails” Mixes of codeine-containing cough medicine with soft drinks or sports drinks. Popularized in rap songs in the late 1990s. Known as “Lean”, “Syrup”, Sizzurp” or “Purple Drank”. Users typically mix an ounce of the medicine with a sports drink, Sprite or Big Red, then plop in a Jolly Rancher candy and pour the mixture over ice. San Diego Chargers defensive back Terrence Kiel charged in September 2006 with illegally shipping cases of prescription cough medicine to a relative in East Texas.

    9. Cabinet for Health and Family Services “Pharm Parties” Short for pharmaceutical party, a rapidly increasing problem with teens and young adults. Bowls and baggies of random prescription drugs called “trail mix”. Collecting pills from the family medicine cabinet called “pharming”. Internet chat rooms are used to share “recipes” for getting high with prescription drugs. Users sometimes refer to pills by color rather than brand name, content or potency.

    10. Cabinet for Health and Family Services The Results of Rx Drug Abuse February 2006. Eddie Cappiello 22, died of drug overdose after a “pharm party” with the equivalent of 67 Xanax pills in his system, leaving behind a 6-week old daughter. June 2006. Justin Knox 22, bit down on Fentanyl patch and died before reaching the hospital. June 2006. Two Transportation Security Administration screeners pleaded guilty to stealing OxyContin pills from passengers.

    11. Cabinet for Health and Family Services

    12. Cabinet for Health and Family Services

    13. Cabinet for Health and Family Services A National Perspective

    14. Cabinet for Health and Family Services KASPER KASPER was initiated in 1999 and the Web-based eKASPER launched in 2005. Between eight and nine million prescriptions for controlled substances are reported to the system each year. Reports are provided to authorized individuals (KRS 218A.202). Presently producing over 1,000 reports per day.

    15. Cabinet for Health and Family Services Top Prescribed Controlled Substances by Therapeutic Category by Doses

    16. Cabinet for Health and Family Services Who Uses KASPER?

    17. Cabinet for Health and Family Services Goal of Trend Reporting To allow the professional licensure boards and law enforcement officials to have the tools needed to identify potential “hot spots” and possible diverters under their scrutiny. The original mandate was to provide “spreadsheet” type tools. By working with our epidemiologist we expanded the concept to include GIS mapping and analysis.

    18. Trends Analysis Tools

    19. Cabinet for Health and Family Services Tools ArcView 9.1 ArcTool Box Spatial Autocorrelation Hot Spot Analysis Spatial Analyst Extension Point density analysis VENN Diagramming Data Sources KASPER extracts U.S. Census 2000 Geographic Levels County ZIP code U.S. Census Block

    20. Cabinet for Health and Family Services VENN Diagramming

    21. Trends Analysis Methods

    23. Cabinet for Health and Family Services Average Prescriptions Dispensed By County

    24. Cabinet for Health and Family Services Average Prescriptions Dispensed By County

    25. Cabinet for Health and Family Services Average Prescriptions Dispensed By County

    26. Cabinet for Health and Family Services Average Prescriptions Dispensed By County

    27. Cabinet for Health and Family Services

    28. Cabinet for Health and Family Services

    29. Cabinet for Health and Family Services Quartile Groupings Patients, Prescribers, Dispensers Geographic Intersection – county level ?% patient activity ?% prescriber Rx activity ?% pharmacy dispensing activity

    30. Using spatial autocorrelation, hot spot analysis, and point-density analysis Confirming activity clusters and significance Operation UNITE

    31. Cabinet for Health and Family Services Spatial Autocorrelation Determination

    32. Cabinet for Health and Family Services Identifying “Hot Spots”

    33. Cabinet for Health and Family Services Confirming Hot Spots with Point Density Analysis

    34. Cabinet for Health and Family Services Directional Distribution – Hot Spot Area

    35. Cabinet for Health and Family Services Directional Distribution - Cumberland

    36. Cabinet for Health and Family Services Directional Distribution – Big Sandy

    37. Concept Development

    38. Cabinet for Health and Family Services Partnership Vision

    39. Methods Summary Getting from here to there and from who to where…

    40. Cabinet for Health and Family Services

    41. Cabinet for Health and Family Services

    42. Thank You! KASPER Web site: www.chfs.ky.gov/KASPER

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