Issue link: https://viewer.e-digitaledition.com/i/100670
froM the stAte MedicAl BoArd of ohio Improving the Integrity of OARRS and Reducing Risks of Doctor Shopping O HIO IS ENGAGED in a battle to end an opiate epidemic that has seen significant increases in the number of prescriptions for controlled substances over the past decade. Regulatory entities and providers alike share in a common goal of reducing the effects this epidemic is having on the communities, businesses, and individuals within the State. The Centers for Disease Control and Prevention (CDC) report that approximately 10% of patients on opioids seek care from multiple prescribers and are likely engaged in some form of diversion of the drugs. CDC data further suggests that approximately 76% of nonmedical opioid users report obtaining drugs that had been prescribed to someone else. The CDC further reports that among persons who died of opioid overdoses, a significant proportion did not have a prescription in their records for the opioid that contributed to their death. In Ohio, estimates suggest that 25% - 66% of persons who have died from prescription drug overdoses used opioids originally prescribed to someone else.1 Prescribers have an opportunity to be part of efforts to reduce the risks of doctor shopping. Recent changes to law and Ohio Automated Rx Reporting System (OARRS) program improvements 44 | Cleveland/Akron/Canton MD News have made it easier than ever to access OARRS prescription history reports so that prescribers may monitor whether their patients are receiving controlled substances from multiple prescribers or routinely obtaining early refills. Professional healthcare licensing boards are taking every opportunity to focus provider attention on ways to reduce the risks of diversion and so-called doctor shopping, and at the same time improve the integrity and quality of data within OARRS. In an effort to improve access to OARRS, prescribers are now permitted to have non-licensed staff such as medical assistants or other office personnel registered as delegates with the Board of Pharmacy for purposes of accessing OARRS. Previously, only licensed healthcare providers such as nurses and physician assistants were permitted to be registered as delegates. The Board of Pharmacy limits the number of non-licensed delegates to three per prescriber. This change was intended to improve workflow in provider���s practices, while also encouraging increased use of OARRS. Prescribers can also play a role in improving the integrity and quality of the data in OARRS by way of the information included on a prescription. Currently, ��� MDNEWS.COM ��� JANUARY-FEBRUARY 2013 prescribers are required to place the patient���s name and address in order for a prescription to be valid.2 This information is verified by the pharmacist when filling the prescription and reported on to OARRS. For OARRS to accurately assign prescription data to a given patient, it uses three points of information that includes the patient���s name, address and date of birth. If prescribers are willing to make the effort to include this information on prescriptions for controlled substances, the accuracy of OARRS data could be improved by ensuring that when a prescription history report is accessed that the most complete and accurate information is available. This information may alert prescribers and pharmacists alike to potential signs of doctor shopping or diversion. NOTE: Registration for OARRS is not limited to opiate prescriptions. Physicians who prescribe any Schedule II through V controlled substances or tramadol should sign up for OARRS via www.ohiopmp.gov/Portal/Default.aspx. ��� 1 Accessed at http://www.cdc.gov/about/ grand-rounds/archives/2011/01-February.htm 2 Rule 4729-5-30, Ohio Administrative Code