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Pharmacoepidemiology

Accuracy in identifying drug-related emergency department admissions is critical to understanding local burden of disease and assessing effectiveness of drug abuse prevention and overdose-reduction initiatives. In 2018 the Illinois Department of Public Health (IDPH) began implementation of a mandatory opioid overdose reporting law, applicable to all hospital emergency departments (ED). The mandate requires reporting of patient demographics, causal substance and antagonist ED administration within 48 hours of presentation. This reporting is not name-based. IDPH currently utilizes a near real-time syndromic surveillance (SyS) reporting system for all hospital ED, capturing most of the mandated criteria. Leveraging this existing system facilitates adherence to the mandate while imposing minimal additional burden of reporting on local hospitals. The Division of Patient Safety and Quality at IDPH has thus chosen to evaluate the completeness of overdose reporting and compliance with the opioid overdose mandate that have resulted from use of the current syndromic surveillance system.

Objective: To evaluate capacity of the BioSense ESSENCE platform and pre-defined overdose queries to identify emergency department admissions related to opioid overdose, in compliance with 2018 mandatory overdose reporting laws in Illinois.

Submitted by elamb on

Medication adherence studies typically use pharmacy-dispensing data to infer drug exposures. These studies often require calculations reflecting the intensity and duration of drug exposure. The typical approach to estimating duration of drug exposure is to use dispensing dates and day supply. Often, pharmacy databases have random and/or systematic errors causing improbable calculations. These errors become particularly problematic when estimating medication duration in drugs with complicated dosing schedules. Experts recommending cleaning data or removing erroneous data before analysis, but do not provide instructional guidelines. We developed an algorithmic approach to improve estimation of drug-course duration, dosing and medication possession ratios (MPRs). This study compares estimated MPRs produced by the standard method with MPRs by the algorithmic approach. Methotrexate was chosen as the first drug to implement the algorithm because of its widespread use for rheumatoid arthritis (RA) and for its complexity in dosing schedules.

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Submitted by teresa.hamby@d… on
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