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A description of Medical Examiner prescription-related deaths and prescription drug monitoring program data.
Am J Emerg Med. 2016 Mar; 34(3):510-4.AJ

Abstract

BACKGROUND

The Centers of Disease Control and Prevention have declared prescription drug abuse an epidemic in the United States. However, demographic data correlating prescription-related deaths with actual prescriptions written is not well described. The purpose of this study is to compare toxicology reports on autopsy for prescription-related deaths with Prescription Drug Monitor Program (PDMP) data.

METHODS

This is a retrospective analysis comparing 2013 San Diego Medical Examiner data on 254 unintentional prescription-related deaths obtained for 12 months before death with data from the California PDMP. Data were analyzed on age, sex, whether there was information on the PDMP, types and quantities of prescribed medications, number of pharmacies and providers involved, and whether there was a match between the Medical Examiner toxicology report and data from the PDMP.

RESULTS

In 2013, there were 254 unintentional prescription-related deaths; 186 patients (73%) had PDMP data 12 months before death. Ingesting prescription medications with illicit drugs, alcohol, and/or over-the-counter medications accounted for 40% of the unintentional deaths. Opioids were responsible for the majority of single medication deaths (36; 70.6%). The average number of prescriptions was 23.5 per patient, and the average patient used 3 pharmacies and had 4.5 providers. Chronic prescription use was found in 68.8% of patients with PDMP data.

CONCLUSIONS

The PDMP data highlight important patterns that can provide valuable insight to clinicians making decisions regarding types and amounts of medications they prescribe. Although there is no guaranteed solution to prevent prescription-related deaths, PDMP data can be useful to prevent coprescribing and medication interaction and by following best clinical practices.

Authors+Show Affiliations

Department of Emergency Medicine, Scripps Mercy Hospital, San Diego, CA.Keck School of Medicine, University of Southern California, Los Angeles, CA.University of Arizona, Tucson, AZ.San Diego County Medical Examiners Office, San Diego, CA.Department of Emergency Medicine, University of California, San Diego, San Diego, CA.Department of Emergency Medicine, University of California, San Diego, San Diego, CA.Department of Emergency Medicine, University of California, San Diego, San Diego, CA. Electronic address: emcastillo@ucsd.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26778639

Citation

Lev, Roneet, et al. "A Description of Medical Examiner Prescription-related Deaths and Prescription Drug Monitoring Program Data." The American Journal of Emergency Medicine, vol. 34, no. 3, 2016, pp. 510-4.
Lev R, Petro S, Lee O, et al. A description of Medical Examiner prescription-related deaths and prescription drug monitoring program data. Am J Emerg Med. 2016;34(3):510-4.
Lev, R., Petro, S., Lee, O., Lucas, J., Stuck, A., Vilke, G. M., & Castillo, E. M. (2016). A description of Medical Examiner prescription-related deaths and prescription drug monitoring program data. The American Journal of Emergency Medicine, 34(3), 510-4. https://doi.org/10.1016/j.ajem.2015.12.023
Lev R, et al. A Description of Medical Examiner Prescription-related Deaths and Prescription Drug Monitoring Program Data. Am J Emerg Med. 2016;34(3):510-4. PubMed PMID: 26778639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A description of Medical Examiner prescription-related deaths and prescription drug monitoring program data. AU - Lev,Roneet, AU - Petro,Sean, AU - Lee,Oren, AU - Lucas,Jonathan, AU - Stuck,Amy, AU - Vilke,Gary M, AU - Castillo,Edward M, Y1 - 2015/12/14/ PY - 2015/07/10/received PY - 2015/12/12/revised PY - 2015/12/12/accepted PY - 2016/1/19/entrez PY - 2016/1/19/pubmed PY - 2016/8/2/medline SP - 510 EP - 4 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 34 IS - 3 N2 - BACKGROUND: The Centers of Disease Control and Prevention have declared prescription drug abuse an epidemic in the United States. However, demographic data correlating prescription-related deaths with actual prescriptions written is not well described. The purpose of this study is to compare toxicology reports on autopsy for prescription-related deaths with Prescription Drug Monitor Program (PDMP) data. METHODS: This is a retrospective analysis comparing 2013 San Diego Medical Examiner data on 254 unintentional prescription-related deaths obtained for 12 months before death with data from the California PDMP. Data were analyzed on age, sex, whether there was information on the PDMP, types and quantities of prescribed medications, number of pharmacies and providers involved, and whether there was a match between the Medical Examiner toxicology report and data from the PDMP. RESULTS: In 2013, there were 254 unintentional prescription-related deaths; 186 patients (73%) had PDMP data 12 months before death. Ingesting prescription medications with illicit drugs, alcohol, and/or over-the-counter medications accounted for 40% of the unintentional deaths. Opioids were responsible for the majority of single medication deaths (36; 70.6%). The average number of prescriptions was 23.5 per patient, and the average patient used 3 pharmacies and had 4.5 providers. Chronic prescription use was found in 68.8% of patients with PDMP data. CONCLUSIONS: The PDMP data highlight important patterns that can provide valuable insight to clinicians making decisions regarding types and amounts of medications they prescribe. Although there is no guaranteed solution to prevent prescription-related deaths, PDMP data can be useful to prevent coprescribing and medication interaction and by following best clinical practices. SN - 1532-8171 UR - https://www.unboundmedicine.com/medline/citation/26778639/A_description_of_Medical_Examiner_prescription_related_deaths_and_prescription_drug_monitoring_program_data_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(15)01079-7 DB - PRIME DP - Unbound Medicine ER -