Medical Association Successfully Lobbies for PDMP Changes

MONTGOMERY — Registered users of the Alabama Prescription Drug Monitoring Program (PDMP) should have noticed a different format earlier this year. The new platform, called NarxCare™, provides enhanced analytics and risk scores with features including prescription information displayed in easy-to-understand graphic representations and allowing the users to obtain prescription information by clicking on the graphics.

Prescribers using the PDMP have often complained accessing the program is cumbersome, time-consuming and complicated, which discourages use of the tool unless it is specifically required by Alabama Board of Medical Examiners rules.

In 2017, Gov. Kay Ivey established the Alabama Opioid Overdose and Addiction Council, which would in part look into options for prevention, treatment, recovery-support and other behavioral health services for substance-use disorders lacking in our state. Leadership from the Medical Association argued a massive upgrade to the PDMP would need to be part of the mission of the Governor’s Opioid Council.

“The Medical Association has been at the forefront of the opioid crisis for many years looking for new ways to identify better options for treatment of patients with substance use disorder and find more intuitive training and tools for our prescribers. The addition of NarxCare is a great first step in streamlining the PDMP and hopefully encouraging more prescribers to use this diagnostic tool in their practice,” said Association Executive Director Mark Jackson.

On Jan. 15, the Alabama Department of Public Health launched the first phase of that upgrade with the NarxCare™ platform to aid prescribers in clinical decision making and provide support to help prevent or manage substance use disorder.

The new format when prescribers search a patient’s history in the PDMP has now changed:

• There are two short tutorials available to walk PMDP users through the new system. Prescribers are strongly encouraged to view the NarxCare™ tutorials.
• In the new NarxCare™ format, the patient’s name and information are listed on the upper right of the screen.
• Each patient will have Narx Scores for narcotics, sedatives and stimulants.
• An Overdose Risk Score (0-999) is also displayed for the patient. The higher the number, the more at-risk the patient is for an overdose.
• The prescriptions are displayed as color-coded, interactive blocks on a bar graph. For example, opioid prescriptions are represented by red blocks. Clicking on a block displays the patient’s prescription information.
• Full prescription information is listed at the bottom of the page in the traditional format seen in Aware.
• Medication Assisted Therapy (MAT) and CDC resources are available by clicking the Resources tab.

The Narx Report

The Narx Report includes a patient’s NarxScores, Predictive Risk Scores, Red Flags, Rx Graph and PDMP Data, as well as access to Resources and Care Team Communications all in a single, easy-to-use interface.

The NarxScores. Every Narx Report includes type-specific use scores for narcotics, sedatives and stimulants. These scores are based on a complex algorithm factoring in numbers of prescribers, morphine milligram equivalents (MME), pharmacies and overlapping prescriptions. Scores are quantified representations of the data in the PDMP and range from 000-999 with higher scores equating to higher risk and misuse, and the last digit always represents the number of active prescriptions.

The Predictive Risk Scores. These composite risk scores incorporate relevant data (PDMP and non-PDMP) into advanced and customized predictive models to calculate a patient’s risk of a host of outcomes, including overdose and addiction. Non-PDMP data sets may include medical claims data, electronic health records, EMS data and criminal justice data.

The Red Flags. There are multiple customizable PDMP- and non-PDMP based red flags. A red flag(s) may contribute to the risk of unintentional overdose or other adverse events.

The Rx Graph. The Rx Graph is simple, clear and comparative. The interactive display allows you to view all the information you need, analyze data, and click into specific data points to see more detail. You can easily visualize and understand patterns in prescribing and usage behaviors, as well as identify overlapping prescriptions.

The PDMP Data. The PDMP Report is for controlled substance data. The PDMP Report aggregates two years of historical prescription data from providers and pharmacies, including quantities and active prescriptions.

For information about the PDMP or NarxCare™, contact the Alabama Department of Public Health’s Pharmacy Division at (877) 703-9869.