Pharmacy database helps catch opioid over prescribers

SANDUSKY — When the Department of Justice presented its case against Dr. Greg Gerber's ability to write prescriptions, a key pieces of evidence was the Ohio Automated Rx Reporting System (OARRS) reports for his patients.The Department of Health and Human Services has declared the opioid epidemic a national crisis and have pointed to the overprescription of painkillers as a key factor.A federal judge placed a temporary restraining order on Gerber's ability to prescribe controlled substances after he was accused of overprescribing opioids to patients."In order to fight our way out of this issue, we have to do so with the help of the prescribers," said. Steven Schierholt, executive director of the Ohio Board of Pharmacy. "There's too much of a correlation between prescription drugs and illegal drug use to be ignored. Our goal is to provide physicians with the tools to be a part of the solution."Reduction in opioid prescriptionsOARRS, Ohio's online prescription database, has become an important tool in the the fight against opioid addiction."If you're a prescriber you can check this system and see what controlled substance prescriptions a patient has been prescribed," Schierholt said. "That information makes for a better interact between pharmacy, doctor and patients."In 2015, it became mandatory for healthcare providers to check OARRS before writing a controlled substance to catch signs of abuse and doctor shopping, when a patient sees multiple doctors to get multiple prescriptions for the same drug."One of the impediments was that it was a separate system and what we've done in Ohio, and we were the first state to do it, we integrated the monitor system into the clinical work flow," Schierholt said.Before Gov. Kasich gave the board $1.5 million to integrate OARRS into the electronic medical records, a prescriber would have to log out of their records and log into a separate site."Now if you're sitting with your physician she see your OARRS history with a click of button," Schierholt said. "We know a doctor's time is valuable and want to make it easy to check."Since they've integrated systems, the board has seen an increase in OARRS queries which have correlated with a decrease in the number of opioids prescribed.The total doses of opioids dispensed to patients in Ohio has decreased by 225 million doses from 2012 to 2017 while the number of queries on OARRS increased by 4,900 percent."The rates of controlled substance doses for Ohio patients are all going going down," Schierholt said.Ohio was also the first state to add additional risk factors to their controlled substance database in 2017. OARRS now also includes Narx scores which calculate a patients risk of unintentional overdose.InvestigationsThe board traditionally starts to investigate doctor's after it received a complaint from a patient, law enforcement or a pharmacy.When the DEA and the pharmacy board investigated Gerber OARRS reports were used to track how often he prescribed opioids, for what diagnosis and to whom.The reports found he frequently prescribed numerous doses to patients without accepted medial reason and he prescribed to multiple people at the same address, a red flag for prescribing, according to the Department of Justices civil complaint."I think that case is a good example of showing the collaboration of the different regulatory boards and that his issues affects us all," Schierholt said.Under the current administration, the pharmacy board has been encouraged to use OARRS to find problem prescribers and patients before they're reported."Recently, we received a grant from the Department of Justice to look at overprescribing by healthcare officials using OARRS," Schierholt said.By using the data collected on OARRS, investigators can tell when there is a pattern of prescription for a certain drug and what diagnosis is given as a reason."I think the number of aberrant prescribers is decreasing, but even a few can do a lot of harm," Schierholt said.Reach reporter Michael Harrington at michaelharrington@sanduskyregister.com, follow the Register at Facebook.com/SanduskyRegisterOxyContin, in 80 mg pills, in a 2013 file image. (Liz O. Baylen/Los Angeles Times/TNS)