December 08, 2020
By Julie Gould
According to recent research presented at ASHP Midyear 2020, regional and state stakeholders and policy makers should utilize prescription monitoring programs to better address rural overdoses and increase the availability of Naloxone.
To better understand the background of the study and what pharmacists can take away from the findings, we spoke with Sami Hanna, PharmD candidate, Touro University.
Please tell us about yourself.
My name is Sami Hanna, and I'm a fourth‑year pharmacy student at Touro University in California. Also, I have a master's in public health from Touro University.
Just a quick background, I'm from Egypt. I've been to a medical school there, and pharmacy school for three years. I have international experience, including how the health care system works over there.
From my experience here at Touro and being into public health, this topic was quite important for me because it affects the public specifically, with the opioid epidemic that we have. It has been a wave of epidemics—if we can call it that.
In 2013, that's when we see the numbers going up. In 2016, that's when it was declared by the CDC that it is a health emergency, and we need to look by the increasing of the number of the overdose, and we see that this number start to increase because of opiates.
What led you to conduct this research?
Again, because it is a new topic and we need to know more data in order how to tackle the opioid epidemic, and specifically in the Mid‑East of the United States, we didn't see much of information. Because it will be different from one environment to another, including the impact of demographics, we needed to study this area in the Mid‑East.
Luckily, we had data from Iowa State from 2018, 2019, and also having 2020. We are working on presenting all of that in the manuscript. The way how we did this research actually was to work it in such a way that we get our data from the PMP, which is the Prescription Monitoring Program in Iowa.
That's basically after the patient had their medication in their hand, and after the patient picks up their medication, all of the data is recorded in pharmacy for the whole of the state of Iowa.
We tried to link that with the EMS, the emergency medical service, when they administer the Naloxone—a medication that is the antidote of the opiate that has a quick reversal for the opiate overdose. We try to look at data documented from those two sources, and we tried to match between those patients in those data set, and the medication on those data set.
We'll analyze their demographic and see what the risks are or what put you on higher risk demographic. That's how we started our research.
Of the findings in your research, were any of them particularly surprising?
It does follow a trend so far. I'm expecting that there will be more surprising findings because, again, we are looking right now at the 2020 data. Also, because of the COVID-19 pandemic, we are expecting to even see a new other trend through the demographics. We're still collecting those data.
But yes, research shows that male have higher risk factors. Yes, that's what we found so far. Also, we found something that no other research, to my knowledge, found. With every new prescription, you have a five percent risk increase of having an overdose.
An example of overdose is among people who are on chronic pain medication, and receive another prescription. With every new prescription, you have an increase of 5% of being overdosed and needing to use a Naloxone rescue.
How can pharmacists take your findings and apply that to practice and their everyday work?
That's actually was our target, to target the stakeholders. You have to look over here on those communities. It's going to be more as a legislation for the pharmacist by having the Naloxone training—as an example—for the non‑health care worker or just a lay person.
Like a taxi driver, he must have a Naloxone in his car, if such and such happen in his car. That's actually some documentaries I want far away from science, and some documentaries in some states actually show people having Naloxone in their car if an overdose happens. That's one thing.
Also, the availability of the Naloxone. Right now, it's quite essential for the cost of the Naloxone and who can get it—it’s an affordability kind of thing and accessibility. Those are things that the stakeholders have to tackle to make it available for the lay people.
Hanna S, Doroudgar S, Xiong X, et al. Utilizing prescription monitoring program data to predict Naloxone administration by emergency medical services providers: A large retrospective analysis of Iowa patients (Abstract P-10). ASHP Midyear 2020. December 6, 2020.