HCS465 Wk2 Annotated Bibliography

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HCS/465

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Medicine

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Dec 6, 2023

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Annotated Bibliography Kristen Draper University of Phoenix Health Care Research Utilization HCS/465 Joseph Harrison Jr Ph.D. 08/22/2023
Danielson, E. C., Harle, C. A., Silverman, R., Blackburn, J., & Menachemi, N. (2021). Assessing Variation in State Opioid Tapering Laws: Comparing State Laws with the CDC Guideline. Pain Medicine , 22(12), 2941-2949. https://doi.org/10.1093/pm/pnab208 This study utilized a systematic search reviewing 50 state statutes and regulations that addressed when and how to taper off opioids that were implemented after December 31, 2019. These statutes and regulations were then compared to the CDC (Center for Disease Control) guidelines and pocket guides for tapering off opioids. The study then evaluated each state by geographical region, population size, the governor's political leaning at the time the laws and regulations were implemented, and the prescribing rate and overdose rate. The purpose of the study was to examine and describe state laws and regulations that address the when and how of tapering off opioids and to determine how these laws vary by state and whether these laws are concordant with the CDC guidelines. As a result, the study concluded that only 27 states had laws that mentioned tapering and that states with higher overdose rates were more likely to enact tapering laws and have associated penalties. It was also found that some state tapering laws do have some federal guideline attributes but lack attributes deemed critical by experts. It was recommended that laws and regulations adjust to fill the gap and become more adherent with the CDC guidelines. DuBois, J. M., Chibnall, J. T., Anderson, E. E., Eggers, M., & Baldwin, K. (2016). A Mixed Method Analysis of Reports on 100 Cases of Improper Prescribing of Controlled Substances. Journal of Drug Issues , 46(4), 457-472. https://doi.org/10.1177/0022042616661836 DuBois et al. (2016) used a mixed method analysis which reviewed published reports on 100 cases that had innapropriate precribing of controlled substances (IPCS) and reviewed
the environmental and individual factors associated with IPCS. The purpose was to characterize such cases and to develop an explanation that would provide a deeper understanding of the diverse factors that account for cases of IPCS. The sample consisted of various typologies such as motivation by financial gain, physicians with self-centered personality traits in small private practices that had little oversight and had a higher opioid demand from vulnerable patients. It also included physicians with substance use disorders themselves and had poor skills or judgement. The study also used forensic theory to interpret the data and develop a theory on how each case occurred. It was identified that most IPCS occurred when physicians had little to no oversight or had self- centered personality traits. It was suggested that small private practices have more peer oversight with collaborative physicians' agreements. It was also recommended that more sensitivity training be conducted for those showing unprofessional behavior during schooling. It was found when comparing this study to previous similar studies that states with and without PDMP (prescription drug monitoring programs) that the use of electronic data tracking software did not lead to an increase of IPCS or result in the increase of complaints or disciplinary action against physicians. Sacarny, A., Yokum, D., Finkelstein, A., & Agrawal, S. (2016). Medicare Letters to Curb Overprescribing of Controlled Substances Had No Detectable Effect on Providers. Health Affairs , 35(3), 471-479. https://doi.org/10.1377/hlthaff.2015.1025 In this study, the sample was composed of 1,525 individuals who prescribed a much higher amount of scheduled II controlled substances than their peers within the same state and specialty within three years. During 2011, 2012 and 2013 the average prescriber from the selected group was responsible for 406 percent more prescription fills when compared
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to their peers. The sample was compromised of prescribers in nine different specialties including, Anesthesiology, Emergency Medicine, General Practitioners, Nurse Practitioners, Orthopedic Surgery, Pain Medicine, Physical Medicine and Rehabilitation, Physician Assistants, and Psychiatry and Neurology. The data was obtained from CMS Medicare part D and included any prescribers that prescribed Schedule II drugs above the 75 th percentile and dispensed 30-day supply of schedule II drugs and then that was divided by thirty. This study had a randomized controlled trial approach that was used to evaluate a low-cost, light touch intervention that was aimed at reducing the number of schedule II-controlled substances that are dispensed, by mailing letters to the prescribers that over prescribe schedule II-controlled substances. The study identified that the primary outcome of schedule II-controlled substances prescription fills over 90 days (about 3 months) post mailing of the letters, it was unable to identify if the letters had any effect on the primary outcome.