The purpose of the study was to develop a set of metrics to identify prescription drug providers with unusual or uncustomary prescribing practices and how these metrics can be used to mitigate the misuse, abuse, and diversion of controlled substances.
Researchers secured a copy of North Carolina's prescription drug monitoring program (PDMP) data for the years 2009-2013 inclusive, after all patient-level data were de-identified. Provider and dispenser names also were removed from the dataset. The dataset received from the PDMP vendor required extensive cleaning and variable creation (see SAMPLING). After consulting with multiple state agencies, the researchers developed the following metrics:
- identifying providers writing high numbers of prescriptions for high doses of opioids (greater than 100 morphine milligram equivalents)
- identifying providers who consistently provide high levels of opioids that fall below this threshold to identify those who may seek to avoid detection
- searching for providers who wrote multiple prescriptions for various classes of controlled substances regardless of dose (paying particular attention to those who co-prescribed opioids and benzodiazepines)
- identifying providers who wrote high numbers of overlapping prescriptions (defined as a prescription written more than seven days before the expiration date of an earlier prescription for the same class of controlled substance)
- examining patients manifesting unusual behaviors in regards to filling prescriptions for controlled substances
- examining providers of multiple patients who traveled long distances from their homes either to secure prescriptions from their providers or fill these prescriptions at distant pharmacies
- identifying providers of patients who visited multiple providers or pharmacies to secure or fill controlled substances
After Prescription Drug Monitoring Program (PDMP) data was received, records with non-controlled substances and incomplete data were removed. All DEA numbers for pharmacies that were duplicated (presumably in error) were removed from the prescriber field. Records with Schedule V drugs were also removed due to having the least potential for abuse among the other legal controlled substances. Prescription drugs used to treat opioid addiction and controlled substances dispensed in vials were also excluded from the final data set.
Data collected by the North Carolina Controlled Substances Reporting System from dispensers on each controlled substance dispensed in Schedule II-V.
North Carolina Controlled Substance Reporting System
administrative records data
This study contains one excel data set.
The data file (2015_NC_PDMP_Synthetic_Data_Set.xlsx, n=10,000, 13 variables) includes a unique ID variable, deidentified dates of when the prescription was dispensed and written, a calculated date of when the prescription can be refilled, formulation of drug as patch versus non-patch, pharmaceutical class of drug, daily dose of opiate medications in morphine milligram equivalents (mme), and total mme in the prescription (deidentified). The file also includes deidentified distances of patient to pharmacy and patient to prescriber, as well as Pharmacy ID, Prescriber ID, and Patient (recipient) ID.