Semester

Spring

Date of Graduation

2011

Document Type

Thesis

Degree Type

MS

College

School of Pharmacy

Department

Pharmaceutical Systems and Policy

Committee Chair

Joel Halverson

Committee Co-Chair

Michael J Smith

Abstract

One objective was to compare the proportion of doctor and pharmacy shoppers between living and deceased users of controlled drug substances (CDS) in West Virginia. A second objective was to identify factors that predict the odds a subject is classified as a shopper. A third objective was to determine factors that predict the odds of dying from CDS use. A final objective was to identify factors that predict the odds of deceased subjects not having verified prescriptions for CDS detected upon autopsy.;A secondary data research study was conducted. The Controlled Drug Substance Monitoring Program and the Forensic Drug Database were used to identify subjects who were 18 years or older and used Schedule II-IV controlled drug substances in the state of West Virginia from July, 1, 2005 to December 31, 2007. Bivariate analyses were used to compare living and deceased subjects for both doctor shopping and pharmacy shopping. Logistic regression was conducted to predict the odds of doctor shopping, pharmacy shopping, and of dying related to CDS use. Bivariate analyses were used to compare decedents with versus without verified prescriptions for CDS detected upon autopsy. Logistic regression was conducted to predict the odds that a decedent did not have verified prescriptions for all CDS detected upon autopsy.;Approximately 25.36% of deceased subjects and 3.61% of living subjects were doctor shoppers. Approximately 17.91% of deceased subjects and 1.31% of living subjects were pharmacy shoppers. Furthermore, 7,778 subjects were considered both doctor and pharmacy shoppers (20.31% of doctor shoppers were also pharmacy shoppers, and 55.83% of pharmacy shoppers were also doctor shoppers). Age, number of different CDS dispensed, number of prescriptions dispensed, and number of pharmacies visited significantly predicted the odds of being classified as a doctor shopper. Life status, age, number of different CDS dispensed, number of prescriptions dispensed, and number of doctors visited significantly predicted the odds of being classified as a pharmacy shopper. Age, number of different CDS dispensed, number of prescriptions dispensed, and number of pharmacies visited significantly predicted the odds of dying. Approximately 30% of decedents had a verified prescription for all their CDS detected upon autopsy. Age, number of different CDS at autopsy, and gender significantly predicted the odds of being classified as not having verified prescriptions for all CDS detected upon autopsy.;In conclusion, there is evidence of doctor shopping and pharmacy shopping for controlled drug substances in West Virginia. Interventions by healthcare professionals are important because only a third of decedents had a verifiable prescription for all their CDS detected upon autopsy. Pharmacists as well as physicians may rely on a prescription monitoring program to identify shoppers. Healthcare professionals should consider integrating prescription monitoring program information during delivery of care, and evaluate its impact in preventing drug-induced and drug-related deaths.

Download

Share

COinS