HomeNewsArticle Display

Drug-monitoring innovations help providers assist patients

FALLS CHURCH, Va. -- Two Military Health System innovations are helping ensure best practices for patients with pain, and for those who have been diagnosed with post-traumatic stress disorder.

 

According to Chris Nichols, the Defense Health Agency’s program manager for Enterprise Intelligence and Data Solutions, the MHS Opioid Registry utilizes cutting-edge technology for data management and reporting to identify patients who have been prescribed opioids.

 

Clinical pharmacy professionals, physicians, and other authorized providers can use the patient lookup capability to proactively monitor and manage patients, and intervene as appropriate.

 

Leading health care experts note that while opioids such as oxycodone, hydrocodone, codeine, and morphine are prescribed to relieve pain, they are highly addictive and overuse can lead to death.

 

“The rates of opioid addiction and overdose deaths are lower in the military than among the general population,” said Vice Adm. Raquel Bono, DHA director, during a House Armed Service Committee hearing in June on Military Health System reform. “Still, the MHS has a role to play.

 

“Our beneficiaries are no strangers to chronic pain,” she said. “While our primary focus is on our own patient population, we are also cognizant of the larger public health crisis surrounding opioids. As health professionals and public servants, we have an obligation to help confront that crisis.”

 

The MHS Opioid Registry was launched in December 2016 and released to all sites in 2017. Data in the registry includes more than 200 variables including demographics, medications, morphine equivalence daily dose, results of urine drug testing, and opioid risk factors. In the future, MHS Opioid Registry users will also be able to evaluate and track alternative non-opioid therapies for pain management.

 

Officials also stated that a registry which is accessible by both DOD and VA providers and staff is currently under development.

 

“The PTS Provider Prescribing Profile was developed by the DHA’s Pharmacy Operations Division; it lists all providers at military treatment facilities who are treating patients with PTSD or acute stress disorder,” said Sushma Roberts, a clinical psychologist and senior program manager for DoD/VA Integrated Behavioral Health, Clinical Communities Support Section, Clinical Support Division. “The tool also documents the medications providers are prescribing.

 

“From February 2000 to June 2018, about 230,000 active-duty service members were diagnosed with PTSD,” Roberts said, adding that 75 percent were diagnosed following a deployment of 30 days or longer. “The clinical practice guideline released in 2017 recommended against prescribing benzodiazepines for PTSD patients,” she added. “Benzos, also known as tranquilizers, act on the brain and central nervous system to produce a calming effect. People can easily develop a tolerance to benzos, health care experts say, needing higher doses and increased frequency to achieve the same effects. People also may suffer withdrawal symptoms, including insomnia, irritability, anxiety, panic attacks, and seizures.”

 

According to Army Lt. Col. Dennis Sarmiento, a psychiatrist and chair of the DHA’s Behavioral Health Clinical Community, benzos are not necessarily bad. There are indications for their use. Short-term, they can help with anxiety, panic, and sleep. Treating such symptoms can help providers engage patients in care and better establish or reinforce rapport.

 

“But medications other than benzos are recommended for treating PTSD because they’re more effective,” Sarmiento said. “For example, antidepressants such as Zoloft, Paxil, Prozac, and Effexor raise the brain’s level of serotonin, a chemical that reduces symptoms of depression and anxiety.

 

“They also can be used with trauma-focused psychotherapy,” he said. “Those therapies include talking or writing about traumatic events, or learning and practicing meditation or deep-breathing exercises to manage anxiety.”

 

Sarmiento notes that throughout the MHS, benzo prescriptions have been on a downward trend since peaking in 2012.

 

According to the tool, the number of benzos prescriptions for MHS beneficiaries diagnosed with PTSD dropped from 1,922 in the first quarter of fiscal year 2017 to 1,622 for second quarter of FY 2018.

Twitter
Head over to https://t.co/ta73txIwPO and click on the calendar on the right for the most up-to-date #WarriorCARE Ev… https://t.co/xwypZyo6cW
Twitter
Mahalo to all for a incredible week of #HealingInHawaii. We ended the first ever PACAF #WarriorCARE event in a bi… https://t.co/Hcyd7kSqjx
Twitter
#AFW2 is experiencing technical glitches in sending out emails to those accepted for #AirForce Trials 2019. We are… https://t.co/4DVa1cRB8e
Twitter
Wheelchair #basketball match-ups dtsrted a few minutes ago. Base leadership is waiting in the wings for their chanc… https://t.co/Klvi0DIJfp
Twitter
#Wheelchair #Rugby competition is underway. It's a fast-moving sport where aggression and passion are rewarded. If… https://t.co/2uqWlQzXCz
Twitter
Awesome job Chief Master Sgt. Tucker! https://t.co/G235vCxX4I
Twitter
#DidYouKnow The PACAF #WarriorCARE Event is a Joint Service effort with upwards of 100 participants. 89 from the… https://t.co/cEuVQvjgXQ
Twitter
#AFW2_warriorwednesday Retired Tech Sgt. Melissa Nueva. Melissa has attended a number of #WarriorCARE event with… https://t.co/5QXYTX0aON
Twitter
#AFW2 Ambassadors spent the day educating Joint Base Pearl Harbor-Hickam #Airmen on the program and how it helps. T… https://t.co/Mk7Ug3yc9c
Twitter
AFW2’s Warriors continue to perform during the PACAF CARE event at Joint Base Pearl- Hickam. #AFW2 #WarriorCAREhttps://t.co/QbnmzntyS6
Twitter
Mark Shepherd, #AFW2 wheelchair basketball coach, talks to #WoundedWarriors about the finer details of how to maneu… https://t.co/U9qC5W2pZw
Twitter
It’s a beautiful morning at Joint Base Pearl Harbor-Hickam, where these Warriors are starting their day out with a… https://t.co/ErKiw6rwoa
Twitter
Sitting #volleyball is one of our more popular sports. These #woundedwarriors are at @jointbasephh for the first ev… https://t.co/KBmNAQZyk6
Twitter
Marsha Gonzales, #AFW2 support branch chief, visited with Staff Sgt. Sean Guillen, a member of the 36th Security Fo… https://t.co/L4O6MYiT0B
Twitter
Marsha Gonzales, AFW2 support branch chief, kicks off the @PACAF #WarriorCARE Event this evening. #HealinginHawaiihttps://t.co/S53VlnJHPr
Twitter
Smiles were abundant this morning as we kicked off our first ever Pacific Air Forces #WarriorCare Event with a day… https://t.co/AsgXKIdiY5
Twitter
#Woundedwarriors ARE HERE!!! They're gearing up to start the @PACAF #WarriorCARE Event at @JointBasePHH. First, the… https://t.co/yQrKrVnGrE
Twitter
Arrival Day Aloha! 💙🌺 The sun is shining, flights are landing and we are quickly approaching the official start of… https://t.co/wgVZngkXL9
Twitter
Team @JointBasePHH will be helping out our #woundedwarriors during the @PACAF #WarriorCARE Event. #AFW2 couldn't do… https://t.co/6bgEog1xzc
Twitter
#AFW2 staff worked hard to get things just right for the @PACAF #WarriorCARE event at @JointBasePHH. Right now the… https://t.co/h7j2geXpsE
Twitter
4,725
Follow Us