Grant: Operating Grant: Population Health Intervention Research

There is growing evidence that the problem of prescription drug abuse is increasing in Ontario, particularly for prescription opioids. The Ontario Ministry of Health and Long-Term Care (MOHLTC), as part of a comprehensive Ontario Narcotics Strategy, is developing a prescription monitoring program for all Ontarians for all narcotic and other controlled substances dispensed in the province. Despite a number of programs in place in Canada and the United States, there is currently very little evaluative work published on prescription monitoring programs. The overall purpose of this proposal is to evaluate the implementation of the new Ontario Narcotics Monitoring System in order to determine the early impact of the program, to develop best approaches for longer-term outcomes evaluation, and to provide program implementers with evidence-based suggestions to optimize program impact. The research questions are: How do prescription patterns of monitored drugs change during the implementation of the prescription monitoring program, both overall and in relation to the prescription alert feature of the program (alerting pharmacists of other recent prescriptions)? How effective is the alert feature of the program in identifying cases of opioid misuse, and can it be used to identify prescribers associated with inappropriate prescribing? How do prescription drug abuse-related outcomes change during the implementation of the prescription monitoring program? What are the experiences, opinions and attitudes of pharmacists, physicians and patients with the program? This project will employ multiple research strategies to the research questions over the 2-year project timeline. Prescription monitoring programs have the potential to significantly impact the growing problem of prescription drug abuse. The imminent implementation of the Ontario Narcotic Monitoring System provides a time-sensitive, valuable opportunity for evaluation from the inception of the program.