Form Grantee-Level PDMP Grantee-Level PDMP Grantee-Level PDMP Outcomes Module

ATTACHMENT 2

Grantee-Level PDMP Outcomes Module – Strategic Prevention Framework for Prescription Drugs (SPF Rx)

Program Evaluation for Prevention (PEPC) – Cross-Site Evaluation

OMB No. 0930-0377

Expiration Date 02/29/2024

Burden Statement: This information is being collected to assist the Substance Abuse and Mental Health Services Administration (SAMHSA) for the purpose of monitoring the Strategic Prevention Framework for Prescription Drugs (SPF-Rx) grant program. This voluntary information collection will be used at an aggregate level to determine the reach, consistency, and quality of the SPF-Rx Program. Under the Privacy Act of 1974, any personally identifying information obtained will be kept private to the extent of the law. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid Office of Management and Budget (OMB) control number. The OMB control number for this project is 0930-0377. Public reporting burden for this collection of information is estimated to average 2.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 5600 Fishers Ln, Room 15 E57B, Rockville, MD 20857.

Contents

Section Page

1. Information and Directions 1

2. Opioid Prescribing Patterns and Prescriber Use of PDMP 2

2.1 Opioid Prescribing Patterns (PDMP Data) 2

2.2 Prescriber Use of PDMP (PDMP data) 4

1. Information and Directions

The Grantee-Level Prescription Drug Monitoring Program (PDMP) Outcomes Module collects outcome data annually from the Strategic Prescription Framework for Prescription Drugs (SPF-Rx) grantees. Grantees will report outcome data for the subrecipient communities in the Community-Level PDMP Outcomes Module.

Grantee is used to indicate the state/tribal entity/jurisdiction receiving the award from the Substance Abuse and Mental Health Services Administration (SAMHSA). Note that grantee-level data refers to the entire state (or tribal area or jurisdiction). It does not refer to the aggregate of the funded communities.

Data submission deadlines are January 15 each year. Report data for the prior calendar year. You will also be asked to provide baseline data for 2 years prior to the start of the grant, if available.

The PDMP Outcome Requirements at a Glance provides a summary of the reporting requirements. See the PDMP Outcomes Module Guidance Manual for more detailed instructions on how to report data and complete this module.

This module reports on opioid prescribing patterns and prescriber use of PDMP data, a key SPF-Rx outcome.

If you need assistance using the web-based data entry system, contact the Help Desk by leaving a message at (866)-245-8079 or sending an email to [email protected]. You can request assistance at any time, and someone will respond to you within 24 hours or the next business day.

2. Opioid Prescribing Patterns and Prescriber Use of PDMP

In this section, grantees will use PDMP data to report on opioid prescribing patterns and prescriber use of PDMP in your state, tribal area, or jurisdiction during the 12-month reporting period. Please see the guidance manual for further details on types of opioid prescriptions to be included.

Data Source Time Frame (Start Date and End Date)

Indicate the time frame during which data for this measure were collected. Enter the start date and end date for the time period of the data you are submitting.

Start Date: ________________________________(month/day/year)

End Date: _________________________________(month/day/year)

1. Opioid Prescribing Patterns (PDMP Data)

Here, you will enter the data for the PDMP indicators to measure opioid prescribing patterns.

PDMP Indicators for Opioid Prescribing Patterns

Required Indicators
Population (total number of residents in the state, tribal area, or jurisdiction)	(State grantees do not need to provide population data)
Total number of unique residents prescribed opioid analgesics
Total number of opioid analgesic prescriptions
Total number of high-dose opioid analgesic prescriptions (>90 MME/day)
Total number of opioid pills dispensed
Average MME/day for all opioid prescriptions dispensed in this period
Percentage of patient prescription days with overlapping opioid and benzodiazepine prescriptions
Number of multiple provider episodes (unique patients filling prescriptions from 5 or more prescribers and 5 or more pharmacies in a 6-month period)
Optional Indicators
Percentage of patient prescription days with overlapping opioid prescriptions
Total number of patients prescribed by a single provider >90 MME/day of opioids for 90 or more consecutive days
Total number of prescribers who prescribed >90 MME/day of opioids for 90 or more consecutive days to any patients

MME = morphine milligram equivalents

Changes in PDMP Linking Algorithm

For the reporting year, did your PDMP change its algorithm for how it aggregates or links patients?

Yes (Explain) _______________________________________________________________

No

Data Comments

Please provide any additional information that would be useful in understanding the PDMP data you have provided related to opioid prescribing practices. Please note any changes that might have affected data quality for the reporting year and any changes to the algorithm to aggregate or link patients.

Data	Additional Information
PDMP indicators for opioid prescribing patterns	Free text

2. Prescriber Use of PDMP (PDMP data)

Here, you will enter the data to measure prescriber use of PDMP. If relevant to your jurisdiction, you may also report on the number of pharmacists registered with the PDMP.

Prescriber Use of PDMP

Required Indicators for Prescribers
Total number of prescribers who prescribed a schedule II–IV controlled substance during this annual reporting period, based on PDMP data (Denominator)
Total number of prescribers registered with the PDMP
Total number of prescribers (or their delegates) who queried the PDMP
Total number of queries by prescribers (or their delegates) to PDMP
Optional Indicator for Pharmacists/Dispensers
Total number of pharmacists registered with the PDMP
Total number of licensed pharmacists in the state (Denominator)

Data Comments

Please provide any additional information that would be useful in understanding the PDMP data you have provided related to prescriber use of PDMP. Please note any changes that might have affected data quality for the reporting year.

Data	Additional Information
Prescriber/dispenser use of PDMP	Free text