PHARMACIST STEVE

It would seem that the bureaucrats in KENTUCKY have decided to get the state in line with George Orwell’s novel “1984”..  Perhaps those with documented CYP450 fast/ultra fast metabolizer of opiates may have to move out of the state to get adequate pain management.  KASPER is the state’s Prescription Monitoring Program (PMP).  Since the medications they are monitoring are the medications that are typically used by those suffering from subjective diseases (pain, depression, anxiety, ADD/ADHD, mental health)… Could this be discrimination against a subset of patients that are covered under the Americans with Disability Act.. and could be unconstitutional ?

https://ekasper.chfs.ky.gov/whatsnew/whatsnew.htm

eKasper 15.11 Release – December 2015

1.)  Information regarding a patient’s MED (Morphine Equivalent Dose) has been added to the Patient Controlled Substance Report (for prescriber and pharmacist user groups).

1. A new column titled Daily MED has been added to the report that reflects the translation of the potencies of each opioid prescribed to the patient to a standard morphine equivalent dose.
2. In the right-side header of the first page of the report, an ACME (Active Cumulative Morphine Equivalent) score will display if a patient has active prescriptions for opioids. The calculation for the ACME is a snapshot based on the “To Date” that was used when requesting the report. The ACME calculation does not include the entire date range of the report. The score will be ‘0’ if there were no active opioid prescriptions as of the “To Date” for the report request. If the ACME is 100 or greater, an exclamation point in a triangle appears next to the number. This is a caution that increased clinical vigilance may be appropriate for the patient. Please note: the ACME and Daily MED calculations are based on prescriptions reported to eKASPER only. No prescription records received from other states will be included in the Daily MED or ACME calculations.
3. A graph of the Daily MED for the date range of the report will display in the header of the report. The graph depicts the Daily MED level overlaid on a 100 MED comparison index.
4. The ACME box and graph will not display if the patient has “No records found”.
5. All prescription records (opioid and non-opioid) that are active as of the “To Date” of the report will be displayed in bold text.
6. An ACME value from 0 to 100 on the first page will populate information regarding the ACME and Daily MED calculations on the last page of the report. An ACME value of 100 or greater will result in the inclusion of information regarding naloxone prescribing on the last page of the report as well. If a patient report returned zero records, no information regarding ACME, Daily MED or Naloxone will display.

2.) Prescriber Master Account Holders can now request a Prescriber Peer Review Report. The Peer Review Report provides a comparison of the Master Account Holder’s prescribing versus prescribers statewide and prescribers in the same Area of work (specialty area). In the Administration screen (below the Prescribing Report Request section), the Peer Review Report can be requested by clicking on the View Peer Review Report button. The Area of work defaults to the practitioner’s specialty found in the Area of work on the Account Maintenance screen. Prescribers may request the report for comparison with a different specialty by clicking on the drop-down arrow and selecting from the list provided. NOTE: some areas of work have been combined into a single specialty (e.g., the Primary Care specialty includes the Family Practice, Hospitalist and Internal Medicine Areas of work. All specialties for APRN users are included in the Nurse Practitioner Area of work).

To view the report, click the View Peer Review Report button. The report will provide prescribing comparison data for the benzodiazepine, opioid, sedative and stimulant drug classes. The report is a compilation of the last 90 days from the current date. The user will not be able to specify a different date range for the Peer Review Report. Changing the date range in the Prescribing Report Request (reverse KASPER) section will not change the date range of the Peer Review Report Request. The selected specialty is displayed at the top of the report, and the comparison data is included in tabular and chart formats for both the number of prescriptions written and number of doses prescribed.

Filed under: General Problems