Prevalence of substance misuse in new patients in an outpatient psychiatry clinic using a prescription monitoring program.

OBJECTIVE: To investigate the value of a prescription monitoring program in identifying prescription drug misuse among patients presenting to a resident physician outpatient psychiatry clinic at an academic medical center. METHOD: Participants were 314 new patients aged 18 years or older presenting to the clinic from October 2011 to June 2012. Resident physicians completed a data collection form for each participant using information from the patient interview and from the prescription monitoring program report. Prescription drug misuse was defined as having any 1 of the following 5 criteria in the prescription monitoring program report: (1) filled prescriptions for 2 or more controlled substances, (2) obtained prescriptions from 2 or more providers, (3) obtained early refills, (4) used 3 or more pharmacies, and (5) the prescription monitoring program report conflicted with the patient's report. RESULTS: At least 1 indicator of prescription drug misuse was found in 41.7% of patients. Over 69% of the patients that the residents believed were misusing prescription drugs actually met 1 of the criteria for prescription drug misuse. The prescription monitoring program report changed the management only 2.2% of the time. Patients with prior benzodiazepine use (χ(2) 1 = 17.68, P < .001), prior opioid use (χ(2) 1 = 19.98, P < .001), a personality disorder (χ(2) 1 = 7.22, P < .001), and chronic pain (χ(2) 1 = 14.31, P < .001) had a higher percentage of prescription drug misuse compared to patients without these factors. CONCLUSION: Using the prescription monitoring program to screen patients with prior benzodiazepine and opioid use, with a personality disorder, and/or with chronic pain may be useful in confirming the suspicion of prescription drug misuse identified at the initial evaluation.

Do "clicker" educational sessions enhance the effectiveness of a social norms marketing campaign?

OBJECTIVE: social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a "standard" social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology ("clickers"). METHODS: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. RESULTS: the authors find "clicker" technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. CONCLUSION: poster SNM campaigns may be most effective when supported by group "clicker" heath-related sessions.