Drug Safety (SC)

Improving medication use systems, reducing adverse drug events and developing innovative assessment and intervention resources

CDC's Guideline for Prescribing Opioids for Chronic Pain

The Carolinas Center for Medical Excellence (CCME) serves as the Quality Innovation Network – Quality Improvement Organization (QIN-QIO) for South Carolina. CCME, a member of the Atlantic Quality Innovation Network (AQIN), partners with providers, stakeholders, patients and caregivers to create healthier communities. CCME collaborates with the QIO of New York and District of Columbia (DC) to meet our objectives.

In our current scope of work, we are tasked with reducing Adverse Drug Events (ADE) in our communities through improving medication safety and enhancing the patient’s coordination of care across disciplines.

Our goals:

  • Achieve a 35% relative improvement rate per 1,000 patients screened by the year 2019.
  • Monitor ADE rates on anticoagulant, diabetic, and opioid agents by care setting, region and readmission rate.

We are proud to have these South Carolina pharmacy leaders serving on our Pharmacy Advisory Committee:

  • Craig Burridge , Chief Executive Officer -  SC Pharmacy Association (SCPhA)
  • Ed Vess RPh, Senior Manager/Market Analysts & Rx Care Plus Pharmacy, Roebuck (QS/1 SharpRx alpha test site) - QS/1 Data Systems
  • Kayce M. Shealy PharmD, Interim Chair and Associate Professor, Department of Pharmacy Practice & Director, Innovation and Entrepreneurship – Presbyterian College School of Pharmacy
  • Morgan B. Adams  PharmD, Ambulatory Clinical Pharmacist @ Advanced Heart Health Center – Palmetto Health Richland
  • Niki Pappos-Elledge PharmD, Health Care Supervisor – Walgreen Company
  • P. Brandon Bookstaver PharmD,  Associate Professor Department of Clinical Pharmacy & Outcomes Sciences, Infectious Diseases PGY2 & Clinical Fellowship Director - USC/Palmetto Health
  • Lori Dupree PharmD, President of the SC Chapter of American Society of Consultant Pharmacists (SCASCP)

Community of Practice
The following forums, containing discussions and resources:

CDC Guideline for Prescribing Opioids for Chronic Pain.

The CDC will provide education and training opportunities to assist providers in implementing the CDC Guideline for safe chronic pain and opioid practices. Accordingly, the CDC will host a seven-part webinar series about the Guideline, that begins on Wednesday, June 22nd at 2:00 pm EDT.

The first webinar will provide an overview of the CDC recommendations. Providers will learn when and how opioids should be initiated for chronic pain, how to assess risk and address harms of opioid use, and when and how opioids should be discontinued. Subsequent modules will touch upon the various recommendations in the Guideline. Each one-hour webinar will be available as a live webinar broadcast and as an archived recording following the live webinars. The webinars are free and offer continuing education credit to physicians, nurses, pharmacists, health educators, and other healthcare providers.

The first four webinars are currently scheduled with the others to follow later this year:

 June 22, 2016

2:00 -3:00 pm EDT

Webinar 1 Overview of the CDC Guideline for Prescribing Opioids for Chronic Pain (Addressing Recommendations 1-12)
July 27, 2016 Webinar 2

Non-opioid treatments 

(Addressing Recommendation 1)

August 3, 2016 Webinar 3

Assessing benefits and harms of opioid therapy 

(Addressing Recommendations 1, 2, 7, 8)

August 17, 2016 Webinar 4

Dosing and titration of opioids 

(Addressing Recommendations 4, 5, 7)

You can learn more about this event here.
If unable to join webinars on the dates, program content and CE are available – see below.
Continuing Education for COCA Calls/Webinars

The purpose of COCA continuing education opportunities is to increase clinicians’ knowledge and competencies of threats to the public’s health, their effects on human populations and evaluation and management strategies of these threats. COCA continuing education is free.

Browse available COCA Calls
How to earn continuing education (CE):

    1. Go to the CDC Training & Continuing Education Online System.
    2. Log in as a participant. If this is your first visit, you will need to register and establish a login name and password
    3. Click on “Search and Register”
    4. Under “keyword search” find the course you are interested in by entering:
      • “WC2286” for calls hosted in last 30 days
      • “WD2286” for calls hosted past 30 days
    5. Select your course
    6. Complete evaluation
    7. Pass posttest at 50%
    8. Print your CE certificate

If you cannot participate in the live COCA Call/Webinar, you can still get CE!

ACCREDITATION STATEMENTS:
CME:The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Continuing Medical Education (ACCME®) to provide continuing medical education for physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Centers for Disease Control and Prevention designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CNE:The Centers for Disease Control and Prevention is accredited as a provider of Continuing Nursing Education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity provides 1.0 contact hour.

CEU:The Centers for Disease Control and Prevention is authorized by IACET to offer 0.1 CEU's for this program.

CECH:Sponsored by the Centers for Disease Control and Prevention, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to total 1.0 total Category I continuing education contact hours. Maximum advanced level continuing education contact hours available are 0. CDC provider number 98614.

CPE:The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This program is a designated event for pharmacists to receive 0.1 CEUs in pharmacy education. The Universal Activity Number is 0387-0000-00-000-000-0 and enduring 0387-0000-00-000-000-0.

This program has been designated knowledge based.

Once credit is claimed, an unofficial statement of credit is immediately available on TCEOnline. Official credit will be uploaded within 60 days on the NABP/CPE Monitor.

CPH:The Centers for Disease Control and Prevention is a pre-approved provider of Certified in Public Health (CPH) recertification credits and is authorized to offer 1.0 CPH recertification credits for this program.

CDC is an approved provider of CPH Recertification Credits by the National Board of Public Health Examiners. Effective October 1, 2013, the National Board of Public Health Examiners (NBPHE) accepts continuing education units (CEU) for CPH recertification credits from CDC. Please select CEU as your choice for continuing education when registering for a course on TCEOnline. Learners seeking CPH should use the guidelines provided by the NBPHE for calculating recertification credits. For assistance please contact NBPHE at http://www.NBPHE.org.

AAVSB/RACE:This program was reviewed and approved by the AAVSB RACE program for 1.0 hours of continuing education. Participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education. Please contact the AAVSB RACE program at race@aavsb.org if you have any comments/concerns regarding this program’s validity or relevancy to the veterinary profession.

Resources

Medication Safety:

Polypharmacy
Polypharmacy: Strategies for Reducing the Consequences of Multiple Medications
By Robert C. Accetta, RPh, C-MTM, CGP
Today's Geriatric Medicine 2016 Vol. 9 No. 3 P. 2
Conducting medication reconciliations at care transitions, eliminating duplicate medications, assessing for drug-drug interactions, and reviewing dosages can reduce the incidence of polypharmacy, ensure patient safety, reduce hospitalizations, and decrease associated costs.
http://www.todaysgeriatricmedicine.com/archive/MJ16p24.shtml

Rational Prescribing
DCRx: The DC Center for Rational Prescribing
http://gwcehp.learnercommunity.com/dcrx
Available Modules - 
Rational Prescribing for Older Adults (1.0 Credit)
This module reviews the consequences of multiple medication drug use in older adults, discusses misconceptions regarding the treatment of Type II diabetes, describes the role of pharmacologic and nonpharmacologic treatments for agitation and insomnia, outlines the process for deprescribing, and encourages a team approach to medication review.
Medical Cannabis: An Introduction to the Biochemistry & Pharmacology (1.0 Credit)
This module discusses the pharmacology of major cannabinoids in Cannabis species, and the quality assessment, modes of administration, and common formulations of medical cannabis. The endocannabinoid system will also be discussed.
Medical Cannabis: Evidence on Efficacy (1.0 Credit)
This module summarizes the state of the evidence and provides clinical perspective on the use of medical cannabis and cannabinoids for treating chronic and acute pain, cancer care, nausea/vomiting, neurologic conditions, glaucoma, and psychiatric conditions.
Medical Cannabis: Adverse Effects and Drug Interactions (1.0 Credit)
This module provides evidence-based information on the safety profile of medical cannabis. Topics include common contraindications, adverse effects, and drug interactions. Specific effects on the respiratory, cardiovascular, immune, neuropsychiatric, reproductive, and other organ systems will be discussed.
Drug Approval and Promotion in the United States (1.0 Credit)
This module describes the United States drug approval process from pre-clinical trials to post-marketing surveillance, regulation of drug advertising and promotion, adverse event surveillance, and how to report adverse drug events and misleading advertising to FDA.
Generic Drugs: Myths and Facts (1.0 Credit)
This module describes the standards the FDA uses to approve generic drugs; differences and similarities between branded and generic drugs; the difference between generic drugs and generic drug names; bioequivalence, patent extension techniques, and common myths about generic drugs.
Additional modules will be available in 2016.

Medication Adherence
Medication Adherence Marie T. Brown, MD, FACP Rush Medical College
How will this module help me successfully identify and prevent medication nonadherence in my practice?

    • Eight steps to improve medication adherence
    • Answers to common questions about how to involve staff and patients in identifying nonadherence and changing behaviors

https://www.stepsforward.org/modules/medication-adherence

If you are interested in participating in Community Coalitions to reduce Adverse Drug Events or if you have any questions, please contact our Medication Safety Pharmacist, Cheryl A Anderson RPh at Cheryl.Anderson@area-I.hcqis.org or 803-212-7560.

We value our QIN-QIO designation by Centers for Medicare and Medicaid Services and the opportunity it affords us to assist our colleagues in their work across all health care settings in South Carolina.

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South Carolina
Cheryl Anderson, Medication Safety Pharmacist
803-212-7560
Cheryl.Anderson@area-I.hcqis.org