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North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective
BACKGROUND: The misuse and abuse of prescription opioids have become an urgent health issue in North Carolina (NC), particularly among Medicaid patients who suffer high rates of morbidity and mortality due to abuse and overdose. The NC Division of Medical Assistance (DMA) implemented a recipient man...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Academy of Managed Care Pharmacy
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833956/ https://www.ncbi.nlm.nih.gov/pubmed/25351973 http://dx.doi.org/10.18553/jmcp.2014.20.11.1122 |
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author | Werth, S. Rose Sachdeva, Nidhi Roberts, Andrew W. Garrettson, Mariana Ringwalt, Chris Moss, Leslie A. Pikoulas, Theodore Skinner, Asheley Cockrell |
author_facet | Werth, S. Rose Sachdeva, Nidhi Roberts, Andrew W. Garrettson, Mariana Ringwalt, Chris Moss, Leslie A. Pikoulas, Theodore Skinner, Asheley Cockrell |
author_sort | Werth, S. Rose |
collection | PubMed |
description | BACKGROUND: The misuse and abuse of prescription opioids have become an urgent health issue in North Carolina (NC), particularly among Medicaid patients who suffer high rates of morbidity and mortality due to abuse and overdose. The NC Division of Medical Assistance (DMA) implemented a recipient management lock-in program, which limits identified patients for a 12-month period to 1 prescriber and 1 pharmacy for benzodiazepine, opiate, and certain anxiolytic prescriptions in order to prevent misuse and reduce overutilization of Medicaid benefits. OBJECTIVES: To (a) evaluate pharmacists’ perceptions of the implementation of the NC recipient management lock-in program (MLIP) and (b) determine how the beliefs and attitudes of pharmacists could promote or inhibit its success. METHODS: We conducted 12 structured phone interviews with NC pharmacists serving lock-in patients. Interview responses were analyzed through construct analysis, which identified themes organized into 3 domains: organization and implementation, perceived effectiveness, and acceptability. RESULTS: Most respondents reported a positive experience with the program but expressed doubt concerning its impact on prescription drug abuse. The program successfully utilized the pharmacist role as a gatekeeper of controlled substances, and the procedures of the program required no active effort on pharmacists’ part. However, respondents suggested that the DMA improve communication and outreach to address pharmacists’ lack of knowledge about the program’s purpose and confusion over remediating problems that arise with lock-in patients. The DMA should also address the ways in which the program can interfere with access to health care and treatment, allow patients to see multiple physicians within the same clinic, and clarify procedures for patients whose complex health issues require multiple specialists. CONCLUSIONS: Although possible improvements were identified, the NC MLIP has strong potential for success as it utilizes pharmacists’ medication gate-keeping role, while minimizing the effort required for successful implementation. |
format | Online Article Text |
id | pubmed-6833956 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Academy of Managed Care Pharmacy |
record_format | MEDLINE/PubMed |
spelling | pubmed-68339562019-11-06 North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective Werth, S. Rose Sachdeva, Nidhi Roberts, Andrew W. Garrettson, Mariana Ringwalt, Chris Moss, Leslie A. Pikoulas, Theodore Skinner, Asheley Cockrell J Manag Care Pharm Research BACKGROUND: The misuse and abuse of prescription opioids have become an urgent health issue in North Carolina (NC), particularly among Medicaid patients who suffer high rates of morbidity and mortality due to abuse and overdose. The NC Division of Medical Assistance (DMA) implemented a recipient management lock-in program, which limits identified patients for a 12-month period to 1 prescriber and 1 pharmacy for benzodiazepine, opiate, and certain anxiolytic prescriptions in order to prevent misuse and reduce overutilization of Medicaid benefits. OBJECTIVES: To (a) evaluate pharmacists’ perceptions of the implementation of the NC recipient management lock-in program (MLIP) and (b) determine how the beliefs and attitudes of pharmacists could promote or inhibit its success. METHODS: We conducted 12 structured phone interviews with NC pharmacists serving lock-in patients. Interview responses were analyzed through construct analysis, which identified themes organized into 3 domains: organization and implementation, perceived effectiveness, and acceptability. RESULTS: Most respondents reported a positive experience with the program but expressed doubt concerning its impact on prescription drug abuse. The program successfully utilized the pharmacist role as a gatekeeper of controlled substances, and the procedures of the program required no active effort on pharmacists’ part. However, respondents suggested that the DMA improve communication and outreach to address pharmacists’ lack of knowledge about the program’s purpose and confusion over remediating problems that arise with lock-in patients. The DMA should also address the ways in which the program can interfere with access to health care and treatment, allow patients to see multiple physicians within the same clinic, and clarify procedures for patients whose complex health issues require multiple specialists. CONCLUSIONS: Although possible improvements were identified, the NC MLIP has strong potential for success as it utilizes pharmacists’ medication gate-keeping role, while minimizing the effort required for successful implementation. Academy of Managed Care Pharmacy 2014-11 /pmc/articles/PMC6833956/ /pubmed/25351973 http://dx.doi.org/10.18553/jmcp.2014.20.11.1122 Text en Copyright © 2014, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Research Werth, S. Rose Sachdeva, Nidhi Roberts, Andrew W. Garrettson, Mariana Ringwalt, Chris Moss, Leslie A. Pikoulas, Theodore Skinner, Asheley Cockrell North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective |
title | North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective |
title_full | North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective |
title_fullStr | North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective |
title_full_unstemmed | North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective |
title_short | North Carolina Medicaid Recipient Management Lock-In Program: The Pharmacist’s Perspective |
title_sort | north carolina medicaid recipient management lock-in program: the pharmacist’s perspective |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6833956/ https://www.ncbi.nlm.nih.gov/pubmed/25351973 http://dx.doi.org/10.18553/jmcp.2014.20.11.1122 |
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