Category: Federal Forum Posters
Purpose: More than 20 percent of veterans currently prescribed stimulants through the Veterans Health Administration have a documented substance use disorder (SUD), less than 50 percent have an annual urine drug screen, and greater than 10 percent are co-prescribed opioids and benzodiazepines. There are currently no protocols, prescribing restrictions, or required monitoring parameters in place for prescription stimulant use within the Lexington VA Health Care System. The purpose of this study is to evaluate the local prescribing practices of stimulants and identify areas of opportunity in the prescribing and monitoring of this drug class.
Methods: This is a single-center quality improvement project evaluating the prescribing practices of stimulants within a VA Health Care System. Veterans will be included if they were prescribed a stimulant through the VA between January 1, 2018 and June 30, 2018, however their entire stimulant use history will be assessed. Data to be collected includes: age, gender, current stimulant regimen, indication and duration of use, prescriber name and specialty, prescribing origin of initial stimulant medication, and if stimulant use predated military service. Monitoring of stimulant use will be assessed via urine drug screens, controlled substance monitoring database, and time between follow up appointments. Deployment history, mental health diagnoses, Post Traumatic Stress Disorder assessment prior to initiation, Attention Deficit (Hyperactivity) Disorder assessment if applicable, documented SUD or stimulant misuse, and concomitant Central Nervous System (CNS) depressant use will also be collected. CNS depressants evaluated are those that have abuse potential or significant psychotropic effects and include benzodiazepines, antipsychotics, opioids, gabapentin, z-hypnotics, and muscle relaxants. This information will be compiled and evaluated with the intent of identifying opportunities for improvement in the prescribing practices and monitoring of stimulant medications.
Results: Not applicable
Conclusion: Not applicable
Caroline Barnard– PGY2 Psychiatric Pharmacy Resident, Lexington Veterans Affairs Medical Center, Lexington, KY