title: Surveillance of methadone-related adverse drug events using multiple public health data sources.
abstract: Healthcare safety and quality surveillance is increasingly conducted by public health agencies. We describe a biomedical informatics method that uses multiple public health data sources to perform surveillance of methadone-related adverse drug events. Data from Utah medical examiner records, vital statistics, emergency department encounter administrative data and a database of controlled substances prescriptions are used to examine trends in state-wide adverse events related to methadone. From 1997 to 2004, population-adjusted methadone prescriptions increased 727%, with evidence to suggest the rise in the methadone prescription rate is for treatment of pain, not addiction therapy. During the same period of time, population adjusted, accidental methadone-related deaths in medical examiner data increased 1770%. Population adjusted methadone-related emergency department encounters rose 612% from 1997 to 2003. Our results suggest that the increase in methadone prescription rates from 1997 to 2004 was accompanied by a concurrent increase in methadone-related morbidity and mortality. Although patient data is not linked between data sources, our results demonstrate that utilizing multiple public health data sources captures more cases and provides more clinical detail than individual data sources alone. Our approach is a successful biomedical informatics approach for surveillance of adverse events and utilizes widely available public health data sources, as well as an emerging source of public health data, controlled substance prescription registries.
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84112 5750, USA. shannon.sims@hsc.utah.edu
authors.forename: Shannon A
authors.initials: SA
authors.lastname: Sims
authors.forename: Laverne A
authors.initials: LA
authors.lastname: Snow
authors.forename: Christina A
authors.initials: CA
authors.lastname: Porucznik
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D003644:Death Certificates; D062787:Drug Overdose; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008691:Methadone / Q000506:poisoning*; D009026:Mortality; D012042:Registries; D016019:Survival Analysis; D014589:Utah / Q000453:epidemiology
chemical_list: D008691:Methadone