Conduct a nationwide epidemiological study of Rx drug diversion for non-medical u

描述（由申请人提供）：Abt联合公司提出了一个为期两年的项目，旨在制定和实施一项正在进行的Rx药物转移监测计划，该计划将提供2008年国家和地方各级的流行病学数据。主要目的将是估计零售药房转移25种不同的受管制处方药的情况，其中大多数都在附表中，并且已知被滥用。将对将这些药物转用于非医疗用途的个人人数、所涉及的处方数量、这样转用于的药物数量（分别以剂量单位和天数计算）以及转用于每种特定药物的所有已分发处方的比例作出估计。将这些估计值与美国人口普查的人口数据相结合，将开发出25种药物在几个层面上的患病率（每10万居民）：国家、地区、州、县、镇/市，如果有意义的话，在次城市层面。还将编制其他地理区域的估计数，例如农村/城市/郊区和最大的20个大都市地区。来自2000年美国人口普查的社会经济数据将用于描述这些不同地理区域的人口特征，并将检查患病率与这些背景特征之间的关系。这将提供一种手段，对全国不同地区和不同人口亚群中处方药转移的流行情况进行细致的分析。这项研究将利用为市场研究目的而开发的专有数据集，这些数据集是独一无二的，因为有关处方、患者、药店和开处方的医生的信息已经通过符合hipaa的程序联系在一起。将开发计算机算法来挖掘这些数据，以寻找可疑模式——患者/处方者/处方者/药房特征的组合——指示转移。由此得出的患病率估计值将与其他调查和监测项目中报告的药物使用估计值进行比较。除了制定2008年的预算外，该项目还将为正在进行的监测计划奠定基础（这将需要单独的资金）。与患者相关的数据可追溯到2001年，并可在随后添加。展望未来，可以根据不断增加的数据，以年度为基础开发患病率估计，并且该计划可以扩展到包括其他处方药。因此，该平台将为科学界提供丰富的数据集和强大的分析工具，以研究全国各地和长期的处方药转移和滥用。

DESCRIPTION (provided by applicant): Abt Associates Inc. proposes a two-year project to develop and implement an ongoing Rx Drug Diversion Surveillance Program that will provide epidemiological data at the national and sub-national levels for 2008. The principal aim will be to estimate the diversion from retail pharmacies of 25 different controlled prescription drugs, most of which are scheduled and are known to be abused. Estimates will be developed of the numbers of individuals diverting these drugs for non-medical use, the numbers of prescriptions involved, the amounts of drugs so diverted (measured in dosage units and, separately, days supply), and the proportions of all dispensed prescriptions of each specific drug that are diverted. Combining these estimates with population data from U.S. census, prevalence rates (per 100,000 residents) will be developed for each of the 25 drugs at several levels: national, regional, state, county, town/city and, where meaningful, at the sub- city level. Estimates will also be developed for other geographical areas, such as rural/urban/suburban areas and largest 20 metropolitan areas. Socio-economic data from the 2000 U.S. census will be used to characterize the populations in these various geographical areas, and the relationships among prevalence rates and these contextual characteristics will be examined. This will provide a means for fine-grained analyses of the prevalence of prescription drug diversion in various areas of the nation and in various population subgroups. The study will exploit proprietary datasets developed for market research purposes, which are unique because information about prescriptions dispensed, patients, pharmacies, and prescribing physicians have been linked by means of HIPAA-compliant procedures. Computer algorithms will be developed to mine these data in search of suspicious patterns-combinations of patient/prescriber/prescription/pharmacy characteristics-indicative of diversion. Prevalence estimates so derived will be compared to estimates of drug use reported in other surveys and monitoring programs. In addition to developing estimates for 2008, the project will lay the foundation for an ongoing surveillance program (which will require separate funding). Patient-linked data are available back to 2001 and could be added subsequently. Going forward, prevalence estimates could be developed on an annual basis with continuously augmented data, and the program could be expanded to include other prescription drugs. This platform would therefore provide the scientific community with a rich dataset and powerful analytic tools to study diversion and misuse of prescription drugs throughout the nation and over time. PUBLIC HEALTH RELEVANCE: This two-year study and the ongoing surveillance program will support improvements in public health and health care delivery. Public investments in treatment capacity depend in part upon accurate estimation of trends in substance misuse at local levels, and more accurate estimates of diverted prescription drugs in these local illicit markets may improve these resource allocation decisions.