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<ul><li>Participants reported:  </li></ul><ul><li>137 cases of concurrent use of other Rx drugs.  286 cases of concurrent ...
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Poster Concurrent Drug Use In Mmt 08 14 09

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Poster presentation on concurrent drug use among clients in methadone maintenance treatment

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Poster Concurrent Drug Use In Mmt 08 14 09

  1. 1. <ul><li>Participants reported: </li></ul><ul><li>137 cases of concurrent use of other Rx drugs. 286 cases of concurrent use of non-Rx drugs </li></ul><ul><li>Women reported taking twice as many concurrent Rx drugs as men. </li></ul><ul><li>Most frequently prescribed drugs were SSRI antidepressants, benzodiazepines, and other opioids. </li></ul><ul><li>40% of women and 23% of men were taking Rx medicines that have been associated with the development of LQTS. </li></ul><ul><li>Of those taking concurrent Rx drugs, 81% said their medical provider was aware they were MMT clients, but only 32% said they discussed taking other Rx drugs with their provider. </li></ul><ul><li>Of those taking non-Rx drugs, 17% said they discussed non-Rx drug use with their health care provider, and 47% said they discussed non-Rx drug use with their case manager. </li></ul>We thank Richard Poppy, MA, LISAC, and the staff at La Frontera HOPE Center for making this research possible. This research is funded y grant #U18 HS 10385-05 from the US Agency for Healthcare Research and Quality Concurrent Drug Use That May Affect Heart Health in MMT Clients Klaus Romero MS, MD, Mary Brown PhD, Rowan Frost MPH, CHES, Raymond Woosley MD, PhD Arizona Center for Education & Research on Therapeutics BACKGROUND Methadone has the potential to affect heart rhythm by lengthening the QT interval of the heart beat. A prolonged QT interval is associated with a rare heart arrhythmia, torsade de points (TdP) that may lead to sudden death. Prolonged QT can only be diagnosed by an electrocardiogram (ECG), but clients beginning methadone maintenance treatment do not routinely received ECGs. Risk factors for prolonged QT include concurrent use of multiple prescription medicines and other non-prescribed drugs that also can induce TdP. STUDY AIMS STUDY METHODS <ul><li>Participants were 30 men and 30 women in their first year of MMT, between age 18 and 65 years, and able to speak and understand English. </li></ul><ul><li>Participants were interviewed by a trustworthy researcher in a private room at the clinic during dispensing hours. </li></ul><ul><li>Information from participants was confidential and not shared with MMT clinic staff. </li></ul><ul><li>Participants received a $10 gift card to Target, which does not sell alcohol. </li></ul>Participant Characteristics Acknowledgements Research Poster Design Services CONCLUSIONS Contact information <ul><ul><ul><ul><li>Both men and women reported frequent use of other prescription and non-prescription drugs, including QT-prolonging drugs. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Discussion with medical professionals about taking methadone along with other drugs is rare, placing MMT clients at potential risk for adverse drug interactions, including those associated with development of LQTS. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>If these findings are supported in other studies, the following practices may help reduce the risk of sudden death due to TdP among susceptible MMT clients: </li></ul></ul></ul></ul><ul><ul><ul><ul><li>MMT staff training </li></ul></ul></ul></ul><ul><ul><ul><ul><li>targeted client education </li></ul></ul></ul></ul><ul><ul><ul><ul><li>ECGs in the first 2 weeks of methadone treatment </li></ul></ul></ul></ul>The aims of this study were 1. To compare the use of other prescription and nonprescription drugs that may affect cardiac health among men and women in their first year of MMT, and 2. To obtain information about other drugs used in combination with methadone in order to reduce the risk of adverse drug events affecting heart health among first year MMT clients. Background: Methadone has the potential to affect heart rhythm by lengthening the QT interval, resulting in acquired long QT syndrome (LQTS). LQTS is associated with a rare heart arrhythmia, torsade de pointes (TdP) that may lead to sudden death. LQTS can only be diagnosed by an ECG, but opiate dependent clients beginning methadone maintenance treatment (MMT) in community clinics do not routinely receive ECGs. Risk factors for LQTS include concurrent use of multiple prescription medications that also can induce TdP. The study aim was to obtain information about concurrent prescription and nonprescription drug use to improve scientific understanding and educational strategies for reducing the risk of adverse drug events affecting cardiac functioning among men and women in their first year of MMT. Providers’ knowledge of, and discussion about, clients taking methadone and other drugs, by sex RESULTS www.azcert..org Mary Brown, PhD Arizona CERT Critical Path Institute 1730 E River Rd Ste 200 Tucson, AZ 85718 www.azcert.org Women (n=30) Men (n=30) Total (N=60) Mean age (SD) 39.7 (9.2) 41.2 (10.5) 40.5 (9.8) Demographic Characteristics Count (%) Count (%) Count (%) Age range (years) 20-35 36-45 46 and above 9 (30.0) 13 (43.3) 8 26.7) 7 (23.3) 10 (33.3) 13 (43.3) 16 (26.6) 23 (38.3) 21 (35.0) Ethnicity/Race Hispanic White Native American African American Other 13 (43.3) 14 (46.7) 2 (6.7) 0 (0) 1 (3.3) 12 (40.0) 13 (43.3) 2 (6.7) 3 (10.0) 0 (0) 25 (41.7) 27 (45.0) 4 (6.7) 3 (5.0) 1 (1.7) Education Some high school High School/GED Some college College Degree 12 (40.0) 7 (23.3) 8 (26.7) 3 (10.0) 9 (30.0) 12 (40.0) 7 (23.3) 2 (6.7) 21 (35.0) 19 (31.7) 15 (25.0) 5 (8.3) Primary Payer Medicaid Other 28 (93.3) 2 (6.7) 27 (90.0) 3 (10.0) 55 (91.7) 5 (8.3) First MMT Encounter 12 (40.0) 6 (20.0) 18 (30.0) Women (n=20) Men (n=17) Total (N=37) Count (%) Count (%) Count (%) Other prescribers knew about participant’s MMT status 17 (85.0) 13 (76.5) 30 (81.1) Provider discussed taking methadone and other Rx, by type MD, RN or NP 7 (35.0) 5 (29.4) 12 (32.4) Pharmacist 3 (15.0) 2 (11.8) 5 (13.5) MMT Case Manager 4 (20.0) 2 (11.8) 6 (16.2) Women (n=30) Men (n=30) Total (N=60) Provider discussed taking methadone and other non-Rx drugs, by type MD, RN or NP Pharmacist MMT Case manager 6 (20.0) 0 (0.0) 11 (36.7) 4 (13.3) 0 (0.0) 17 (56.7) 10 (16.7) 0 (0.0) 28 (46.7)

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