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B. Identify/monitor high-risk patients

WHY: If physicians are able to identify patients that are of high-risk for misuse or illegal use of prescription stimulants, they can closely monitor and limit access to such medications.

Predictive Data Modeling

Identifying risk factors and protective factors that increase or decrease the odds of a patient misusing prescription stimulant medications can be modeled for individual patients.

Currently

Substance Abuse and Mental Health Services Administration (SAMHSA) has identified various risk (and protective) factors for high-risk misuse patients:

  • Individual-level factors
  • Relationship-level factors
  • Community-level factors
  • Societal-level factors

Individual-Level Risk Factors

  • History of mental illness
  • Acute and chronic pain
  • Physical health problems
  • Heightened physiological reaction to certain types of drugs

Relationship-Level Risk Factors

  • Witnessed a family member overdose
  • Have accessed stimulants for the first time in their homes
  • Friends/social networks
  • Parents expressing approval of drug misuse

Community-Level Risk Factors

  • Moving 3+ times in the past year
  • Living in an urban environment
  • Community norms

Societal-Level Risk Factors

  • Discriminatory practices towards underrepresented or marginalized individuals

More detailed information on factors can be found here.

While strides have been made to identify risk and protective factors for increased prescription stimulant misuse, researchers need to apply these factors to a predictive model that is integrated with patients’ EHR data to identify whether or not that patient is at high-risk for misusing.

There is also encouragement to focus on identifying more risk and protective influences at the community and societal levels. This would provide a more holistic perspective of misuse and place less emphasis on the individual and relationships levels.

 

Note: Image from Real Time Medical Systems