Objectives: Addiction to prescription narcotics is a global issue, and detecting individuals with narcotic use disorder (NUD) at an early stage can help prevent narcotics misuse and abuse. We developed a novel index for the early detection of NUD based on an analysis of real-world prescription patterns in a large hospital.

Methods: We analyzed the narcotic prescriptions of 221,887 patients, prescribed by 8,737 doctors from July 2000 to June 2018. To facilitate the early detection of patients at risk of developing NUD after a prolonged period of narcotic use, we developed a weighted morphine equivalent daily dose (wt-MEDD) score. This score was based on the number of prescription dates where the actual MEDD exceeded the intended MEDD. We compared the performance of the wt-MEDD scoring system in identifying patients diagnosed with NUD by doctors against other high-risk NUD indices. These indices included the MEDD scoring system, the number of days on prescribed narcotics, the frequency and duration of prescriptions, narcotics prescriptions from multiple doctors, and the number of early narcotic refills.

Results: A wt-MEDD score cut-off value of 10.5 successfully identified all outliers and diagnosed patients with NUD with 100% sensitivity and 99.6% specificity. This score demonstrated the highest sensitivity and specificity for detecting NUD compared to all other indexes. The predictive performance was further improved by combining the wt-MEDD score with other high-risk NUD indexes.

Conclusion: We developed a novel index, the wt-MEDD score, which showed excellent performance in the early detection of NUD.

ABSTRACT

In response to the changes in the Coronavirus disease 2019 (COVID-19) epidemic situation, Ewha Womans University established Ewha Safe Campus (ESC), an on-campus infection outbreak management system, to allow students and faculty members to safely resume face-to face classes in 2022. The COVID-19 testing station, Ewha Safe Station, is the core element of ESC. Symptomatic students and faculty members perform a combo swab self-PCR test or receive a nasopharyngeal swab PCR test from experts to prevent the spread of COVID-19 through early detection and management. ESC is significant in that it detects infection risks and proactively implements preemptive measures in a university. The COVID-19 health response system model at the university level was applied for the first time in South Korea, reaching a milestone in the history of university health in South Korea. In particular, it is highly valuable that the test was free of charge, as it enabled all of the examinees to have easy access to the test through joint cooperation with the Seegene Medical Foundation. This is a successful example of cooperation between schools and private institutions for public health improvement. In the future, the direct and indirect effects of the establishment and implementation of ESC need to be evaluated and confirmed, and areas requiring improvements need to be identified in preparation for another infectious disease outbreak in the future.

Citations

• A Proactive Testing Strategy to COVID-19 for Reopening University Campus during Omicron Wave in Korea: Ewha Safe Campus (ESC) Project
  Whanhee Lee, Kyunghee Jung-Choi, Hyunjin Park, Seunghee Jun, Nackmoon Sung, Sun-Hwa Lee, Misun Chang, Hee Jung Choi, Chung-Jong Kim, Hyesook Park, Eunhee Ha
  The Ewha Medical Journal.2023;[Epub]     CrossRef