Introducing the official NAVIPPRO™ website
Explore the new NAVIPPRO™ website and learn more about the complete NAVIPPRO solution. The website is an excellent resource to discover more about NAVIPPRO′s sophisticated system, including easy access to NAVIPPRO–related publications, press releases, and events.
NAVIPPRO facilitates post–marketing surveillance of product–specific prescription drug use and abuse. The newly designed website focuses on four areas of NAVIPPRO risk management: surveillance; signal detection; signal verification;and intervention, prevention, and education programs. With a page devoted to each topic area, you now have access to more detailed information on each component as well as dynamic links to select prevention and intervention programs.
The website also features information on Inflexxion′s® custom RiskMAP consulting capabilities and includes brief biographies on each member of NAVIPPRO′s distinguished Advisory Board. Easily navigate through the site, sign-up for NAVIPPRO′s quarterly newsletter, and download publications written by Inflexxion researchers.
Looking for more details? Contact us directly from the new website and we will follow–up your information request right away.
NAVIPPRO™ adds real-time, patient-reported, product-specific data to your risk management activities
NAVIPPRO™ is a comprehensive and innovative suite of tools that facilitate post–market monitoring of product–specific prescription drug misuse and abuse. The NAVIPPRO system combines surveillance, signal detection, signal verification, and intervention and prevention education to monitor and prevent potential opioid analgesics abuse, with stimulant, and other schedule II and III therapeutic agent data coming soon. NAVIPPRO starts with accurate and sensitive surveillance data from both, proprietary and public sources. One of the critical sources, Inflexxion’s Addiction Severity Index–Multimedia Version (ASI–MV®) Connect, is a unique proprietary system that collects data from a national network of substance abuse treatment facilities. This quarter′s issue of NAVIPPRO Signal focuses on the ASI–MV Connect and its associated data.
Used at nearly 250 treatment centers nationwide, ASI–MV Connect is a computerized “virtual” interview making use of rich audio and video components. In the program, video interviewers ask patients questions which assess a variety of psychosocial and substance abuse factors in the client′s life and problem severity in these areas. ASI–MV Connect then generates a report and treatment planning recommendations for the clinician. Inflexxion has added a series of new questions about prescription drug abuse to the standard questions within the ASI–MV. If a patient indicates that he or she has abused prescription opioids they then answer a series of product specific questions about routes of administration and sources of the drugs. The current version of ASI–MV Connect includes detailed images of over 60 branded and generic drug products that patients can view and select when answering.
Upon completion of the ASI–MV Connect assessments, responses are immediately uploaded to the ASI–MV Data Center. This means that data are available in real–time to the substance abuse clinicians and to Inflexxion′s own NAVIPPRO experts for viewing, querying, and detailed analysis. Because the data collected is geographically specific, NAVIPPRO experts can generate geospatial maps of areas with high abuse rates. The real–time, geospatial nature of ASI–MV Connect’s data is one of the key features that enables NAVIPPRO to offer unique, empirical insights into prescription drug abuse issues as they occur. Moreover, by using Inflexxion′s proprietary smart client technology, ASI–MV Connect can be easily and quickly updated to account for new drugs as they enter the market or as particular concerns evolve.
ASI–MV Connect provides a robust snapshot of current, product–specific prescription drug use and abuse. This data is unique to NAVIPPRO: no other risk management solution can offer this data.
To learn more about NAVIPPRO, please e–mail NAVIPPROinfo@inflexxion.com.
Interview with Inflexxion’s Vice President of Clinical Development, Substance Abuse – Albert Villapiano, Ed.D.
Dr. Albert Villapiano, a psychologist and co–principal investigator on several NIH grants, has been involved in the research, development, and implementation of innovative interactive applications that aim to improve the quality of substance abuse treatment nationally. He brings over 25 years of experience as a clinician, trainer, researcher, and administrator. Dr. Villapiano has held academic appointments at Harvard University and Boston University Medical Schools.
What is the value of the ASI–MV Connect system to substance abuse treatment? How is ASI–MV Connect data used for surveillance in NAVIPPRO?
The Addiction Severity Index (ASI) is the most widely used interview and assessment tool in the world and has been translated into 18 different languages. Inflexxion′s ASI–MV Connect is the only client self–administered version of the ASI. It′s a standardized, research-based tool that reduces staff time and paperwork while offering clinicians quick access to clinical reports. On average, ASI–MV Connect saves about an hour of clinician’s time on each assessment.
The ASI–MV Connect Data Center is an internet–based resource that automatically receives HIPAA compliant ASI–MV data from substance abuse treatment centers around the country and provides those centers access to informative presentations of their data in real–time. The real–time feature is one of the ASI–MV Connect Data Center′s unique characteristics that make it extremely appealing to NAVIPPRO subscribers. Within 15 minutes of a completed ASI–MV Connect assessment, data is uploaded to the ASI–MV Connect Data Center and available for aggregate analysis. That′s a huge benefit when compared with other data sets that are 6 to 18 months, or more, behind. Also, the ASI–MV Connect Data Center gives NAVIPPRO subscribers the ability to track prescription drug abuse at product–level in a way that hasn′t been available before.
Who uses ASI–MV Connect and how is data from this system collected?
ASI–MV Connect is used primarily in substance abuse treatment centers around the country. It′s also used as part of the criminal justice system in drug courts, probation departments, driving under the influence (DUI) programs, and Treatment Accountability for Safer Communities (TASC) networks. It is also used in Temporary Assistance for Needy Families (TANF) welfare programs.
Data from ASI–MV Connect assessments is uploaded to the ASI–MV Connect Data Center via a secure process that cleanses it of identifying client information before it leaves the host computer. In this way, all data in the ASI–MV Connect Data Center is de-identified and HIPAA–compliant, yet it retains product–specific information on what prescription opioid drugs were abused, how they were taken, and where they were obtained.
Can you walk us through the ASI–MV Connect experience and what happens when clients indicate non–medical use of a prescription opioid within the past 30 days?
Intake interview clients are asked to come in one hour before they are scheduled to meet with a clinician. They go through paper work and are asked to self-administer the ASI–MV Connect assessment on a clinic computer. Assuming their mental status is stable, the client self-administers the interview in about 60 minutes. Audio and video are used to augment the virtual interviewers that guide clients through each question of the seven ASI domains: medical, employment, legal, drug, alcohol, family ⁄ social, and psychiatric.
There are two main ways clients are prompted to answer opioid specific questions. First, if they answer ‘yes’ to having a pain problem and being prescribed medication, they are prompted to answer opioid specific questions. Secondly, if they answer ‘yes’ to using a non–heroin opiate in the last 30 days or in their lifetime, they are prompted to answer opioid specific questions. These ‘yes’ responses trigger more specific opioid questions that include graphics of specific products which clients are instructed to select if they have taken that drug. For each prescription product selected, they are asked about frequency of use, if they took them as their doctors prescribed, and what was their preferred route of administration. They are also asked how they obtained these drugs. For example, did they go to one or many doctors? Did they take them from family or friends? Did they purchase them from a dealer or on the internet? When clients finish ASI–MV Connect their counselors print out a detailed clinical narrative report and complete the intake assessment process. After the ASI–MV interview is completed, the client’s data is automatically uploaded to the ASI–MV Connect Data Center.
How accurate is a self–administered assessment tool? What if a client can’t read or is unfamiliar with using a computer?
In two NIDA funded research studies both the English and Spanish ASI–MV scores proved to be valid and reliable. In addition, there is a growing body of research showing that people tend to disclose more personal information and are more candid when communication is mediated through the use of a computer. We have just submitted an article for publication that supports this point.
Clients who have reading difficulties are usually able to self–administer the ASI-MV with minimal assistance because all questions are read aloud by a virtual interviewer. There is also a repeat button that clients can use as many times as they need and each answer blinks when it is read, so clients know which answer matches their choice. Many clients have found ASI–MV Connect engaging because the virtual interviewers coach clients through the assessment with motivational comments such as ‘You are halfway done,’ ‘good job,’ and ‘do you want your certificate of completion?’ As long as clients are able to use a computer mouse, they can navigate the ASI–MV Connect.
To what degree can ASI–MV Connect data add accurate geographic specificity to the NAVIPPRO system?
ASI–MV Connect data can identify where product-level prescription drug abuse is occurring, down to the 5–digit zip code of substance abuse centers and the 3–digit zip code of clients′ addresses. With this data, NAVIPPRO experts develop geospatial maps that indicate parts of the country where high levels of abuse are occurring. Data from ASI–MV Connect helps the NAVIPPRO system detect early signals of possible problem areas around the country.
How is the ASI–MV Connect program able to adapt to changes in substance abuse patterns, for example when new drugs enter the market?
Because ASI–MV Connect is a web–based program, we have the flexibility to seamlessly upgrade the program to all provider sites from our central location. We can add information about new drugs or update questions to answer specific research hypotheses.
Is ASI–MV Connect able to provide early indication of important changes in the pattern of abuse within a specific region?
Let me rephrase your question a bit. How sensitive is ASI–MV Connect data to early signs of abuse? In one example, within a month of a pharmaceutical company releasing a generic form of OxyContin, ASI–MV Connect data indicated early signs of possible abuse in a rural eastern state. We were able to call the centers that showed increased activity and ask what was happening and was it possible for this drug to be affecting their clients in such a short time? The people we spoke to told us that a well known source in that area had access to prescriptions for this drug. Our conversation took place within three days of detecting abuse of this new drug within the ASI–MV Connect dataset.
Dr. Villapiano received his Ed.D. from Boston University and can be contacted at avillapiano@inflexxion.com.
Explore NAVIPPRO data: Join us as we present posters at the American Pain Society’s 27th Annual Scientific Meeting
The NAVIPPRO team will present the following posters at American Pain Society’s (APS) 27th Annual Scientific Meeting in Tampa, Florida this May:
Title: Women who abuse prescription opioid abuse: findings from the National Addictions Vigilance Intervention and Prevention Program
Women represent a large and growing population of prescription opioid abusers, yet there have been few efforts to understand special considerations for women’s prevention and treatment needs. Findings underscore the need to research and incorporate gender-specific prescription opioid abuse prevention and treatment efforts.
Title: Geographic differences and validation of prescription opioid abuse rates: a multi-data stream analysis
As researchers strive to characterize abuse of prescription opioids in the United States, it becomes increasingly clear that there are significant geographic differences in abuse rates throughout the country. Abuse rates of prescription opioids vary across states and within states. Examination of abuse data from multiple datasets and at fine–grained geographic resolution is invaluable for monitoring abuse of prescription drugs, as well as developing and implementing interventions.
Title: What clinical domains should be assessed in a computerized clinical advisory system for pain treatment?
Pain management is a complex science and practice, and the application of good clinical practice standards for pain treatment is limited. Treatment of chronic pain regularly addresses complicated clinical presentations. Treatment decisions are based on ever-briefer clinic encounters that are increasingly conducted by non–specialists. Currently in development, the Pain Assessment Interview Network Clinical Advisory System (PAIN–CAS) offers a systematic and validated assessment of pain patients (at intake and follow-up) along with provider reports containing treatment guidelines and patient feedback reports. The PAIN–CAS will be a unique computerized resource that presents assessments in an easy-to-use, interview-based format. The PAIN–CAS is a tool that may help standardize the treatment of chronic pain.
Title: Viral spread of prescription opioid administration techniques in internet chat forums
Post–marketing surveillance of potentially-abused prescription medications is increasingly considered a component of RiskMAPs. Internet monitoring may be an important source of leading–edge data, comprising one element of an early warning system. Some prescription drug abusers use the internet to share experiences, preferences, extraction methods, and warnings about possible dangers. The internet is an ideal tool for individuals involved in drug abuse, allowing unfettered and anonymous exchange of ideas and knowledge between people who may otherwise be geographically isolated. A single idea about one drug can spread to other substances and other websites, potentially reaching an increasing number of abusers and affecting drug abuse in the population at large.
To view full abstracts for the above poster information, visit the APS searchable database at www.ampainsoc.org/meeting/index.htm. The abstracts are scheduled to be online in March 2008. For more information on these posters or to schedule one-on-one time during the annual meeting, please e-mail NAVIPPROinfo@inflexxion.com.
- NAVIPPRO™ adds real–time, patient–reported, product–specific data to your risk management activities
- Interview with Inflexxion®′s Vice President of Clinical Development, Substance Abuse - Albert Villapiano, Ed.D.
- Explore NAVIPPRO data at the American Pain Society’s 27th Annual Scientific Meeting
American Pain Society: 27th Annual Scientific Meeting
May 8-10, 2008, Tampa, Florida
The College on Problems of Drug Dependence: CPDD 70th Annual Meeting
June 14-19, 2008, San Juan, Puerto Rico
Founding Sponsors
The NAVIPPRO™ team would like to recognize the continued sponsors of founding sponsors; Alpharma Pharmaceuticals LLC., and Endo Pharmaceuticals.
Did you know?
There are over 30,000 opiate-specific assessments, averaging 400 new cases per week, from more than 250 individual treatment facilities contributing to the ASI-MV® Connect database. In particular, assessments that indicate prescription opiate abuse are included in NAVIPPRO surveillance.
The following is a regional breakdown of ASI-MV Connect facilities across the United States:
Midwest: 41
Northeast: 14
South: 72
West: 115
In addition, some facilities are using a Spanish version of the ASI-MV Connect to gather information about substance abuse in the Spanish-speaking populations of their communities.
