Pharmacy Practice and The Law by Richard Abood

Author:Richard Abood [Abood, Richard]
Language: eng
Format: mobi
Publisher: Jones and Bartlett ebooks
Published: 2010-08-10T04:00:00+00:00

Ascertaining the Legitimacy of Opioid Prescriptions in Pain Treatment

One of the most difficult situations pharmacists encounter is when a prescriber or prescribers issue several prescriptions to chronic pain patients for very large quantities and very large doses of opioids. Large quantities and doses are sometimes necessary to treat severe chronic pain patients. Because pharmacists are held to a corresponding responsibility with the prescriber, these situations can be uncomfortable if the pharmacist fears the patient might not be a legitimate pain patient. General DEA tips on determining the validity of prescriptions were mentioned previously and should be considered. More specifically to pain treatment, pharmacists should be aware of the standards of practice for diagnosing and treating pain. One good source is the model guidelines established by the Federation of State Medical Boards (available at http://painpolicy.wisc.edu). If a pharmacist is concerned about the legitimacy of a pain patient, the pharmacist should not hesitate to contact the prescriber and ascertain if he or she is complying with practice standards. Pain management physicians should have no problem sharing medical records with the pharmacy, or developing a collaborative practice arrangement with the pharmacy.

Absent medical record documentation or a collaborative practice situation when uncertainty exists, pharmacists should consider interviewing the patient when appropriate with such questions as: What causes the pain? What past treatments has the patient attempted for the pain? What is the nature and intensity of the pain? What is the duration of the pain? What effect is the pain having on the patient’s quality of life? The pharmacist should then ask the same questions of the prescriber and should receive the same answers from both the prescriber and the patient. If available, pharmacists should also utilize the state’s prescription monitoring program to evaluate a chronic pain patient’s behavior.

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