In an effort to improve the care of our patients, reduce redundant phone calls while prescribing physicians are away, and resolve any confusion, I have adapted the guidelines used on K15 (>8 weeks controlled substance script)
Applicable to primary prescribers:
There are a lot of attachments (primarily for those of you who are prescribing recurrent controlled substances). In addition to the controlled substance contract being used, the ‘medication contract K17’ is also to be provided to patients to provide realistic expectations. In clinic assessment of continued script need will be due every 6 months (includes urine toxicology screen). Smartphrase: “.HFNARCOTICMANGEMENT“. MAPS are to be run on the patients every 3 months.
I will be having the nurses ask any primary prescribers to obtain his own MAPS ID (so that every patient isn’t being looked up under my MAPS ID). The nurses can run these reports. To minimize the time spent by the nurses on the phone and with the patient (which takes away from dealing with ill patients), we will be moving exclusively to electronic scripts.
I have also attached the NIH recommendations regarding chronic pain management.
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Applicable to all senior staff:
Coverage of controlled substance scripts while provider is away (based on K15 practices and NIH recommendations):
- Scripts will only be written for the time that physician is away. Write in sig area ‘supply until Dr. ____ returns on ___’.
- Scripts are only written by senior staff (checker will be approached by nurse), electronic scripts only (no fellows or residents are involved in this process)
- If following criteria are not met, script is NOT to be refilled by covering provider written expectations provided to all patients on controlled substances prescribed by pulmonologist)
- MAPS within past 3 months shows abnormalities (other providers writing scripts = violation of contract provided to patient)
- No pain/anxiety assessment in clinic within 6 months (by primary pulmonologist)
- Refill requested too early
- No covering weekend or after hours script requests are to be considered
I will also find the instructions for obtaining the electronic controlled substance fob.
Attachments:
Tier 3 – HFMG Primary Care Non-Cancer Pain Management Policy_v1 (002) 2017
k17-opiod-non-cancer-pain-mgmt-process-sep-16
triggers-for-behavioral-health-referral-sep-16;
pain-management-overview-smart-phrase-sep-16;kthavar
opioid-risk-tool-patient-form-sep-16;
resources-for-patients-who-need-to-seek-alternative-therapy-or-provider