Everyone was frustrated with the situation, and aware that this was a growing problem we had to do something about, says Meddings.
But, she adds, the clinic also wanted to ensure that it didnt punish the patients who legitimately needed the medications and that it offered help to those who had developed a dependence or addiction to narcotics, or whose urine tests showed they were using other illegal drugs. Also important was the need to show patients that they could still receive their other primary medical care from the clinic, even if they violated the opioid policy and could no longer receive prescriptions for Oxycontin or other drugs.
And, since Meddings had learned from national experts that its hard to predict which patients will misuse opioids, it was decided to apply the policy to all patients receiving opioid prescriptions not just those who the physicians or staff suspected of having an opioid problem.
The first step was to create a registry of all patients receiving opioid prescriptions and their prescribing clinic physicians, in order to establish a clear relationship between the patient and a specific clinic physician to oversee the opioid management plan. Clinic staff also helped screen new patients, from the moment they called for an appointment, so that patients were aware that an evaluation process was necessary before new patients could receive opioid prescriptions from the clinic.
Second, Meddings and Beatty taught their physician colleagues how to use the state of Ohios online prescription database, which allows doctors and pharmacists to see whether a single patient has been doctor shopping to get prescriptions for the same drug from several providers. Michigan has a similar online service.
Third, the team developed a mandatory agreement that patients and doctors would si
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| Contact: Kara Gavin kegavin@umich.edu 734-764-2220 University of Michigan Health System Source:Eurekalert |