Pain Management
Physician Challenge
With more than 200 million prescriptions for opioid medications being written every year, it’s hard to escape the notion that physicians are being targeted for creating the opioid epidemic that this nation is facing.
Physicians are responding, but this is creating additional costs and challenges, such as:
- Keeping up with State and Federal regulations;
- Finding time in the day to follow up with patients;
- Contacting patients after office hours;
- Adding to the workload of an already busy staff.
Following up with patients takes time and puts pressure on administrative and clinical staff which puts a strain on practice resources and adds costs to the practice. It is vitally important that patients who are on controlled substances for pain management adhere to policies and regulations put forth by their physician.
Pain Management Support Program
Our team of licensed pharmacists ensures that the medication regimen is followed. This includes the patient medication pick-up habits, looking for red flags in the federal database such as increased dispensing of controlled substances, multiple pharmacies, and doctor shopping. Our team conducts screenings for current opioid misuse, illicit drug use and abuse. The PharmD team also determines compliance with treatment regimens and urine drug screening frequency and can assist with the scheduling of urine drug screening appointments with:
- Engagement call check-in every 1-2 months to see how the patient is doing;
- Review of the UDS for regularities and irregularities;
- Scheduling the UDS when appropriate;
- Review of PDMP for red flags/ irregularities;
- Conducting opioid abuse risk assessments using the ORT (Opioid Risk Tool) and COMM (Current Opioid Misuse Measure) Risk with an assessment once per year;
- Counseling the patient on Naloxone (how to obtain, how to use, side effects, etc);
- Medication Reconciliation with patients;
- Prior Authorizations;
- PGX, if directed by physician;
Pre-Contact Activities
- Access and review last month’s notes in the patient’s chart and obtain an overall sense of the patient’s current status to:
- Review the drug list and identify all controlled substances;
- Look at the PMP under scanned documents to confirm that the medications were dispensed or if there are any irregularities;
- Review the last UDS (Urine Drug Screen) in scanned documents and compare to the drug list and confirm anticipated positives and notate any irregularities;
- Look for completed ORT for new patients;
- Confirm the COMM was completed once per year (unless there is a change) for every patient.
2. Create the appointment for the call under the appropriate provider.
Patient Outreach
1. Patient Arrival:
- If the ORT is missing complete the ORT;
- If the COMM is missing, notate missing COMM to be completed at the next check-in call;
- If the urine sample was not dropped off, then schedule the UDS for the patient before their next appointment with their provider.
2. Complete the UDS Checklist note and include:
- Call start and stop time;
- Summary of findings
Post-Patient Activities
- Update status on a spreadsheet, record time spent, and initial when note is completed.
2. The pharmacist marks as complete with name on the documentation spreadsheet.