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College Action Plan on Inappropriate Prescribing
As part of the Joint Statement of Action to Address the Opioid Crisis, the College identified and committed to specific action within its own area of responsibility of medical regulation.“ We have set out timely, concrete actions to address problematic opioid prescribing,” said Dr. Rocco Gerace, College Registrar.“ And we are committed to reporting on our progress in delivering these results.” The cornerstone of the College’ s action plan is a collaboration with the Ontario Ministry of Health and Long-Term Care to promote patient safety. Specifically, the College is contacting those physicians whose prescribing practices have been flagged by the Narcotic Monitoring System( NMS) as potentially concerning. The Ministry has been providing information to the College where it appears, based on NMS’ s analysis of dispensing data, that some physicians are engaging in prescribing patterns that may not be consistent with the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain and may suggest a possible risk to patients. Upon receipt of this information, the College considers the accuracy of the data, and the clinical context in which prescribing occurs, and seeks information from the prescribing physician in order to better understand and evaluate the prescribing.“ Our goal is to better understand the presence and level of risk for patients from opioid prescribing and to work with physicians to change practices, where needed. Understanding and questioning prescribing practices is not intended to discourage appropriate opioid prescribing,” said Dr. Gerace.“ We must ensure that physicians have the tools they need to prescribe safely and with confidence,” he said. The College pledged to:
Identify possible high-risk prescribing and follow up with each doctor to determine clinical context. By June 2017
Develop a plan to identify low-risk prescribing and provide a variety of educational interventions, including tools, that are tailored to individual needs of prescribers. By June 2017
Publicly report, as permitted by legislation, on the outcomes of the current approach. By December 2017
Update existing policy to reflect revised Canadian Guidelines and Health Quality Ontario Quality Standards( if available). By December 2017
Once all physicians have access to narcotics profiles, include the expectation in policy for physicians to check the medication profile prior to prescribing narcotics.
Use prescribing information( comparative prescribing reports or prescribing data), when available, to inform educational approaches in conjunction with assessment of physician practice.
Support and contribute to a broader strategy to ensure necessary supports are available to patients and other health professionals. MD
Issue 4, 2016 Dialogue 25