MDNews - San Antonio

I N S E P T E M B E R 2 01 4 , the results of a survey posed to 56 primary care physicians were published in the Journal of Opioid Management. The survey involved a general health questionnaire, a test of opioid knowledge, an opioid therapy provider survey and a questionnaire addressing concerns about analgesic prescriptions. The majority of respondents, 89 percent, indicated concerns about medication misuse, while 84 percent said managing patients with chronic pain was stressful. Less than half, 46 percent, felt they were adequately trained in prescribing opioids. Interestingly, among this study group, younger physicians were less apt to prescribe opioids and had less confidence in managing patients with pain. Maunak Rana, MD, Director of Pain Management at Advocate Illinois Masonic Medical Center in Chicago, says he believes that study to be very accurate. He says he and his colleagues are often concerned about what they don't know. "When a patient comes in and asks for controlled sub- stances — schedule II or III drugs — they don't always give a complete picture of what is going on," Dr. Rana says. "There can be a lack of transparency. We don't know what medications a patient may be taking, either prescribed by other physicians or obtained through their social contacts. As medical professionals, we need a complete picture to evaluate a patient." Dr. Rana closely follows the Risk Evaluation Mitigation Strategy (REMS) issued by the FDA and even goes a few steps further. He carefully interviews and evaluates his patients, reviews their medical records, and conducts urine tests to determine exactly what drugs are in his patients' systems. He also includes a National All Schedules Prescription Electronic Reporting Act (NASPER) database review to get an eagle's-eye view of overall drug use. "NASPER is an outstanding tool, providing us with a snapshot of the medications a patient is using," Dr. Rana says. "We have a clearer insight, allowing for better and safer patient care." Dannemiller, a nationally known m e d i c a l e d u c a t i o n company, has been helping to fight this battle for years. COO Erin Fletcher says the San Antonio-based company has a long history of leading the way with educational programs to combat this universally recognized drug issue. "Dannemiller has provided CME in pain management for three decades," Fletcher says. "We are currently implementing a grant in collaboration with Elsevier and the Journal of Opioid Management to provide a number of opioid educational platforms. In addition to webcasts, we provide free CME credits via online training modules and free CME credits via a journal supplement, which is also online. Part of our Pain Review Course in Chicago this August will be dedicated to REMS review and education." Bernard Abrams, MD, a Clinical Professor of Neurology at the University of Missouri, Kansas City School of Medicine, helped write the grant. As the author of more than 50 pain diagnosis publications, Dr. Abrams states, "As prescribers, we have powerful drugs at our disposal. We have to pay attention to whom we prescribe them to, what the indications are, for how long we prescribe them and what effect they are having on patients." Dr. Abrams notes that opioids are a two-edged sword. There are severe consequences for misprescribing opioids. Following the REMS protocols is critical to protect the patient from physical harm and the physician from a malpractice suit or criminal charges. "We have to be vigilant," Dr. Abrams says. "We have to watch this particular class of drugs for something unique — abuse, misuse and diversion. Opioids are in a class of their own." To learn more, physicians can access a wealth of information at the REMS Opioids Recourse Center at opioidremsresource.com/cmece. ■ Risk Evaluation Mitigation Strategies By Jackie Hogan Boyle New Resources Available for OPIOID ++++++++++++++++++++++++++++++ + +++ + +++ ++++++++++++++++++++++++++++++ PRACTICE MANAGEMENT ❯ M D N E W S . CO M ■ MD NEWS San Antonio | 1 1

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