Updates from the drug programs

PharmaNet access—recommended best practice and in some cases, mandatory

Access to PharmaNet provides BC physicians with a reliable and current source of collateral information about their patients’ medical care. Appropriate access and review of PharmaNet has always been encouraged by the College, but to date has only been mandated in two contexts:

  1. transient care settings (e.g. walk-in clinics and emergency departments)
  2. methadone clinics

This direction is provided both in the Methadone Maintenance Program’s Clinical Practice Guideline as well as in the College’s professional standard titled Walk-in Clinics—Standard of Care which states:

It is best practice for physicians to use PharmaNet, particularly when dealing with patients who require prescriptions for controlled substances. PharmaNet is mandatory for physicians working in transient care settings or methadone maintenance programs. Patient consent is necessary to access a PharmaNet profile.

The increasing complexity of modern medications with potential for serious reactions and interactions has made it difficult to explain why any physician would choose not to access information available on PharmaNet. Recently the Prescription Review Committee asked the College Board to consider making PharmaNet access a (required) professional standard of care.

In the past, the focus has been on opioids, sedatives and other psychoactive medications, but future direction could require all BC physicians to have access to PharmaNet and to use it as clinically indicated. (Although outside of the hospital setting it is necessary to obtain patient consent to access PharmaNet, this should be part of the agreement to medical care and prescribing in every practice setting.)

In this modern age, it is not acceptable to blame prescribing errors on lack of knowledge about a patient’s medication history when a database is readily available at minimal cost. Registrants who continue to be disconnected are strongly encouraged to enable access to PharmaNet in all work locations as soon as possible.

Take Home Naloxone Program—an important tool to address BC’s opioid crisis

The March/April 2014 edition of the College Connector encouraged physicians to become familiar with BC’s Take Home Naloxone Program (BCTHN). The BC Centre for Disease Control (BCCDC) developed the Take Home Naloxone Program in August 2012 in response to an identified public health need. At-risk individuals are trained in overdose prevention, recognition and to respond to opioid overdose by administering naloxone and contacting appropriate medical care. The BCCDC reported in August 2014 that over 1,215 naloxone kits had been distributed to more than 2,200 people across 51 sites in BC. In a recent CMAJ article, Banjo et al. found evidence of at least 85 overdose reversals resulting from the program.

The College’s Prescription Review and Methadone Maintenance Programs encourages physicians who prescribe opioids for replacement therapy or analgesia to consider Take Home Naloxone as an important tool in addressing BC’s opioid overdose crisis and refer appropriate patients.

More information

Physicians have an important role in promoting Take Home Naloxone to identified at-risk individuals. A number of resources are available for those interested in learning more about Take Home Naloxone:

  1. The BCTHN website includes a program guide, articles and tools to better understand the relevant medical, ethical and legal issues, as well as a decision support tool to assist clinicians.
  2. Physicians or clinics wishing to become an identified site for dispensing Take Home Naloxone can access the “New Site Registration” materials here
  3. To refer at-risk patients to a site offering patient training and a naloxone kit, a list of sites is available here.