Core principles for safe and effective prescribing are set out in the College professional standard Safe Prescribing of Drugs with Potential for Misuse/Diversion, and approved by the Prescription Review Panel. These principles are intended as a guide for physicians to ensure safe, judicious and responsible prescribing to all their patients. The College recognizes that opioid therapy will be different when treating pain in the settings of active cancer treatment, palliative care and end-of-life care.
The College does expect appropriate pharmacovigilance in the prescribing of controlled drugs.
Prescription Review Program Staging Process
The program begins with a review of the physician’s PharmaNet practitioner prescription profile, followed by several stages of educational activities.
At each stage, a PharmaNet practitioner prescription profile is reviewed by the medical consultant. Depending on the unique situation of each case, files may progress linearly stage by stage, go back and forth between stages, or may be accelerated through the program. If the review reveals prescribing patterns that are consistent with the College standards and guidelines, Safe Prescribing of Drugs with Potential for Misuse/Diversion, the panel would likely direct that the file be closed.
For those physicians with particularly challenging prescribing profiles, a face-to-face discussion with a medical consultant is offered as an opportunity to discuss barriers to, and opportunities for, improvements in prescribing practice. The educational and remedial activities provided by the PRP are of a collegial nature, supported by research and best practices.
Continuing Medical Education
Prescribers Course
Prescribers Course
Family physicians consistently rate prescribing for chronic pain amongst the most difficult areas of their professional lives. In a discipline where communication is the core skill set, talking to patients in realistic terms about the risks and benefits that attend the use of opioids, benzodiazepines and other potentially habituating medications challenges even the most seasoned practitioners. Participants in this intensive course will learn new approaches, primarily though interview simulations in small groups, supported by sympathetic, experienced, clinical teachers.
For more information, please visit the events page.
Chronic Pain Management Conference
Chronic Pain Management Conference
Presented by the Foundation for Medical Excellence in cooperation with the College of Physicians and Surgeons of British Columbia. This course is designed to assist clinicians in managing the most challenging of pain patients—those with complex chronic pain.
For more information, please visit the events page
References
Resources
- Recommended Resources from Drug Programs
- Safe Prescribing Tool Kit
- Michael G. DeGroote National Pain Centre at McMaster University
- Sample Pain Treatment Agreement
- Opioid Manager point-of-care tool
- Narcotic Log: Narcotic and Controlled Drug Administration and Purchasing Record
- The Pharmacists Clinic at UBC
Guidelines
Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain
- CDC Guideline for Prescribing Opioids for Chronic Pain
Guidelines for primary care providers who treat chronic, non-cancer pain in an outpatient setting, to ensure safe prescribing. - CDC Guideline for Prescribing Opioids for Chronic Pain: Resources
Quick reference tools to supplement the CDC guidelines and assist prescribers in making treatment decisions, and communicating with patients. - New England Journal of Medicine: Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline
Royal Australian College of General Practitioners (RACGP) Guideline
- Part A: Clinical Governance Framework (for prescribing drugs of dependence in general practice)
- Part B: Benzodiazepines
American Society of Interventional Pain Physicians (ASIPP) Guidelines
