Staging process

The goal of the Prescription Review Program (PRP) is to ensure patient safety and safe prescribing by reaching out to registrants when their prescribing may fall outside of accepted guidelines. The staging process is a multi-stage process for registrants that may involve literature recommendations, a self-audit and self-reflection, educational courses, medical consultant feedback, interviews, and panel reviews.

About the staging process

Depending on the unique situation of each case, files may progress linearly stage by stage, go back and forth between stages, or may be moved forward or backward. Some files may move through all stages while others are closed after one stage of the program.

A file can be closed any time if a registrant’s prescribing patterns are confirmed to be within accepted guidelines, or if the registrant’s approach to prescribing considers risk mitigation and evidence-based practice. A PRP file may be open anywhere from a few months to two years, depending on the complexity of the file. Correspondence will clearly outline the program timelines and expectations, and College staff are available to answer any questions registrants may have.

Triage

The PRP can be notified of a potential prescribing concern from a variety of sources, including other health-care professionals, pharmacies, and patients.

A medical consultant will review a registrant’s recent prescribing profile in combination with an objective program entry benchmark to determine if there are instances where the prescribing may fall outside of relevant standards and guidelines.

A file will be opened if there are multiple instances where clarification is required. As the prescribing profile provides no clinical context for prescribing decisions, the program will then reach out to the registrant for clinical background in relation to the prescription profile.

Feedback

Throughout the process, the program’s medical consultants will periodically review an updated prescribing profile along with relevant file information to provide educational feedback in relation to each registrant’s unique practice.

Registrants who have gone through the PRP have consistently rated consultant feedback as the most beneficial element of the program.

Courses

In many cases, medical consultants may recommend that a registrant attend a specific course. Physicians can claim credits for practice audit activities such as quality assurance exercises.

Prescribers’ Course

The College hosts a Prescribers’ Course in the spring and fall of each year. This is a one-day, intensive course that helps prescribers talk to patients in realistic terms about the risks and benefits of the use of opioids, benzodiazepines, and other potentially addictive medications. The course is designed for registrants to learn new approaches, primarily through interview simulations in small groups, supported by sympathetic, experienced, clinical teachers.

Chronic Pain Management Conference

In addition, the College also collaborates with the Foundation for Medical Excellence to host the annual Chronic Pain Management Conference in March.

Interview

A registrant in the program may have an interview scheduled with a medical consultant, or if directed, with the deputy registrar and legal representation.

An interview is a collegial opportunity for the registrant to discuss barriers to, and opportunities for, making their prescribing safer.

Panel review

Medical consultants may request a file be reviewed by the Prescription Review Panel for their expert advice. The panel is also responsible for referring files to the Inquiry Committee should they deem it necessary.  

The panel is comprised primarily of physicians with extensive experience from a variety of backgrounds such as community family practice, pain management, addiction medicine and psychiatry. It is also comprised of pharmacists, nurses, and members of the public.