Pharmacists to do an assessment of anyone looking for opioids
New guidelines for pharmacists dispensing an opioid medication were introduced Oct. 1.
The pharmacist must now complete a thorough assessment of the person with an opioid prescription or if they are buying an exempted codeine product that does not require a prescription.
“We expect a pharmacist no mater what the prescription is that they assess each patient, make sure that it is the appropriate medication for their condition or even if medication is required at all,” said Barry Strader, communications director for the Alberta College of Pharmacists. “They’re like that second set of eyes after they’ve seen their doctor, just to go over everything.”
The assessment by the pharmacist must include a review of the Electronic Health Record (Netcare) every time a prescription for an opioid medication is dispensed or sold. The pharmacist must document details of the assessment with a written treatment plan for those using an opioid on a long-term basis or for those considered to be at high risk for misuse or addiction, say the guidelines.
“When the patient is on long-term opioid therapy, or perhaps at high risk of misuse or addiction, then they have to develop a treatment plan for that individual,” said Strader.
The pharmacist is required to collaborate with the prescriber involved in the care of the individual using opioid medication. The patient must also be monitored by the pharmacist for “signs of opioid misuse, diversion or addiction, and take appropriate action”.
“If people are coming in for early release of their medication often that could be a sign that they’re dependent or misusing the medication,” said Strader.
Guidelines on the Alberta College of Pharmacists website also say the pharmacist must work with the patient to establish “realistic expectations for pain management,” to help them understand opioid medication is not a “cure” and make them aware of the risks of taking an opioid medication.
The goal of the pharmacist’s assessment is to ensure patients and prescribers consider all the appropriate options before opioid therapy and that they are being closely monitored.
Rather than a duplicate of what doctors are doing it is more about being a “double check” to ensure what is prescribed is appropriate for that patient for their condition, said Strader.
“I think that we can all agree that the opioid crisis has put a real spotlight on how opioid medications are being prescribed and how they’re being taken and so pharmacists have a big role in that,” said Strader, noting it is with the safety of the patient in mind.
“Also, making sure that the medication they’ve been prescribed is the best one for their condition. Sometimes it is not an opioid. That’s where the pharmacist can help make that call.”
Before introducing the new guidelines ACP collaborated with the College of Physicians and Surgeons Alberta, which was well aware and in support of the guidelines, said Strader.
A spokesperson for CPSA says there has been very little feedback from physicians on how the pharmacist guidelines are working.