ACP and the College of Physicians & Surgeons of Alberta (CPSA) are collaborating to identify potential high risk patients and notify involved pharmacists and physicians.
Patients who are receiving daily OME (oral morphine equivalent) doses greater than 600 mg and seeing more than two physicians and attending more than two pharmacies in a three-month period will be identified using Triplicate Prescription Program (TPP) data. All the prescribing physicians and dispensing pharmacists will receive an advisory letter from their college.
The combination of high opioid doses and attending multiple physicians and pharmacists is worrisome and we will alert the health providers of this concern so that appropriate clinical decisions can be considered for these patients.
The prescribing may not be inappropriate, but in general CPSA would recommend that physicians have strategies to manage opioid prescribing with firm boundaries to minimize the risk of harm.
ACP recommends that if pharmacists identify or become aware of issues concerning these prescriptions that they collaborate with the physicians involved in their patients’ care. Tools to help manage high risk patients will be included in the letter to the physicians and pharmacists of these patients.
Some of these patients identified will be struggling with an addiction disorder and getting appropriate treatment will be important to consider in their management. Further information on addiction services in Alberta can be found at: https://myhealth.alberta.ca/Pages/default.aspx
We will begin this process this summer and hope that this information will help physicians and pharmacists to manage these high risk patients collaboratively and with appropriate strategies in place.
