You can win a Pizza Party for your office!
|
|
- Noah Ball
- 5 years ago
- Views:
Transcription
1 You can win a Pizza Party for your office! Geeta Patwa, MD and her staff from Chaparral Medical Group were the winners of the last InfoLink Pizza Party.
2 IMPROVING QUALITY OF LIFE: INTER VALLEY FOCUSES ON HEART FAILURE MANAGEMENT Because chronic heart failure (HF) is one of the top three chronic diseases diagnosed among individuals aged 65 years and older, Inter Valley is focusing on HF for its 2016 to 2018 quality improvement program (QIP) to promote effective management of chronic disease. Our goal is to lower rates of member mortality and to improve their quality of life. National HF Trends The 2015 American Heart Association (AHA) statistics on heart disease and stroke show that 5.7 million people in the United States have HF, with a projected increase to 8 million by Of the 870,000 individuals diagnosed with HF annually, 50% will die within 5 years. HF is one of the leading causes of hospitalization for those aged 65 years and older. Over 50% of those with HF are readmitted to the hospital within six months of hospital discharge. Inter Valley Health Plan HF Trends Members with HF represent 13% of Inter Valley Health Plan membership. Of members admitted to the hospital with HF, 9.4% are readmitted. Of the 2,893 members identified with HF, only 58% are receiving treatment with angiotensinconverting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or beta blockers. Physician Oportunities Improve your patients adherence to their thera peutic regimens with appropriate prescribing and optimization of ACE inhibitors, ARBs, and beta blockers. Promote clinical practice guidelines. Increase the average daily supply of ACE inhibitors, ARBs, or beta blockers to at least 180 days when patient compliance is at 50%. Increase the percentage of members who are receiving proper clinical treatment for HF. Heart Failure Management Implementation Detailed reports of which patients are not receiving treatment for HF will be available to physicians and provider groups. Physicians and their patients are encouraged to contact our dedicated Care Management team for assistance obtaining nurse interventions, developing treatment plans, and promoting behavioral changes to improve coping with HF. Clinical practice guidelines, educational materials, and other support tools will be made available in order to inform and engage physicians and members. Overall Outcome for the Heart Failure Management Program Reduce the risk of hospitalizations which may help mitigate readmission and improve overall management of members in the outpatient setting. Reduce the risk of nonfatal heart attacks in patients with HF. Improve the quality of life for patients with HF and increase patients satisfaction with their care. 2
3 GET YOUR OFFICE RUNNING SMOOTHLY When your office isn t running smoothly (exam rooms aren t stocked, nurses are running from patient to patient, patients are waiting too long, or the paperwork is piling up), it s the patients who suffer most. Most problems in a doctor s office can be traced back to inefficiency in processes rather than problems with staff. Here are some simple ideas to help you treat inefficiency in your office, so you can keep the focus on treating your patients. Map it out. Make a flow chart of the steps involved in each of your processes from beginning to end (eg, the steps for providing a patient referral or the steps for scheduling lab testing). Once you can see all the moving parts, it will be easier to determine improvements. Hold staff meetings. Have a brief staff meeting each morning to discuss the day s schedule and troubleshoot any potential problems. This will give you a chance to come up with a plan if you anticipate obstacles. Stay informed. Make sure both you and your staff have all the information you need about how various processes work. The more you know, the more successful you will be and the better able you will be to make any necessary adjustments as challenges arise. Manage patient expectations. Explain what you can about a process to your patients in advance, so they know what to expect. If they are prepared for what comes next, they will feel more comfortable and have more trust in you and your staff. Foster teamwork. A smooth-running office requires everyone s involvement, from the front desk to the exam room. Make sure you are fostering an environment of teamwork. TIMELY ACCESS TO CARE Every year Medicare members are asked to rate the Health Plan and their doctors on the members ability to obtain Access to Care in a timely manner. This rating system is one of the important scores that affect the health plans 5-Star Rating. URGENT APPOINTMENTS We understand that managing the expectations of Medicare members can be tricky, but California law requires that health plans provide timely access. This means that there are limits on how long patients should wait to get health care appointments. The purpose of the timely access law is to make sure patients get the care they need. Sometimes appointments may be needed even sooner than the law requires. In this case, the doctor should provide that appointment or direct the patient to Inter Valley so that we may help them obtain an appointment from another doctor if needed. NON-URGENT APPOINTMENTS Sometimes waiting longer for care is not a problem. You may offer longer wait times if it s not harmful to the health of the patient, but explaining the delay to the member is essential. On your right are guidelines from the Department of Managed Health Care. Inter Valley Health Plan requests that the office staff is aware so they can better meet the California law and manage the expectations of Inter Valley Health Plan members. 3
4 PSA LEVEL SCREENING: TEST OR NOT TO TEST population, regardless of age. They say the tests may find cancers that are so slow-growing and that routine intervention and the associated serious side effects offer no benefit, on a population-wide basis. So, what should be done about the issue of PSA testing? First, ask your male patients to do a little family history search to determine if there is a first-degree relative (father, brother, uncle, or grandfather), with a history of prostatic cancer. As you know, elevated PSA levels and the benefit of related interventions, have come into question in recent research reports. Inter Valley Health Plan has encouraged its members to talk to their doctors about the benefits, risks, and limitations of prostate cancer screening before deciding whether to be tested. The American Cancer Association (ACA) guidelines make it clear that prostate-specific antigen (PSA) testing should not occur unless this discussion happens. They recommend that most men at average risk for prostate cancer start the discussion at age 50 and those with higher risk for prostate cancer should start the discussion earlier. The U.S. Preventive Services Task Force (USPSTF) and the American Association of Family Practitioners (AAFP), however, don t recommend routine PSA screening for men in the general Second, determine if they have had the test in the past, as one of the important aspects of this test is not just the PSA level today, but that level in relationship to previous levels. Third, be prepared to answer a few questions for your patients about PSA screening and whether it is right for them. This will assure that your patients fully understand your answers, and ultimately that they are comfortable with your recommendation to test or not to test. 4
5 PHARMACY UPDATE Inter Valley Health Plan s Pharmacy and Therapeutics Committee continually reviews all drugs for formulary inclusion or exclusion. This information was accurate at the print date. For more up-to-date information about additions, limitations or exclusions on our Formulary please visit our website at Aspx or call Pharmacy Services, 7:30 am to 8 pm, 7 days a week, at or TTY/TDD SERVICE TO SENIORS & OC PREFERRED CHOICE ADDITIONS TO THE FORMULARY COVERED ALTERNATE TIER UTILIZATION DRUG NAME DRUG NAME DESCRIPTION LIMITS ALOSETRON TAB 0.5, 1MG LOTRONEX Generic Drugs PA, QL (60 per 30 days) BEXAROTENE TARGRETIN Generic Drugs PA BREO ELLIPTA INH LUTIACASONE & VILANTEROL Preferred Brand GLATOPA INJ 20MG/ML COPAXONE Generic Drugs PA, QL (30 per 30 days) DIGOXIN TAB 0.125MG DIGOXIN Generic Drugs DUTASTERIDE CAP 0.5MG AVODART Generic Drugs QL (30 per 30 days) LANTUS INJ 100/ML VIAL INSULIN GLARGINE Preferred Brand QL (30 per 30 days) LEVOTHYROXINE TAB 25, 50, 75, 88, 100, 112MCG LEVOTHYROXINE Preferred Generic LEVOTHYROXINE TAB 125, 137, 150, 175, 200, 300MCG LEVOTHYROXINE Preferred Generic KLOR-CON 8 TAB 8MEQ ER POTASSIUM CHLORIDE Preferred Generic KLOR-CON 10 TAB 10MEQ ER POTASSIUM CHLORIDE Preferred Generic KLOR-CON M20 TAB 20MEQ ER POTASSIUM CHLORIDE Preferred Generic LYRICA CAP 25, 50, 75, 100 MG PREGABALIN Preferred Brand LYRICA CAP 225, 300MG PREGABALIN Preferred Brand LYRICA SOL 20MG/ML PREGABALIN Preferred Brand MEMANTINE TAB HCL 5, 10MG NAMENDA Generic Drugs QL (60 per 30 days) MEMANTINE TITRA PAK 5-10MG NAMENDA Generic Drugs QL (60 per 30 days) MYCOPHENOLATE CAP 250MG CELLCEPT Generic Drugs PA MYCOPHENOLATE TAB 500MG CELLCEPT Generic Drugs PA OLOPATADINE DRO 0.1% PATANOL Generic Drugs PREDNISOLONE SUS 1% OP PREDNISOLONE Generic Drugs PREMARIN TAB 0.3, 0.45, 0.9, 1.25MG CONJUGATED ESTROGENS Preferred Brand XELJANZ TAB 5MG TOFACITINIB Specialty PA DESERT PREFERRED CHOICE ADDITIONS TO THE FORMULARY COVERED ALTERNATE TIER UTILIZATION DRUG NAME DRUG NAME DESCRIPTION LIMITS LEVOTHYROXINE TAB 25, 50, 75, 88, 100, 112MCG LEVOTHYROXINE Preferred Generic LEVOTHYROXINE TAB 125, 137, 150, 175, 200, 300MCG LEVOTHYROXINE Preferred Generic PA = Prior Authorization QL = Quantity Limits 5
6 OPIOID DISCONTINUATION FAQs 6 With careful patient selection, education, and monitoring, opioids can be safe and effective tools to improve function and pain intensity in chronic non-cancer pain. However, discontinuation may become necessary, either because of inefficacy, adverse effects, or misuse. The table below provides information to help clinicians deal with this challenging patient care situation. CLINICAL QUESTION: What are some situations to which opioid tapering and/or discontinuation might be considered? Misuse Re-evaluate treatment 1 Educate patient 1 Increase frequency/intensity of monitoring 1 Involve addiction or mental health providers 1 Prescribe limited quantities 1 Egregious misuse (injecting tablets) will likely require discontinuation 1 Use of illicit drugs or non-prescribed opioids Refer, ideally to a specialized program that can provide directly-observed therapy. 1 Diversion Usually requires immediate discontinuation. 1,2 Alternative is to refer to a specialized program that can provide directly-observed therapy. 1 Non-adherence to opioid agreement Restructure therapy (more intense monitoring, opioid tapering, addition of non-opioid or psychiatric treatment). 1 Overdose Adverse effects (sleep apnea, low libido, nausea, constipation) 1,4 Consider opioid rotation (e,g, switching patient from one opioid to another). 1 Consider tapering to a safe dose and continuing. 2 True allergic reaction requires immediate discontinuation. 10 No progress toward therapeutic goals If there is no sustained clinically meaningful improve ment (> 30%) in pain AND function, compared to base line or dosage increase, using validated tools, then 2 Discontinue, 2 or Go back to previous dose if it provided some benefit. 3 Tools recommended to assess progress in this context include the Three Item PEG Assessment Scale and the Two Item Graded Chronic Pain Scale, available at Files/2015AMDGOpioidGuideline.pdf. Reduced analgesia Restructure therapy (e.g., more intense monitoring, opioid tapering, addition of non-opioid or psychiatric treatment) 1 Hyperalgesia Discontinuation probably necessary. 5 Repeated dose escalation or need for high doses 1 Assess risk/benefit: 1 Assess underlying diagnosis and concomitant condition. 1 Assess psychological issues and social situation. 1 Assess pain control, function, quality of life, and progress toward therapeutic goals. 1 Assess adverse effects. 1 Assess adherence. 1 Rule out misuse or diversion. 1 Restructure therapy (e.g. more intense monitoring, opioid tapering, addition of non-opioid or psychiatric treatment). 1 Consider opioid rotation. 1 Consider dose reduction rather than complete discontinuation if opioid is providing some benefit. 5 Consider prescribing naloxone for patients on high doses to keep patients and families safe CLINICAL QUESTION: How do I prepare patients for opioid discontinuation? When starting chronic opioid therapy, set clear expectations. This may help prevent opposition to discontinuation if it is indicated later. 2 Use motivational interviewing techniques to identify reasons for patient opposition to discontinuation. 2 Identify and treat depression to improve pain control and improve taper success. 2,9 Patient education points Chronic pain is complex, opioids are not a cure-all, and may not provide adequate pain relief long-term. 2,4 Side effects of chronic opioid therapy include low hormone levels leading to fracture risk, low libido, and low energy and mood; worsening sleep apnea, leading to fatigue, and constipation. 1,4 When opioids are no longer providing good pain relief, most people feel better without them. 4 Most patients do not experience increased pain. 1,3 You are not abandoning the patient, and will help them with their pain. 9 Pain will be addressed with non-opioid alternatives. 2,5,9 Withdrawal symptoms are uncommon if the dose is tapered slowly. 9 CLINICAL QUESTION: What can be expected if the opioid is tapered or discontinued? Patients being tapered due to lack of efficacy may or may not experience a worsening of pain. 1 In VA populations (n=50) being tapered for reasons other than aberrant behavior, 70% of patients had no change or less pain vs baseline despite a 46% average dose reduction. 1 Some insomnia and anxiety should be expected. 4 Patients should plan ahead for not feeling well. 4 Increased pain is an early symptom of withdrawal, pain with opioid dose reductions is not a sign that the
7 OPIOID DISCONTINUATION FAQs opioid is effective for the patient s pain. 4,9 Pain due to withdrawal should resolve after the first week. 4 Unmasking of psychiatric conditions may occur. 1 CLINICAL QUESTION: How should the opioid be tapered / discontinued? General Concepts High quality evidence to guide tapering is lacking, individualize. The reason for discontinuation and the amount of opioid being used will influence the rate of taper. At high doses, rapid taper may cause withdrawal or drug seeking. 1 Discontinuation immediately if there is diversion. 2 Adjust taper based on response, such as appearance of withdrawal symptoms. 2 Consider referral for patients who have risk factors for failure. High-dose, substance use disorder, active psychiatric disorder, previous outpatient taper failure, or benzodiazepine use. 2 If benzodiazepine discontinuation is indicated, discontinue opioids before discontinuing benzodiazepines. 2 Consider consolidating the patient s opioids into a single long-acting formulation. 4 Choose a product that offers small dose increments (e.g., morphine 10mg) to facilitate slow tapering. 3 A short acting formulation can be used once the lowest dose of the long-acting formulation is reached. 9 Fentanyl patch can be switched to a long-acting 9, 10 formulation, or tapered in decrements of 12 mcg/hr. Before constructing the taper, check for insurance coverage limitation, and availability of specific opioid products/strengths at your local pharmacy. Flexibility may be needed. Tapering Protocols Taper over two to three weeks in the event of severe adverse effects, overdose, or substance abuse disorder. 2 Otherwise taper by 10% or less of the original dose per week. 2 An even slower taper (e.g., 10% every two to four weeks) may be needed for patients who have been taking opioids for years. 9 High doses may be able to tapered rapidly (e.g., 25% to 50% every few days) until reaching 60 mg to 80 mg of morphine or its equivalent. Then the rate can be slowed (e.g., 10% of the original dose per week) to prevent withdrawal. 1 Keep in mind that a more rapid taper may be possible. The minimum dose to prevent withdrawal may be only 25% of the previous day s dose. 9 A sample Opioid Tapering Template is available at Opioid-Taper-Template.pdf. CLINICAL QUESTION: How should the patient be monitored during dose reduction or discontinuation Check pain control and functional status at each visit. 2 Managed increase pain with non-opioids. 2 Monitor for psychiatric disorder such as depression or panic disorder. 2 Monitor for withdrawal (e.g., flu-like symptoms, insomnia, anxiety, abdominal cramps and other GI symptoms, goose bumps, fatigue, malaise). 4 If withdrawal symptoms occur, managed the symptoms (see below) and slow the taper (e.g., to 5% per week) or suspend the taper, do not increase the dose (Don t backpedal). Warn patients that they are at risk of overdose if they try upping the dose on their own. Opioid tolerance is lost after a week or two of abstinence. 3 Consider prescri bing naloxone for use in an overdose emergency. CLINICAL QUESTION: What adjunctive medications may help with withdrawal symptoms? Acetaminophen or NSAIDs for malaise and myalgias. 5,6 Ondansetron 8 mg q 12 h for nausea and other symptoms. 6,8 Trazodone for insomnia (25 mg to 100 mg at bedtime). 5 Hydroxyzine 25 to 50 mg three times daily as needed for anxiety, lacrimation and rhinorrhea. 7 Loperamide for diarrhea (not usually needed for gradual taper). 5 Clonidine is not usually needed for gradual tapers. 3 References 1. Chou R, Fanciullo GJ, Fine PG, et al. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 2009;10: Washington State Agency Medical Directors Group. Interagency guideline on prescribing opioids for pain. 3rd edition, June wa.gov/files/2015amdgopioidguideline.pdf. (Accessed October 30, 2015). 3. Harden P, Ahmed S, Ang K, Wiedemer N. Clinical implications of tapering chronic opioids in a veteran population. Pain Med 2015;16: University of British Columbia. Squire P, Jovey R. Managing opioid withdrawalinformation for patients Patients-TCMP-2014-Managing-Opioid-Withdrawal.pdf. (Accessed October 31, 2015). 5. Saskatoon City Hospital. Rx Files. Opioid tapering. July rxfiles/uploads/documents/opioid-taper-template.pdf. (Accessed October 31, 2015). 6. Smithedajkul PY, Cullen MW. Managing acute opiate withdrawal in hospitalized patients. ACP Hospitalist. October archives/2009/10/residents.htm#sb1. (Accessed October 31, 2015). 7. Butt P, McLeod M, Becker-Irvine C. Saskatoon Health Region. Mental Health and Addiction Services: Brief/Social Detox unit. locations_services/services/mhas/documents/resources%20for%20professionals/ Opioidwithdrawalprotocol-finaldraftJan _000.pdf. (Accessed October 31, 2015). 8. Wakim JH. Alleviating symptoms of withdrawal from an opioid. Pain Ther 2012;1:4. 9. Berna C, Kulich RJ, Rathmell JP. Tapering long-term opioid therapy in chronic noncancer pain: evidence and recommendations for everyday practice. Mayo Clin Proc 2015;90: U.S. Department of Veterans Affairs/U.S. Department of Defense. Tapering and discontinuing opioids. May OpioidTaperingFactSheet23May2013v1.pdf. (Accessed November 1, 2015). PL Detail-Document, Opioid Discontinuation: FAQs. Pharmacist s Letter/Prescriber s Letter. December
8 INTER VALLEY HEALTH PLAN 300 South Park Avenue PO Box 6002 Pomona CA PRESORTED STD U.S. POSTAGE PAID PERMIT #108 CLAREMONT CA Info-Link CONTRIBUTING EDITORS Kenneth E. Smith, MD, MBA Chief Medical Officer Cyndie O Brien Communications Emma Adarkwa Communications Fidel Valenzuela, Pharm D Pharmacy Susan Tenorio, BSN, RN Plan Operations Reynaldo Whitt, RN Health Services EDITOR S NOTE: We value your opinion. If you have any comments on this issue or have a topic suggestion for future issues, please contact Cyndie O Brien at or cobrien@ivhp.com. Inter Valley Health Plan is a not-for-profit HMO with a Medicare contract. Enrollment in Inter Valley Health Plan depends on contract renewal WIN A PIZZA PARTY ON US! Inter Valley is proud of their providers and all the great work they do. As a token of our appreciation we are rewarding one lucky physician and their entire staff with a pizza party, delivered directly to their office. Geeta Patwa, MD and her staff from Chaparral Medical Group are the most recent winners of our Physician Pizza Party. Their office is located in Pomona. Your staff provide exceptional care to patients, and essential support to you every day. Show them how much you appreciate all they do by entering them for a chance to win. Fill in the information below and mail to Inter Valley Health Plan, Attn. Pharmacy Dept, 300 South Park Ave, PO Box 6002, Pomona CA , or fax to Entries must be post-marked by April 22, Encourage your patients to make their as far in advance as possible. 2. Give your patient as much as you can. 3. If a patient has undergone and the results are, and. 4. Encourage your patient to become or stay, and suggest. 5. Ask about all the your patient takes in order to avoid with other. Physician: Phone: Office Address: Zip:
Medicare Part D 2016 Formulary Changes Service To Senior and OC Preferred
Medicare Part D 2016 Formulary s Service To Senior and OC Preferred Inter Valley Health Plan may add or remove drugs from our formulary during the year. If we remove a drug from our formulary, add prior
More informationPART VI: TAPERING OPIOIDS ROBERT JENKINSON MD MARCH 7, 2018
PART VI: TAPERING OPIOIDS ROBERT JENKINSON MD MARCH 7, 2018 TAPERING OPIOIDS GETTING STARTED ON OPIOIDS IS EASY BUT GETTING PATIENTS OFF IS HARD WE ARE ARE OBLIGED TO TAPER PATIENTS DOWN AND OFF OPIOIDS
More informationten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment
ten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment This booklet was created to help you learn about tapering. You probably have lots
More informationUse of Opioids for Chronic Non Malignant Pain (CNMP)
I. PURPOSE Use of Opioids for Chronic Non Malignant Pain (CNMP) We the Safe Opioid Prescribing and Review Committee (SOPARC) are inspired to support a shift in opioid prescribing that improves clinical
More informationTake once a week, Sunday mornings at 7:30"
Info-Link7.08 acg.qxd:info-link2.07 8/8/08 2:51 PM Page 2 Take once a week, Sunday mornings at 7:30" These doctors have discovered a great new RX for their patients. Details inside. www.ivhp.com Info-Link7.08
More informationHOPE. Considerations. Considerations ISING. Safe Opioid Prescribing Guidelines for ACUTE Non-Malignant Pain
Due to the high level of prescription drug use and abuse in Lake County, these guidelines have been developed to standardize prescribing habits and limit risk of unintended harm when prescribing opioid
More informationDISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.
DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this
More informationPractical Tools to Successfully Taper Prescription Opioids. Melissa Weimer, DO, MCR
Practical Tools to Successfully Taper Prescription Opioids Melissa Weimer, DO, MCR Objectives Understand how to calculate morphine equivalents per day Understand the steps necessary to plan a successful
More informationNew Guidelines for Opioid Prescribing
New Guidelines for Opioid Prescribing What They Mean for Elders with Chronic Pain Manu Thakral, PhD, ARNP Kaiser Permanente Washington Health Research Institute Kaiser Permanente Washington Health Research
More information3. Has the patient had a sustained improvement in Pain or Function (e.g. PEG scale with a 30 percent response from baseline)?
Pharmacy Prior Authorization AETA BETTER HEALTH KETUCK Opioids Long-Acting and Short-Acting (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More information2. Is this request for a preferred medication? Y N
Pharmacy Prior Authorization AETA BETTER HEALTH EW JERSE (MEDICAID) Opioids Long-Acting and Short-Acting (Medicaid) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review
More informationControlled Substance and Wellness Agreement
Controlled Substance and Wellness Agreement You and your provider have agreed on the use of controlled substance medications to treat your: We want to make sure you know how to manage your new prescription(s)
More informationSubject: Pain Management (Page 1 of 7)
Subject: Pain Management (Page 1 of 7) Objectives: Managing pain and restoring function are basic goals in helping a patient with chronic non-cancer pain. Federal and state guidelines require that all
More informationCDC Guideline for Prescribing Opioids for Chronic Pain. Centers for Disease Control and Prevention National Center for Injury Prevention and Control
CDC Guideline for Prescribing Opioids for Chronic Pain Centers for Disease Control and Prevention National Center for Injury Prevention and Control THE EPIDEMIC Chronic Pain and Prescription Opioids 11%
More informationCalifornia. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile California Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationApproaches to Responsible Opioid Prescribing. The Opioid Naïve Patient
Approaches to Responsible Opioid Prescribing The Opioid Naïve Patient Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted
More informationThe Dark Art. Of Supervising & Managing Controlled Substances
The Dark Art Of Supervising & Managing Controlled Substances David A. Frenz, M.D. Vice President & Executive Medical Director North Memorial Health Care Robbinsdale, Minn. 27 October 2016 www.doctorfrenz.com
More informationKnock Out Opioid Abuse in New Jersey:
Knock Out Opioid Abuse in New Jersey: A Resource for Safer Prescribing GUIDELINE FOR PRESCRIBING OPIOIDS FOR CHRONIC PAIN IMPROVING PRACTICE THROUGH RECOMMENDATIONS CDC s Guideline for Prescribing Opioids
More informationTapering Opioids Best Practices*
Tapering Opioids Best Practices* Chuck Hofmann, MD, MACP 5 th Annual EOCCO Office Staff and Provider Summit September 28, 2017 Disclosure No Conflicts of Interest to report Learning Objectives Understand
More informationDepartment of Veterans Affairs Network Policy No.: VA Desert Pacific Healthcare Network (VISN 22) Date: September 23, 2014 Long Beach, CA
Department of Veterans Affairs Network Policy No.: 2014-01 VA Desert Pacific Healthcare Network (VISN 22) Date: September 23, 2014 Long Beach, CA CHRONIC OPIOID USE FOR NON-MALIGNANT PAIN 1. PURPOSE: To
More informationVirginia. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile Virginia Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationPharmacy Law Disclosure Statement. Objectives 6/11/2016. I have no conflicts of interest to disclose related to this presentation.
Pharmacy Law 2016 Ronda H. Lacey, J.D., M.S. Pharm Disclosure Statement I have no conflicts of interest to disclose related to this presentation. Objectives At the conclusion of this continuing education
More informationPrescription Opioid Addiction
CSAM-SCAM Fundamentals Prescription Opioid Addiction Presentation provided by Meldon Kahan, MD Family & Community Medicine University of Toronto Conflict of interest statement I received funds from Rickett
More informationAhsan U. Rashid, M.D., F.A.C.P.
Ahsan U. Rashid, M.D., F.A.C.P. OPIOID MAINTENANCE AND CONSENT Instructions: Review this document before signing. This document will help both the patient and caregivers in establishing a medical program
More informationPalliative Care: Improving quality of life when you re seriously ill.
Palliative Care The Relief You Need When You re Experiencing the Symptoms of Serious Illness Palliative Care: Improving quality of life when you re seriously ill. Dealing with the symptoms of any painful
More informationChronic Pain Pharmacist role in the clinic
Chronic Pain Pharmacist role in the clinic WSPA Annual Meeting 2015 Alvin Goo, PharmD Clinical Associate Professor University of Washington Schools of Pharmacy and Family Medicine Speakers Declaration
More informationOpiate Use Disorder and Opiate Overdose
Opiate Use Disorder and Opiate Overdose Irene Ortiz, MD Medical Director Molina Healthcare of New Mexico and South Carolina Clinical Professor University of New Mexico School of Medicine Objectives DSM-5
More informationManagement of Pain - A Comparison of Current Guidelines
Management of Pain - A Comparison of Current Guidelines The Centers for Disease Control and Prevention (CDC) released a guideline in 2016 regarding the prescribing of opioids for chronic non-cancer pain
More informationMedicare Part D 2016 Formulary Changes Service To Senior and OC Preferred
Medicare Part D 2016 Formulary s Service To Senior and OC Preferred Inter Valley Health Plan may add or remove drugs from our formulary during the year. If we remove a drug from our formulary, add prior
More informationPatient Information Leaflet. Opioid leaflet. Produced By: Chronic Pain Service
Patient Information Leaflet Opioid leaflet Produced By: Chronic Pain Service November 2012 Review due November 2015 1 Your Pain Specialist has recommended treatment with strong pain killers (opioids).
More informationNew Guidelines for Prescribing Opioids for Chronic Pain
New Guidelines for Prescribing Opioids for Chronic Pain Andrew Lowe, Pharm.D. CAPA Meeting October 6, 2016 THE EPIDEMIC Chronic Pain and Prescription Opioids 11% of Americans experience daily (chronic)
More informationOpioid rotation or switching may be considered if a patient obtains pain relief with one opioid and is suffering severe adverse effects.
Dose equivalence and switching between opioids Key Messages Switching from one opioid to another should only be recommended or supervised by a healthcare practitioner with adequate competence and sufficient
More informationMedicare Part D Opioid Policies for 2019 Information for Patients
CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Part D Opioid Policies for 2019 Information for Patients Introduction Prescription opioid pain medications like oxycodone (OxyContin ), hydrocodone (Vicodin
More informationSCHEDULE YOUR PREVENTIVE CARE VISIT Preventive care visits, or routine checkups, are important to your health.
We re in this together: Quality Health Care Member FOCUS EASY CHOICE 2018 ISSUE 1 SCHEDULE YOUR PREVENTIVE CARE VISIT Preventive care visits, or routine checkups, are important to your health. Why are
More informationBest Practices in Prescribing Opioids for Chronic Non-cancer Pain
Best Practices in Prescribing Opioids for Chronic Non-cancer Pain Disclosures S C O T T S T E I G E R, M D, F A C P, D A B A M A S S I S T A N T C L I N I C A L P R O F E S S O R D I V I S I O N O F G
More informationINFORMED CONSENT FOR OPIOID TREATMENT FOR NON-CANCER/CANCER PAIN Texas Pain and Regenerative Medicine
INFORMED CONSENT FOR OPIOID TREATMENT FOR NON-CANCER/CANCER PAIN Texas Pain and Regenerative Medicine The purpose of this agreement is to give you information about the medications you will be taking for
More informationModule. Managing Feelings About. Heart Failure
Module 6 Managing Feelings About Heart Failure Taking Control of Heart Failure Contents Introduction 3 Common Feelings After a Diagnosis of Heart Failure 4 Recognizing Emotions After Diagnosis of Heart
More informationSCHEDULE YOUR PREVENTIVE CARE VISIT Preventive care visits, or routine checkups, are important to your health.
We re in this together: uality Health Care Member FOCUS HAWAII 2018 ISSUE 1 SCHEDULE YOUR PREVENTIVE CARE VISIT Preventive care visits, or routine checkups, are important to your health. Why are preventive
More informationOpioid Review and MAT Clinic CDC Guidelines
1 Opioid Review and MAT Clinic CDC Guidelines January 10, 2018 Housekeeping Use chat feature to inform everyone who s at your clinic Click chat on Zoom option bar Chat Everyone the names of those who are
More informationMEDICATION MANAGEMENT AGREEMENT
MEDICATION MANAGEMENT AGREEMENT The goal of this agreement is to ensure that you and your physician comply with all state and federal regulations concerning the prescribing of controlled substances. The
More informationUtah. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile Utah Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points of view
More informationPROVIDER BULLETIN. Published by Wyoming Workers Compensation Medical Case Management Unit October 21, 2015
Matthew H. Mead Governor State of Wyoming Department of Workforce Services DIVISION OF WORKERS COMPENSATION 1510 East Pershing Boulevard, South Wing Cheyenne, Wyoming 82002 http://www.wyomingworkforce.org
More informationStrategies in Managing Opioid and Benzodiazepine Co-Prescribing
Strategies in Managing Opioid and Benzodiazepine Co-Prescribing Scott Endsley, MD Associate Medical Director, Quality Partnership HealthPlan of California October 25, 2016 Audio Instructions To avoid echoes
More informationModule. Module. Managing Other Chronic Conditions. Managing Other Chronic Conditions
Managing Other Chronic Conditions 8 Managing Other Chronic Conditions Taking Control of Heart Failure Important Information Please write down important contact information in the space below. You may also
More informationSubstitution Therapy for Opioid Use Disorder The Role of Suboxone
Substitution Therapy for Opioid Use Disorder The Role of Suboxone Methadone/Buprenorphine 101 Workshop, December 10, 2016 Leslie Lappalainen, MD, CCFP, dip ABAM Prepared by Mandy Manak, MD, ABAM, CCSAM
More informationLouisiana. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile Louisiana Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationRecommendations in Opioid Prescribing Guidelines for Chronic Pain
Recommendations in Opioid Prescribing Guidelines for Chronic Pain The use of opioids for treating chronic pain has been increasing. 1 In 2010, an estimated 20% of patients presenting to physician offices
More informationNBPDP Drug Utilization Review Process Update
Bulletin # 802 December 1, 2010 NBPDP Drug Utilization Review Process Update The New Brunswick Prescription Drug Program (NBPDP) employs a Drug Utilization Review (DUR) process which identifies, investigates
More informationClinical Policy: Lofexidine (Lucemyra) Reference Number: ERX.NPA.88 Effective Date:
Clinical Policy: (Lucemyra) Reference Number: ERX.NPA.88 Effective Date: 07.31.18 Last Review Date: 08.18 Revision Log See Important Reminder at the end of this policy for important regulatory and legal
More informationPolicy on Pharmacological Therapies Practice Guidance Note Reducing Dosing Errors with Opioid Medicines V04
Policy on Pharmacological Therapies Practice Guidance Note Reducing Dosing Errors with Opioid Medicines V04 Date issued Issue 1 Nov 2018 Planned review Nov 2021 PPT-PGN 18 part of NTW(C)38 Pharmaceutical
More informationEducation Program for Prescribers and Pharmacists
Transmucosal Immediate Release Fentanyl (TIRF) Products Risk Evaluation and Mitigation Strategy (REMS) Education Program for Prescribers and Pharmacists Products Covered Under this Program Abstral (fentanyl)
More informationSection I. Short-acting opioid Prior Authorization Criteria
Request for Prior Authorization for Opioid analgesics Website Form www.highmarkhealthoptions.com Submit request via: Fax - 1-855-476-4158 Requests for opioid analgesics may be subject to prior authorization
More informationChronic Pain Management in the Primary Care Setting
Chronic Pain Management in the Primary Care Setting Keeping you and your patients safe. Joel Porter, MD October 1, 2015 Chronic Pain Management Chronic pain is a major public health problem Existing chronic
More informationUpdated: 08/2017 DMMA Approved: 11/2017
Request for Prior Authorization for Therapy to Treat Binge Eating Disorder Website Form www.highmarkhealthoptions.com Submit request via: Fax - 1-855-476-4158 All requests for medications to treat Binge
More informationMethadone Treatment. in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone Treatment in federal prison This booklet will explain how to qualify for Methadone treatment in prison, the requirements of the Correctional
More informationSHARED CARE GUIDELINE FOR THE MANAGEMENT OF PATIENTS ON NALTREXONE FOR OPIOID DEPENDENCE
SHARED CARE GUIDELINE FOR THE MANAGEMENT OF PATIENTS ON NALTREXONE FOR OPIOID DEPENDENCE INDICATION Naltrexone is a pure opiate antagonist licensed as an adjunctive prophylactic therapy in the maintenance
More informationOpioid epidemic and PEHP
Opioid epidemic and PEHP Agenda Overview of opioid crisis Utah perspective PEHP: clinical interventions Impact of interventions Why are we here? In the 1990s, the medical establishment came to believe
More informationOpioid Management of Chronic (Non- Cancer) Pain
Optima Health Opioid Management of Chronic (Non- Cancer) Pain Guideline History Original Approve Date 5/08 Review/Revise Dates 11/09, 9/11, 9/13, 09/15, 9/17 Next Review Date 9/19 These Guidelines are
More informationMethadone Treatment. in federal prison
INFORMATION FOR FEDERAL PRISONERS IN BRITISH COLUMBIA Methadone Treatment in federal prison This booklet will explain how to qualify for Methadone treatment in prison, the requirements of the Correctional
More informationCynthia B. Jones, Director Department of Medical Assistance Services (DMAS)
Department of Medical Assistance Services 600 East Broad Street, Suite 1300 Richmond, Virginia 23219 MEDICAID MEMO http://www.dmas.state.va.us TO: All Prescribing Providers, Pharmacists, and Managed Care
More informationPrescription Monitoring Program (PMP)
06/15/2018 FACT SHEET Implementation of Enacted Prescribing Limits and Requirements and Relevant Opioid Prescribing Laws and Rules Background: The 2016 law (Chapter 488) makes five major changes to opioid
More informationProposed Revision to Med (i)
Proposed Revision to Med 501.02 (i) I. Purpose This rule has been adopted to enable the Board to best protect public health and safety while providing a framework for licensees to effectively treat and
More informationStandard of Practice for Prescribing Opioids (Excluding Cancer, Palliative, and End-of-Life Care)
Standard of Practice for Prescribing Opioids (Excluding Cancer, Palliative, and End-of-Life Care) Preamble This Standard establishes the standards of practice and ethical requirements of all physicians
More informationNurse Practitioner Practice Guideline Treatment Agreements
Nurse Practitioner Practice Guideline Treatment Agreements In November 2012, the New Classes of Practitioners Regulations (NCPR) under Canada s Controlled Drug and Substances Act (CDSA) came into force,
More informationOPIOIDS FOR PERSISTENT PAIN: INFORMATION FOR PATIENTS
OPIOIDS FOR PERSISTENT PAIN: INFORMATION FOR PATIENTS This leaflet aims to help you understand your pain, so that you can work with your health care team to self-manage your symptoms and improve your quality
More informationSafe Prescribing of Drugs with Potential for Misuse/Diversion
College of Physicians and Surgeons of British Columbia Safe Prescribing of Drugs with Potential for Misuse/Diversion Preamble This document establishes both professional standards as well as guidelines
More informationThe CARA & Buprenorphine Prescribing for APNs & PAs
The CARA & Buprenorphine Prescribing for APNs & PAs William J. Lorman, JD, PhD, MSN, PMHNP-BC, CARN-AP FIAAN Assistant Clinical Professor, Drexel University, Philadelphia, PA V. P. & Chief Clinical Officer,
More informationAN INTRODUCTION TO THE TREATMENT OF OPIOID USE DISORDERS IN PRIMARY CARE
AN INTRODUCTION TO THE TREATMENT OF OPIOID USE DISORDERS IN PRIMARY CARE Valerie Carrejo, MD Assistant Professor UNM Family Medicine Advances in Primary Care April 14, 2017 Objectives Review the basic
More informationTHE PROS & CONS OF THE CDC GUIDELINES FOR SAFE OPIOID PRESCRIBING
THE PROS & CONS OF THE CDC GUIDELINES FOR SAFE OPIOID PRESCRIBING Ernest J Dole, PharmD, PhC, FASHP, BCPS Clinical Pharmacist University of New Mexico Hospitals And Clinical Associate Professor University
More informationJennifer Wyman, MD, Academic Lead, Opioids Clinical Primer Assistant Professor, Dept. of Family & Community Medicine, University of Toronto
Team Based Approaches to Chronic Pain Management: Opioid Stewardship Jennifer Wyman, MD, Academic Lead, Opioids Clinical Primer Assistant Professor, Dept. of Family & Community Medicine, University of
More informationMethadone Maintenance 101
Methadone Maintenance 101 OTP/DAILY DOSING CLINICS - ANDREW PUTNEY MD Conflicts of Interest - Employed by Acadia HealthCare 1 Why Methadone? At adequate doses methadone decreases opioid withdrawal symptoms
More informationGG&C Chronic Non Malignant Pain Opioid Prescribing Guideline
GG&C Chronic Non Malignant Pain Opioid Prescribing Guideline Background Persistent pain is common, affecting around five million people in the UK. For many sufferers, pain can be frustrating and disabling,
More informationManaging Narcotics on Workers Comp Claims. Presented By: Craig S. Stern, PharmD, MBA President Pro Pharma Pharmaceutical Consultants, Inc.
Managing Narcotics on Workers Comp Claims Presented By: Craig S. Stern, PharmD, MBA President Pro Pharma Pharmaceutical Consultants, Inc. October 21, 2014 Outline Rationale Scope list drug list Recommended
More informationPharmacist s Role In Pain Management. Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017
Pharmacist s Role In Pain Management Katrina Lynn, Pharm D PSHP Annual Assembly: October 12, 2017 1 Presentation Objectives Briefly discuss Geisinger Health System and the use of Pain Management Pharmacists
More informationSUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets. Risk Evaluation and Mitigation Strategy (REMS) Program
SUBOXONE Film, SUBOXONE Tablets, and SUBUTEX Tablets Risk Evaluation and Mitigation Strategy (REMS) Program Office-Based Buprenorphine Therapy for Opioid Dependence: Important Information for Prescribers
More informationD. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine
D. Janene Holladay, M.D. Board Certifications: American Board of Anesthesiology American Board of Pain Medicine American Board of Addiction Medicine Financial Disclosure I have no relevant financial relationships
More informationOpioids Limitation For Quantity and Dosage
Opioids Limitation For Quantity and Dosage Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy
More informationLong Beach Memorial Medical Center Emergency Department Pain Management Policy for Noncancer Patients
Scope: The emergency department (ED) is the universal safety net for medical care in the United States. One of the most common presenting complaints to the ED is pain. 1 Pain is an extremely complex medical
More informationPoisoning Deaths vs. Motor Vehicle Related Injury Deaths, MA Residents ( )
Source: National Vital Statistics Poisoning Deaths vs. Motor Vehicle Related Injury Deaths, MA Residents (1997 2008) The source of the data is: Registry of Vital Records and Statistics, MA Department of
More informationTo Prescribe or Not To Prescribe
To Prescribe or Not To Prescribe AzSHRM Quarterly Meeting May 11, 2018 Presented by: Karen Wright, RN BSN ARM CPHRM MICA Senior Risk Management Consultant 1 OBJECTIVES List three common classes of medications
More informationStart your patient s drug education
PDR Network Provider Solutions: PDR + for Patients Here Start your patient s drug education So They Get Here FREE Patient Drug Education from PDR PDR+ helps you educate your patients about their prescriptions.
More informationDelaware Emergency Department Opioid Prescribing Guidelines
Delaware Emergency Department Opioid Prescribing Guidelines This guideline is intended for physicians working in hospital-based Emergency Departments (EDs) and free-standing emergency centers in the state
More informationWILLIAMS, WYCKOFF & OSTRANDER, PLLC Attorneys at Law
WILLIAMS, WYCKOFF & OSTRANDER, PLLC Attorneys at Law Wayne L. Williams Douglas P. Wyckoff Dane D. Ostrander 2958 Limited Lane N.W. P O Box 316 Olympia, WA 98507 Telephone (360) 528-4800 Telefax (360) 943-2430
More informationPALLIATIVE CARE The Relief You Need When You Have a Serious Illness
PALLIATIVE CARE The Relief You Need When You Have a Serious Illness PALLIATIVE CARE: Improving quality of life when you re seriously ill. Dealing with any serious illness can be difficult. However, care
More informationPsychotropic Medication
FOM 802-1 1 of 10 OVERVIEW The use of psychotropic medication as part of a child s comprehensive mental health treatment plan may be beneficial and should include consideration of all alternative interventions.
More informationMedication Agreements Promoting awareness, dialogue and level-set expectations
Medication Agreements Promoting awareness, dialogue and level-set expectations A young man had his leg amputated following a work-related injury. His pain doctor, by all accounts, was trying to responsibly
More informationCOMPASS RECOVERY OPIOID REHABILITATION PROGRAM QUESTIONAIRE FOR PROSPECTIVE OPIOID REHABILITATION. Name Birthdate / /
COMPASS RECOVERY OPIOID REHABILITATION PROGRAM QUESTIONAIRE FOR PROSPECTIVE OPIOID REHABILITATION Name Birthdate / / Home phone ( ) - Cell phone ( ) - Please answer the following questions which will help
More informationRisk Reduction Strategies in Pain Management
Risk Reduction Strategies in Pain Management Melissa J. Durham, PharmD, MACM, BCACP, DAAPM Assistant Professor of Clinical Pharmacy USC School of Pharmacy Clinical Pharmacist, The USC Pain Center Learning
More informationOpioid Task Force Kick-Off Meeting. February 29, 2016
Opioid Task Force Kick-Off Meeting February 29, 2016 Scope of the Opioid Problem and Data Review Olivia Kasirye, MD, MS County Public Health Officer OVERVIEW The Opioid Epidemic Opioid Task Force Development
More informationTaking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain
Taking Opioids Responsibly for Your Safety and the Safety of Others: Patient Information Guide on Long-term Opioid Therapy for Chronic Pain Department of Veterans Affairs (VA) and Department of Defense
More informationCanadian Guideline for Opioids for Chronic Non-Cancer Pain. Speaker Disclosure. Objectives. Canadian Guideline for Opioids for Chronic Non-Cancer Pain
Canadian Guideline for Opioids for Chronic Non-Cancer Pain John Fraser Community Hospital Program New Glasgow November 1, 2017 This speaker has been asked to disclose to the audience any involvement with
More informationTreatment of Pain in an Emergent Setting
Updated: October 22, 2018 Prescribing Guidelines for Pennsylvania Treatment of Pain in an Emergent Setting Opioids, including heroin and fentanyl, contribute to thousands of overdose deaths in Pennsylvania
More informationThe Challenging Patient with Chronic Opioid Usage MD ACP Meeting
The Challenging Patient with Chronic Opioid Usage. 2018 MD ACP Meeting Darius A. Rastegar, MD March 12, 2018 1 Prescribing Opioids: A question of balance Opioids are an effective treatment for acute pain.
More informationOpioid Prescribing Tips & Tricks CANDY STOCKTON, MD MAY 2018
Opioid Prescribing Tips & Tricks CANDY STOCKTON, MD MAY 2018 Disclosures None Educational Objectives Understand CA state medical board guidelines for prescribing opioids for chronic pain Understand the
More informationNaloxone and Combating the Opioid Epidemic
Objectives Naloxone and Combating the Opioid Epidemic Jeff Jacobson PharmD Southpointe Pharmacy Discuss the current opioid crisis Define the role of Naloxone in opioid overdose Analyze the barriers to
More informationOklahoma. Prescribing and Dispensing Profile. Research current through November 2015.
Prescribing and Dispensing Profile Oklahoma Research current through November 2015. This project was supported by Grant No. G1599ONDCP03A, awarded by the Office of National Drug Control Policy. Points
More informationEXTENDED RELEASE OPIOID DRUGS
RATIONALE FOR INCLUSION IN PA PROGRAM Background Hydrocodone (Hysingla ER, Vantrela ER, Zohydro ER), hydromorphone (Exalgo), morphine sulfate (Arymo ER, Avinza, Embeda, Kadian, MorphaBond, MS Contin),
More informationFor female patients only: To the best of my knowledgei am NOT pregnant. Patients Initials:
Which doctor are you here to see? NAME OF PATIENT: DATE: TO THE PATIENT: As a patient, you have the right to be informed about your condition and the recommended medical or diagnostic procedure or drug
More informationSHARED CARE GUIDELINE FOR THE MANAGEMENT OF PATIENTS ON NALTREXONE FOR ALCOHOL DEPENDENCE INDICATION
SHARED CARE GUIDELINE FOR THE MANAGEMENT OF PATIENTS ON NALTREXONE FOR ALCOHOL DEPENDENCE INDICATION Naltrexone is used as part of a comprehensive programme of treatment against alcoholism to reduce the
More informationNeuropathic Pain Treatment Guidelines
Neuropathic Pain Treatment Guidelines Background Pain is an unpleasant sensory and emotional experience that can have a significant impact on a person s quality of life, general health, psychological health,
More information