844 IAC 2.2-3-5 - Physician assistant discussion with patient; treatment agreement
Authority: IC 25-22.5-2-7; IC 25-22.5-13-3
Affected: IC 25-1-9; IC 25-27.5
Sec. 5.
The physician assistant shall discuss with the patient the potential risks and benefits of opioid treatment for chronic pain, as well as expectations related to prescription requests and proper medication use. In doing so, the physician assistant shall do the following:
(1) Where alternative modalities to opioids
for managing pain exist for a patient, discuss them with the patient.
(2) Provide a simple and clear explanation to
help patients understand the key elements of their treatment plans.
(3) Counsel women between fourteen (14) and
fifty-five (55) years of age with child bearing potential about the risks to
the fetus when the mother has been taking opioids while pregnant. Such
described risks shall include fetal opioid dependency and neonatal abstinence
syndrome (NAS).
(4) Discuss with
the patient risks of dependency and addiction.
(5) Discuss with the patient safe storage
practices for prescribed opioids.
(6) Provide a written warning to the patient
disclosing the risks associated with taking extended release medications that
are not in an abuse deterrent form, if the physician assistant prescribes for
the patient a hydrocodone-only extended release medication that is not in an
abuse deterrent form.
(7) Discuss
with the patient the risks and benefits of using an abuse deterrent
formulation, as opposed to a non-abuse deterrent formulation, if such a
formulation exists for the opioid product the physician assistant is
prescribing to the patient. Nothing in this subdivision shall be construed to
require a physician assistant to prescribe an opioid in an abuse deterrent
formulation.
(8) Together with the
patient, review and sign a "Treatment Agreement", which shall include at least
the following:
(A) The goals of the
treatment.
(B) The patient's
consent to drug monitoring testing in circumstances where the physician
assistant determines that drug monitoring testing is medically
necessary.
(C) The physician
assistant's prescribing policies, which must include at least a:
(i) requirement that the patient take the
medication as prescribed; and
(ii)
prohibition of sharing medication with other individuals.
(D) A requirement that the patient inform the
physician assistant:
(i) about any other
controlled substances prescribed or taken by the patient; and
(ii) if the patient drinks alcohol while
taking opioids.
(E) The
granting of permission to the physician assistant to conduct random pill
counts.
(F) Reasons the opioid
therapy may be changed or discontinued by the physician assistant. A copy of
the treatment agreement shall be retained in the patient's
chart.
Notes
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