The Patient as an Integrated Member of the Treatment Team: Clinical Steps for Effective Patient Education

REMS 2015 published on September 28, 2015
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Jennifer Bolen, JD
Founder, The Legal Side of Pain and The Pain Lawyer™
A Division of the J. Bolen Group, LLC
Knoxville, Tennessee

Now that you have completed Module IV, I would like to provide you with just a few reminders and suggestions of what you should be incorporating in your practice to deal with patient counseling. Substandard patient counseling would go something like this. Let the patient figure it out themselves. Let them read the package insert. I do not have time for that. My informed consent documents are good enough and that is all I have to do. That is substandard. That is not right. Patient counseling is a process. It involves a dialogue with the patient. It involves pointing out where patients can get information. It involves going over the risks, the benefits, the treatment alternatives, and special issues associated with the medication. A lot of that stuff is set forth in your package insert. The REMS program and the FDA have created many tools that you can use with your patients to help educate them. Do not think about this as trying to do it all in one visit. Think about it as a process. Think about how it happens in your practice. Many of the FDA documents used to help patients educate on safe use of these medications, safe storage, and safe disposal are beautiful color handouts, and you could blow them up and put them in your examination rooms, you can hand them out to your patients, you could cover them through other staff members in your practice. Whatever the case, engage in patient counseling, it is very critical that you show you care for your patients and that if they have questions about their ability to safely store their medication, then tell them where they might find out more information because storage of these materials is critical as well. I think it is important that you understand that the people that evaluate you and from a state licensing board perspective in any kind of trial situation, those individuals are patients and your documentation tells a lot about whether you care for your patients as individuals, whether you have really individualized treatment or not, and if you do not consider these things in the prescribing of extended-release or long-acting opioids, that could send a very bad signal. It is a big responsibility, but it is something that can easily be handled if you think about this process over time. So engage in patient counseling, it is critical.

Am I liable if my patients sell or share their medications? The answer to that question is you certainly could be, and that is part of that patient counseling, patient evaluation, and patient selection process. Have you really covered these issues with your patient? A treatment agreement is one of the good places to cover this question. Counsel your patients not to sell or share their medication and tell them why. That taking one of these medications by somebody who does not have them in the body could kill them. That is really important for patients to understand. Selling is outright illegal. We all know that but put it in the document and go over it and repeat this kind of education periodically, update your treatment agreements once a year and it will send the signal that you do care and you took reasonable steps to prevent abuse and diversion. That is the burden that the law puts on you and that you prescribe these medications for a legitimate medical purpose in the usual course of professional practice. And the best practices that we are talking about are what start to fill out that the usual course of the professional practice requirement, that is a tool kit that we are building here for you through these different modules.

So do not forget to click on the tools link in this module where you will find some comprehensive resources and forms that you can download and use in your practice. For patient counseling, this can make your job much easier and can show that you really care. Do it today. Thank you.

Last modified: September 28, 2015