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| Vol. 23, No. 19 |
| October 15, 2001 |
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Pain Management - By KATHLEEN CHARTER At a recent gathering sponsored by the Texas Medical Center's Pain and Palliative Care Group, approximately 40 Houston-area health care professionals, and others interested in pain and palliative medicine, assembled to hear Dr. Roger W. Anderson share the Texas Board of Pharmacy's perspective on pain management. Dr. Anderson has been a member of the board for two years, and was recently elected vice president. In addition, he is the pharmacy director at The University of Texas M.D. Anderson Cancer Center, which is the largest cancer center and pharmacy in the world. "Pain management has become of great interest to many people," Dr. Anderson said. "All disciplines need to work together for this common goal." Recent pharmacy-related activities that Dr. Anderson reported on included:
Dr. Anderson said the Journal of the American Pharmaceutical Association study concluded that pharmacists play a pivotal role in ensuring patient access to medications. "In the context of federal and state controlled substance policies, our findings suggest that incorrect knowledge and attitudes of some pharmacists can be detrimental," he said. "Patients need to have access to their correct pain medications, in the appropriate doses." The study recommends that pharmacists need additional education about the use of controlled substances for pain management, both in colleges and continuing education. Dr. Anderson said state pharmacy boards should consider adopting guidelines or policy statements in conjunction with nursing and medicine boards that:
"Pain education is key," Dr. Anderson said. "We need to make sure that we understand how pain is defined under these addiction-related terms." Another topic for discussion was the use of triplicate prescriptions. Currently they are managed by the Texas Department of Public Safety. An important point to note, Dr. Anderson said, was that as of Sept. 1, the state board changed the Emergency Dispensing Amendment (S.B. 753). The new amendment says that physicians now have seven days to provide an official prescription to the pharmacy when they have to prescribe pain medicine under emergency circumstances, rather than the previously allotted time of 72 hours. They will also allow filling of Schedule II controlled substances via facsimile copy, as long as the original prescription is submitted within that seven-day period. Other Schedule II changes include the design of the official triplicate prescriptions. They now are a single copy, making them easier to handle, and are printed on special paper. Each is preprinted with the name and control number, and when photocopied, the word "VOID" appears. They are also heat sensitive, and the "Rx" symbol will appear when rubbed or heated. Finally, microlines are imbedded, and when the prescription is copied, practitioner signature lines become the phrase "txdps," and appear over and over in a straight line. Dr. Anderson said the bottom line is that pharmacists must take care of their patients. "They will not get in trouble with us if they truly have the patients' best medical interest in mind," he said. "If pharmacists question a prescription, they should always contact the practitioner, and, if the prescription is for a legitimate medical purpose, dispense it." The Pain and Palliative Care Group meets approximately every two months. Membership is free and open to patients, physicians, and anyone interested in the subject. Topics covered include record keeping, institutional approaches to pain management and palliative care, patients' points of view, and problems that chronic pain patients may face with employers. The next program is tentatively scheduled for Thursday, Nov. 29.
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