All patients aged 19 years and older prescribed long-term treatment for chronic pain (ICD-10 G89.4) and/or ADHD (ICD10 F90.0). The following exclusion criteria were used: pregnancy, discontinuation of medication, loss of insurance coverage, decision to prescribe drugs elsewhere (for example. B psychiatrist, pain specialist, etc.) unappreciated during the study period. The final sample size was No. 50. Only patient visits directly related to the prescribing of chedule II drugs containing controlled substances were included in the data set. Unrelated visits were excluded from this study. The safety and care of our patients is our priority! Recent changes in state law (as well as our office guidelines and procedures) regarding controlled substances have been designed with your safety and attention in mind. Models of patient agreements were consulted online, verified and tailored to the needs of the clinical environment. The final agreement on patients included a clear purpose and a prescription policy.
The responsibilities of the patient and the physician have been clearly described. Data protection issues were raised, as were the consequences of a patient`s refusal to sign or comply with the agreement. The agreement required the following practical changes: a signed patient agreement, Schedule II, in the patient`s medical record; Reviewing the state`s prescribing control program at each hospital visit for controlled substances; random urine screens of at least one screen/patient/12 months; and no written recipes outside of a mandatory 3-month visit. The first sample included 69 patients, 19 of whom filled valid exceptions for not signing a patient contract and leaving a final sample of No. 50 patients. Exclusions included pregnancy (n-1), absences during studies (n-5), discontinued medications (n-6), medications prescribed elsewhere (n-5) and loss of insurance (n-2). Table 1 provides a detailed description of the sample`s characteristics. The average age (standard deviation) was 50.7 (16.3). Of the final sample (n-50), the majority of patients were white (96.0%) women (62.0%). There was almost an equal proportion of Chedule II drugs prescribed for chronic pain and ADHD.
Table 2 shows changes in compliance or derogation from the elements of the agreement signed between the pre-introduction and post-introduction periods. All measures improved markedly after implementation: the agreements signed in the diagrams exceeded the compliance target by 90% and all the pre-measures/post-measures were statistically significant (P < 0.001). Patients with controlled chemical treatment must sign an agreement on controlled substances. Some of the conditions of this agreement are: the patient agreement was developed and adopted by practice before the implementation date of 1 May 2015. Throughout the development and implementation of the agreement, physicians remained sensitive to the stereotype of the drug researcher, who is often supported by patients prescribed by controlled substances.