Concerned about the risks of addiction among patients who consume pharmaceutical opioids, the College of Physicians of Quebec (CMQ) launched a monitoring program in January to tighten the screws on doctors who prescribe too much or incorrectly.
“We are alarmed, concerned”, underlined the Dr Mauril Gaudreault, president of the CMQ, in an interview at Duty last January on the sidelines of the launch of this new program. “Is there overprescription? Are there any delinquent doctors? Probably, but I don’t know. »
It is precisely to answer these questions that the CMQ decided to ensure better surveillance of its members, a program that has been in preparation for more than a year. “Given that this was becoming an area that concerns society – and that concerns the College, too – the idea is to identify doctors whose practice is inadequate,” he explained.
Year in and year out, inspectors from the College of Physicians of Quebec identified inadequate practices in the prescribing of opioids during their routine visits.
“There were a few times where we noticed problems in the doctor visited or inspected in relation to this, but it happened infrequently, we are talking about 2% or 3%,” explained the Dr Gaudreault. “But I am convinced that with a program like this, which will target something in particular, there will certainly be more than 2% or 3% of doctors for whom the prescription would perhaps need to be more adequate. »
As part of this program, the Régie de l’assurance santé du Québec (RAMQ) will report to the CMQ all prescriptions for opioids or benzodiazepines that appear problematic. The professional inspection department will subsequently analyze the file and, if necessary, will meet with the doctor to follow up.
“If there are problems, we will offer to help them in the educational sense of the term, see with them if there are things to upgrade in terms of knowledge, whether it is a training course or support with a tutor,” explained Dr.r Gaudreault. In the case of a truly problematic practice, the CMQ may also “limit their exercise”.
He reiterated that doctors must exercise caution when dealing with opioids. “The prescription that I give can always be at the origin of a possible problem of dependence: it is in this sense, prudence. »
In a reminder of good practices sent to their members last year, the College of Physicians, the Order of Pharmacists and the Order of Nurses of Quebec reiterated the importance of “evaluating each case rigorously in order to avoid the harmful effects of opioids and reduce the risk of their misuse.”
They recommend “using the minimum required dose”, reducing the quantities served at one time in pharmacies (a practice known as splitting) and specifying the validity period of prescriptions.