Analysis of Controlled Substance Agreements from Private Practice Physicians

Collen, Mark

doi:10.3109/15360280903324127

Cited by 14 publications

(10 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients would like information on side effects, drug interactions, addiction potential, privacy of the PPA and drug testing. However, a recent analysis of 41 PPAs from 18 states reported that while 98% of the PPAs stipulated the one doctor rule, only 83% contained information on adverse/side effects, 53% contained information about goals of treatment and 34% contained information on drug–alcohol or drug–drug interactions [16]…”

Section: Discussionmentioning

confidence: 99%

Perceptions of patient provider agreements

Albrecht

Khokhar

Pradel

et al. 2015

Journal of Pharmaceutical Health Services Research

View full text Add to dashboard Cite

Objectives Use of patient provider agreements (PPAs) is increasing, yet there is limited evidence on the effectiveness of PPAs to prevent prescription opioid misuse and diversion, and few guidelines for providers. We conducted eight focus groups to understand patient and prescriber perceptions of PPAs. Methods We recruited 40 patients who had been asked to sign a PPA and 40 prescribers who had administered at least one PPA. We developed topic guides for the two groups based on prior literature. Focus groups were audio-recorded and transcribed verbatim. Two investigators independently performed the content analysis of the transcripts and reached consensus on recurring themes. Key findings PPA use varied according to physician specialty. General practitioners used PPAs the least but reported increasing pressure from liability insurers to use them. Many patients reported signing a PPA in the emergency room of a hospital. Prescribers and patients reported a lack of understanding among patients concerning the purpose and content of the PPA. Prescribers questioned the legal status of the PPA, while patients believed that the PPA was a legal document intended to protect prescribers. Patients and prescribers valued PPA content items differently, although both groups agreed that signing a PPA would not prevent opioid misuse. Conclusions We identified several themes concerning the administration, content, effectiveness and utility of PPAs that highlight areas of research to improve PPAs. We also describe trends requiring further investigation. Understanding content of importance to patients will facilitate the development of a patient-centred PPA.

show abstract

Section: Discussionmentioning

confidence: 99%

Perceptions of patient provider agreements

Albrecht

Khokhar

Pradel

et al. 2015

Journal of Pharmaceutical Health Services Research

View full text Add to dashboard Cite

show abstract

“…Pain clinicians often require patients to sign a "controlled substance agreement" in order to receive opioid therapy (8). A controlled substance agreement is a written document that contains information about medication risks and side effects, lists instructions for obtaining refills, establishes rules for compliance, and discusses penalties for violations (9). A majority of agreements contain a stipulation requiring patients to consent to random drug screens (9,10) that search for licit and illicit drugs.…”

Section: Introductionmentioning

confidence: 99%

Profit-Driven Drug Testing

Collen¹

2012

Journal of Pain & Palliative Care Pharmacotherapy

Self Cite

View full text Add to dashboard Cite

Random drug testing of people being treated for chronic pain has become more common. Physicians may drug test patients on opioid therapy as a result of concerns over prosecution, drug misuse, addiction, and overdose. However, profit motive has remained unexplored. This article suggests profits also drive physician drug-testing behavior and evidence is offered, including an exploration of Medicare reimbursement incentives and kickbacks for drug testing.

show abstract

“…Opioids are considered controlled substances (12) and clinicians often have their patients sign a controlled substance agreement (CSA) as a condition of receiving opioid therapy (13). A "controlled substance agreement" is a written document that contains information about medication risks and side effects, lists instructions for obtaining refills, establishes rules for compliance, and discusses penalties for violations (14). Many also provide for consent to opioid therapy and drug testing, and patients are required to sign the agreements (15).…”

Section: Introductionmentioning

confidence: 99%

The Fourth Amendment and Random Drug Testing of People With Chronic Pain

Collen

2011

Journal of Pain & Palliative Care Pharmacotherapy

Self Cite

View full text Add to dashboard Cite

It is common for physicians who prescribe opioids for chronic pain to drug test their patients. This practice may soon be mandated by the State of Washington as a result of passage of their new law ESHB 2876. Random drug testing of people simply because they seek treatment for chronic pain arguably constitutes a suspicionless and warrantless search that violates both the Fourth and Fourteenth Amendments. Issues discussed include consent, circumstantial coercion, and "special needs" searches.

show abstract

Analysis of Controlled Substance Agreements from Private Practice Physicians

Cited by 14 publications

References 4 publications

Perceptions of patient provider agreements

Perceptions of patient provider agreements

Profit-Driven Drug Testing

The Fourth Amendment and Random Drug Testing of People With Chronic Pain

Contact Info

Product

Resources

About