pain contracts

[ohmeowzer RN, RN]

my mother started with a new Dr. she is 75 and has very severe osteoarthritis ... i was a little miffed when he had her sign a pain contract. he said medicare requires a pain contract ... for pain meds to be given over a long period of time .. i have never heard of that for medicare . i have been a nurse for 25 years and can't see why he would have a 75 year old woman sign that. does medicare require this or is this just his policy ? my mom never drinks or has never taken any type of drugs legal or illegal.. she was in the convent in the roaring 60's when the hippies were wild. i think chronic pain management in the US is very poor... my mom looked at the contract and was appalled.. her last Dr never had her sign anything like that... any thoughts on pain contracts? .. and does ,medicare really require them or was this his excuse? she was only getting a refill on her lortab 10 she's been on for 5 years for her arithitis... and he tried her on oxycodone without a pain contact and she could not take it .. to much .. she went back to her old med lortab ... anyway in Jan we are going back to her old dr... anyway thank you for your input .. i appreciate all of you !!

[MunoRN, RN]

As far as I can tell, Medicare doesn't require a pain contract, although I wouldn't be opposed if they did. I don't think it's unreasonable for an MD to ask that you not sell the Narcotics they are prescribing you, or that you not fill narcotic prescription from every Doc in town. 75 year old women are certainly not immune from opiate abuse.

[Trekfan]

my mother started with a new dr. she is 75 and has very severe osteoarthritis ... i was a little miffed when he had her sign a pain contract. he said medicare requires a pain contract ... for pain meds to be given over a long period of time .. i have never heard of that for medicare . i have been a nurse for 25 years and can't see why he would have a 75 year old woman sign that. does medicare require this or is this just his policy ? my mom never drinks or has never taken any type of drugs legal or illegal.. she was in the convent in the roaring 60's when the hippies were wild. [color=sandybrown]i think chronic pain management in the us is very poor... my mom looked at the contract and was appalled.. her last dr never had her sign anything like that... any thoughts on pain contracts? .. and does ,medicare really require them or was this his excuse? she was only getting a refill on her lortab 10 she's been on for 5 years for her arithitis... and he tried her on oxycodone without a pain contact and she could not take it .. to much .. she went back to her old med lortab ... anyway in jan we are going back to her old dr... anyway thank you for your input .. i appreciate all of you !!

i think that new doc. of yours was full of #### as far as i know there is no such rule (but that is not to say they have not made one ) they made my mom sign one of thouse when her pain med keep disapiring "turns out the ot was taking them" but anyway but you are right chronic pain management here is a joke

[ohmeowzer RN, RN]

yeah i think he was full of ... too.. my mom was shocked and in jan we are going back to her old doctor...

[ohmeowzer RN, RN]

As far as I can tell, Medicare doesn't require a pain contract, although I wouldn't be opposed if they did. I don't think it's unreasonable for an MD to ask that you not sell the Narcotics they are prescribing you, or that you not fill narcotic prescription from every Doc in town. 75 year old women are certainly not immune from opiate abuse.

well you are right.. ive been a nurse for 25 years ,, thats fine if he wants her to sign it. but don't fib to your patients about it being a requirement... he is history in Jan ...we are heading back to her former Doc...

[wooh, BSN, RN]

He probably requires them from all of his patients so that he can say he requires them from all of his patients. Otherwise, you get someone that "should" have a contract and they get offended by it, like you and your mom. If you don't plan on abusing the meds prescribed, then there shouldn't be a problem.

[Hospice Nurse LPN, BSN, RN]

As far as I can tell, Medicare doesn't require a pain contract, although I wouldn't be opposed if they did. I don't think it's unreasonable for an MD to ask that you not sell the Narcotics they are prescribing you, or that you not fill narcotic prescription from every Doc in town. 75 year old women are certainly not immune from opiate abuse.

75 y/o women aren't immune from their family members taking them, either. I think pain contracts are a good idea.

[~Mi Vida Loca~RN, ASN, RN]

They are used at my clinic. They are required by anyone on long term pain meds and you also have to go to the clinic once a month to pick up the paper prescription. It can't be called in or have refills on it.

I have no problems signing the pain contract, going in every month to pick up the script is a pain in the rear.

[SouthernPoint]

http://doctorlaw.wordpress.com/2011/07/07/medicare-proposes-to-cut-back-on-pain-management-alternative-to-pills/

Maybe this is the Underlining Reason why.

[linearthinker, DNP, RN]

Pain contracts (or better yet. controlled substance contract) are a very good idea and should be the standard of care with every pt. on any long term schedule II.

[imintrouble, BSN, RN]

One of our docs has these contracts. I'm not sure what his rationale or why he initially started them. What I do know is that it has cut down on drug seekers requesting him for their primary physician. It requires too much time and effort for a pt who only wants a quick fix.

[~Mi Vida Loca~RN, ASN, RN]

One of our docs has these contracts. I'm not sure what his rationale or why he initially started them. What I do know is that it has cut down on drug seekers requesting him for their primary physician. It requires too much time and effort for a pt who only wants a quick fix.

I am not sure where the extra time and effort comes into play. All it takes is an extra 15 seconds to sign your name and initial the lines. Maybe 45 seconds if you're a slow reader.