Dr. Andrea Furlan (left), the Medical Lead of the Toronto Rehab Pain Program and Dr. Pamela Leece (right), a family physician, review the Canadian Opioid Guideline. Dr. Furlan and project co-applicant Dr. Leece received federal funding to address family physicians’ adherence to the guideline for opioid prescriptions. (Photo: UHN)
Dr. Andrea Furlan, Medical Lead, Toronto Rehab Pain Program, received over $550,000 in funding from Health Canada to address family physicians' knowledge of safely prescribing opioids for patients suffering from chronic non-cancer pain. Her project is one of six across the country selected by Health Canada for funding.
Fifty per cent of Canadian physicians are family physicians, and most often they are the ones who provide care and opioid prescriptions for patients with chronic pain. The goal of Dr. Furlan's project is to reduce variability in opioid prescribing.
"We know that approximately 30 per cent of physicians will not prescribe opioids to chronic non-cancer patients, while others are too liberal with opioid prescriptions," says Dr. Furlan.
Chronic pain in Canada
With 2.7 million Ontarians living with chronic pain every day, it is the most common reason for people in the province to seek health care and the primary complaint in up to 78 per cent of visits to the emergency department.
"Finding a primary care doctor that has available tools to assess if that patient is the right candidate for opioids means that the doctor is not putting them at risk of getting addicted to the medicine, dying of overdose or developing complications," says Dr. Furlan.
Canadian opioid guidelines
There are currently guidelines in place for physicians to follow in order to safely prescribe opioids: the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain.
Dr. Furlan's project has three main objectives: first, it aims to develop an online self-assessment program to improve physician knowledge of the Canadian opioid use guidelines. It will also create and test measurements of knowledge, processes and clinical practice pursuant to the guidelines. Finally, the third objective is to understand the main facilitators and barriers that exist for physicians in their adherence to the guideline.
Existing opioid prescription management projects
Dr. Furlan has already pioneered several projects with regards to safe opioid prescription and management. The common goal of all her projects is to make it easy for physicians to adhere to the guidelines, subsequently reducing variability in prescriptions.
Her recent projects include the creation of an app called
Opioid Manager in 2012 which is used by physicians along with their patients to help with pain management and the safe prescription of opioids. This year Dr. Furlan built on her first app and created
My Opioid Manager (MyOM), which helps patients understand the use and side effects of opioids and enables them to track their pain and opioid use.
Another project by Dr. Furlan, developed last year, is the
Extensions of Community Healthcare Outcomes (ECHO) demonstration project. It uses teleconferencing technologies to increase communication between primary care providers and chronic pain specialists to empower physicians in underserved areas.
