Washington Administrative Code
Title 246 - Health, Department of
PROFESSIONAL STANDARDS AND LICENSING
Chapter 246-918 - Physician assistants Washington medical commission
OPIOID PRESCRIBING-CHRONIC PAIN MANAGEMENT
Section 246-918-855 - Patient evaluation and patient record-Chronic pain
Universal Citation: WA Admin Code 246-918-855
Current through Register Vol. 24-18, September 15, 2024
When the patient enters the chronic pain phase, the patient shall be reevaluated as if presenting with a new disease. The physician assistant shall include in the patient's record:
(1) An appropriate history including:
(a) The nature and intensity of the
pain;
(b) The effect of pain on
physical and psychosocial function;
(c) Current and relevant past treatments for
pain, including opioids and other medications and their efficacy; and
(d) Review of comorbidities with particular
attention to psychiatric and substance use.
(2) Appropriate physical examination.
(3) Ancillary information and tools to include:
(a) Review
of the PMP to identify any medications received by the patient in accordance
with the provisions of WAC 246-919-985;
(b) Any pertinent diagnostic, therapeutic,
and laboratory results;
(c)
Pertinent consultations; and
(d)
Use of a risk assessment tool that is a professionally developed, clinically
recommended questionnaire appropriate for characterizing a patient's level of
risk for opioid or other substance use disorders to assign the patient to a
high-, moderate-, or low-risk category.
(4) Assessment. The physician assistant must document medical decision making to include:
(a) Pain related diagnosis, including
documentation of the presence of one or more recognized indications for the use
of pain medication;
(b)
Consideration of the risks and benefits of chronic opioid treatment for the
patient;
(c) The observed or
reported effect on function or pain control forming the basis to continue
prescribing opioids; and
(d)
Pertinent concerns discovered in the PMP.
(5) Treatment plan as provided in WAC 246-918-860.
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