| (vii) potential for impairment of judgment and motor
skills.
(D) Patients who are at-risk for abuse or addiction
require special attention. Patients with chronic pain and histories
of substance abuse or with comorbid psychiatric disorders require
even more care. A referral to an expert in the management of such
patients must be considered in their treatment.
(E) Medical records. The medical records shall document
the rationale of the treatment plan and the rationale for prescribing
a Schedule III, IV or V analgesic. The medical records must be sufficient
to document compliance with this rule, including, but not limited
to, containing:
(i) the medical history and the physical examination;
(ii) diagnostic, therapeutic and laboratory results;
(iii) evaluations and consultations;
(iv) treatment objectives;
(v) discussion of risks and benefits;
(vi) informed consent;
(vii) treatments;
(viii) medications (including date, type, dosage and
quantity prescribed); and
(ix) instructions and agreements.
(2) The Board may open a complaint against an optometric
glaucoma specialist if the Board finds evidence that the optometric
glaucoma specialist is engaging in potentially harmful prescribing
patterns or practices may be occurring. A potentially harmful prescribing
pattern or practice may be determined from:
(A) the number of times an optometric glaucoma specialist
prescribes a Schedule III, IV or V analgesic;
(B) patterns of prescribing combinations of Schedule
III, IV or V analgesics and other dangerous combinations of drugs;
(C) data from the Prescription Monitoring Program indicating
that the volume of prescribing places the optometric glaucoma specialist
in the top prescribers in the state at any time in the preceding 12
months for prescriptions of Schedule III, IV or V analgesics, except
for an optometric glaucoma specialist prescribing the drugs to treat
cancer patients or patients in hospice facilities;
(D) complaints and/or information, from non-anonymous
complainants related to inappropriate prescribing practices, including
those from law enforcement agencies or health care regulators;
(E) A patient overdose death related to Schedule III,
IV or V analgesics, prescribed by a optometric glaucoma specialist;
or
(F) arrest of an optometric glaucoma specialist related
to improper or fraudulent prescribing of controlled substances;
(3) Language in this section regarding the prescribing
of a Schedule III, IV or V analgesic is not intended to expand the
classes of drugs that may be prescribed by an optometric glaucoma
specialist under subsections (a) - (e) of this section.
|
| Source Note: The provisions of this §280.10 adopted to be effective August 3, 2000, 25 TexReg 7176; amended to be effective March 9, 2009, 34 TexReg 1591; amended to be effective January 2, 2019, 43 TexReg 8596; amended to be effective May 22, 2023, 48 TexReg 2576 |
