Module 5: Monitoring and Evaluation
Responding to prescription fraud
Responding to prescription fraud (Canadian Medical Protective Association)
Identifying Forgeries and Fraudulent Prescriptions (Ontario College of Pharmacists)
Prior to prescribing or renewing a prescription for controlled drugs, it is important to ask the patient if he or she has sought or obtained controlled drugs from another prescriber in the past 30 days. It is an offence under the federal Controlled Drugs and Substances Act for a patient to fail to disclose this information to a prescribing practitioner.
Despite this precaution, a pharmacist may report that a patient has “double prescribers”. In such situations, it may be helpful to discuss the matter directly with the patient if this is unlikely to put the pharmacist or the prescribers in danger. If the double prescribers appear to be part of a drug dependency problem, it should be managed accordingly. Consultation with the other treating prescriber may also be appropriate.
Police investigating suspected offences may request information from prescribers about the prescriptions issued to one of their patients. In these circumstances, prescribers should verify the authenticity of the prescription they are alleged to have written. Patient information should not be volunteered, however, except to verify the information on the prescription such as the name, date and drug amount.
Provincial college policies regarding acceptable release of patient information to police vary across jurisdictions. The prescriber should contact his or her college or the Canadian Nurses Protective Society for specific guidance.
In some situations, it may be necessary to consider terminating the practitioner-patient relationship with persistently exploitive, non-cooperative and non-compliant patients.