(A) For purposes of this
rule:
(1) "OARRS"
means the "Ohio Automated Rx Reporting System" drug database
established and maintained pursuant to section 4729.75 of the Revised
Code.
(2) "OARRS
report" means a report of information related to a specified patient
generated by the drug database established and maintained pursuant to section
4729.75 of the Revised Code.
(3) "Personally
furnish" means the distribution of drugs by a prescriber to the
prescriber's patients for use outside the prescriber's practice
setting.
(4) "Protracted
basis" means a period in excess of twelve continuous weeks.
(5) "Reported
drugs" means all the drugs listed in rule 4729-37-02 of the
Administrative Code that are required to be reported to the drug database
established and maintained pursuant to section 4729.75 of the Revised Code,
including:
(a) Controlled substances in schedules II, III, IV, and V,
and
(b) All dangerous drug products containing carisoprodol or
tramadol.
(c) Other non-controlled dangerous drug products as listed in
rule 4729-37-02 of the Administrative Code in the definitions as paragraph
(A)(5)(b) of this rule.
(B) If a licensed optometrist believes or
has reason to believe that a patient may be abusing or diverting drugs, the
optometrist shall use sound clinical judgment in determining whether or not the
reported drug should be prescribed or personally furnished to the patient under
the circumstances.
(1) To assist in this
determination, the licensed optometrist shall access OARRS and document receipt
and assessment of the information received if the patient exhibits the
following signs of drug abuse or diversion:
(a) Selling prescription drugs;
(b) Forging or altering a prescription;
(c) Stealing or borrowing reported drugs;
(d) Increasing the dosage of reported drugs in amounts that
exceed the prescribed amount;
(e) Having a drug screen result that is inconsistent with the
treatment plan or refusing to participate in a drug screen;
(f) Having been arrested, convicted or received diversion, or
intervention in lieu of conviction for a drug related offense while under the
physician's care;
(g) Receiving reported drugs from multiple prescribers, without
clinical basis; or
(h) Having a family member, friend, law enforcement officer, or
health care professional express concern related to the patient's use of
illegal or reported drugs.
(2) Other signs of
possible abuse or diversion which may necessitate accessing OARRS include, but
are not limited to the following:
(a) A known history of chemical abuse or
dependency;
(b) Appearing impaired or overly sedated during an office visit
or exam;
(c) Requesting reported drugs by specific name, street name,
color, or identifying marks;
(d) Frequently requesting early refills of reported
drugs;
(e) Frequently losing prescriptions for reported
drugs;
(f) A history of illegal drug use;
(g) Sharing reported drugs with another person; or
(h) Recurring emergency department visits to obtain reported
drugs.
(C) A licensed optometrist prescribing
or personally furnishing reported drugs to treat a patient on a protracted
basis shall, at a minimum, document receipt and assessment of an OARRS report
in the following circumstances:
(1) Once the licensed
optometrist has reason to believe that the treatment will be required on a
protracted basis; and
(2) At least once
annually, thereafter.
(D) A licensed optometrist shall
document receipt and assessment of all OARRS reports in the patient
record.
(1) Initial reports
requested in compliance with this rule shall cover a time period of at least
one year;
(2) Subsequent reports
requested in compliance with this rule shall, at a minimum, cover the period
from the date of the last report to present.
(E) In the event an OARRS report is not
available prior to writing a prescription for a reported drug or personally
furnishing the reported drug, a licensed optometrist shall document in the
patient record why the OARRS report was not available.
(F) Paragraph (C) of this rule does not
apply to a hospice patient in a hospice care program as those terms are defined
in section 3712.01 of the Revised Code.
