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September 23-24, 2019 | Prague, Czech Republic
2
nd
International Conference on
Palliative Care
Clinical Trials and Pharmacovigilance
Joint Event
&
Impact of ambiguous and restrictive regulations onopioid-prescribingpractice inGeorgia
Pati Dzotsenidze
Iv. Javakhishvili Tbilisi State University, Georgia
W
hile there is a wide dispute regarding long term opioid
use for different health conditions worldwide, chronic
pain management with opioids remains a challenge even in
incurable patients in many countries, including Georgia. One
of the most prominent causes of undertreating pain is overly
restrictive legislation, which is regulating use of opioids for
pain management. Besides the regulations, creating a variety
of barriers, there are some contradictory elements within
the older regulations and normative orders adopted later
in Georgia, that confound the regulatory parameters and
can strengthen physicians’ unwillingness to prescribe such
medications.
To identify barriers to pain management in Georgia we
conducted a survey among 550primary health carephysicians
(Family Doctors) that are responsible on opioid prescription.
Overall, 289 questionnaires were analyzed. To highlight all
possible consequences of the irrationally strict legislation,
we studied influence of restrictions on physicians’ medical
practice, administrative issues, physicians’ understanding of
legislative aspects governing opioid use, and their impact on
opioid-prescribing practice.
We found that 38%of the physicians avoid prescribing opioids
at all and only one-third of them make an independent
decision to treat the patients with opioids. About one-third
of the physicians know the updated liberalized legislation
and even fewer follow it. The physicians and administrators
or managers of their health care facilities prefer to follow the
old regulatory rules. Those who apply more liberal legislation
and have better medical practice are investigated three to five
times more by legal authorities for prescribing morphine to
incurable patients than those who do not. Those physicians
who know anyone that has been investigated because of
opioid prescribing practice, aremore concerned that they can
be also investigated. Physicians who are concerned that they
might be investigated are less inclined to prescribe opioids
or use liberalized regulations. Hence, ambiguous legislation
negatively influences opioid-prescribing practice.
e
:
pati.dzotsenidze@tsu.geJournal of Primary Care and General Practice | Volume 2
J Prim Care Gen Pract, Volume:2