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Methadone Prescribers’ Peer Assessment

Many of the components are the same as a regular peer assessment, but there are specific areas of compliance for methadone prescribers we assess to minimize public risk.

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The CPSO’s Methadone Specialty Panel operates under the Quality Assurance Committee (QAC) and oversees assessments for physicians prescribing methadone for the treatment of opioid use disorder. The panel is comprised of physicians with addiction treatment experience, including but not limited to methadone maintenance treatment, as well as public members from CPSO’s Council.

Frequency of methadone assessments

Being a methadone prescriber for the treatment of opioid use disorder in Ontario requires an initial assessment one year after taking the recommended course, completing a preceptorship and taking on a minimum of 6-10 patients for whom you are the most responsible physician. If that assessment is successful, we continue to assess prescribers based on the QAC’s regular selection criteria

Preparing for the assessment

When you are due for an assessment, there are a number of pre-assessment activities that happen first:

  • You must complete a Physician Questionnaire. This helps program staff determine if you are eligible for assessment and identify the most appropriate assessor for your practice.
  • The CPSO assigns an experienced methadone prescriber to conduct your assessment. 
  • The Assessment Coordinator assigned to manage your assessment sends you a package containing the name of the assessor visiting your practice. If you identify any conflicts with your assigned assessor, please inform the coordinator as soon as possible.
  • The assessor contacts you to arrange a mutually convenient date for the assessment and discuss the record selection process. If you use an electronic medical record (EMR) system, you must make arrangements ahead of time to ensure the assessor has temporary, read-only access to the system.
  • There may be instances where we exempt or postpone an assessment, such as, but not limited to, maternity/sabbatical leave, current illness, or conversion to EMR. Upon completion of the Physician Questionnaire, the Assessment Coordinator follows up to discuss those situations.

There are more valuable guidelines and tips for getting ready for the assessment on our Peer Assessment page.

Methadone Prescribers’ Peer Assessment Process

When the QAC or Specialty Panel selects a physician for an assessment, you must:

  • Allow the assessor to enter and inspect your practise;
  • Give the assessor access to review your patient care records;
  • Provide any information requested by the panel or assessor in the specified form;
  • Speak with the panel or assessor, if necessary; and 
  • Take part in a program designed to evaluate your knowledge, skill and judgment, if requested by the Specialty Panel.

What we review during the assessment?

Medical Records

The assessor conducts a detailed review of your medical records to understand your practice and approach to patient care. We evaluate methadone prescribers’ quality of care, including compliance with the Methadone Maintenance Treatment (MMT) Standards and Guidelines and relevant CPSO policies, including, but not limited to, Prescribing Drugs and Test Results Management. We encourage you to audit some of your charts using the MMT document as your benchmark for the content and structure of your patient records before the assessment. 

Many of the medical record’s components are required by regulation, while the CPSO’s Medical Records policy also details those considered extremely useful in facilitating quality patient care.

Specific to methadone prescribing

The Methadone Maintenance Treatment for Opioid Dependence policy outlines additional compliance requirements for prescribers administering methadone on-site and/or delegating the administration of methadone to regulated health professional staff, including:

  • Administration;
  • Responsibility for doses;
  • Transportation and transfer of custody;
  • Destruction of unused or unserviceable doses;
  • Safe and secure storage; and
  • Reconciling doses and accounting for lost or stolen doses.