How does it work in your state?
“Real Time Prescription Monitoring (RTPM) is a computer system that aims to reduce misuse of controlled medicines in Australia. It will alert prescribers and pharmacists to a patient’s medication history before they write or dispense prescriptions for a controlled medicine.” According to health.gov.au the system was introduced to limit levels of overdose and accidental death from over-prescribing.
In April 2020, Victoria became the first state to adopt the mandatory prescription monitoring system enabling healthcare practitioners to access any patient’s prescription histories. This approach allows an individual’s list of prescriptions and dispensed medications to be visible to practitioners and prescribers, regardless of where in the country they may have sought clinical care in the past.
Under this new order, Victorian healthcare practitioners and other prescribers will be mandated to check a patient’s prescription history through SafeScript which will survey the system before issuing a written or electronic prescription for medicines. This approach aims to identify high-risk patients but does not prevent practitioners from dispensing a medicine they believe is clinically required to treat a patient.
In Victoria, SafeScript oversees the dispensing of the following medicines:
- All Schedule 8 medications and codeine containing medicines
- Zopiclone (z drugs)
- Ketamine and quetiapine
- Stimulants for Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy such as dexamphetamine, lisdexamfetamine, methylphenidate
The ACT and TAS currently have a non-mandatory local prescription monitoring system in place. In both States, there is a clinical support tool called DORA - Drugs and Poisons Information System Online Remote Access which is intended to enable practitioners and prescribers to identify and manage the dispensing of certain medicines. It is a secure, real-time web-based system that allows prescribers and pharmacists to identify individuals who may be displaying signs of drug dependency or drug seeking behaviours.
The use of DORA by health professionals is not mandatory. Nevertheless, all eligible prescribers and pharmacists are urged to use DORA as a new part of their clinical practice. Under DORA, dispensing data is available for Schedule 4 and 8 opioids and all other Schedule 8 drugs.
In TAS, DORA has been progressively rolled out across several general practices and pharmacies since 2012.
New South Wales
In NSW, there is an electronic reporting system with the capability to enable real-time prescription monitoring for Schedule 8 drugs, but there is no mandatory real-time prescription system in place yet, at the time of writing this article. The Electronic Recording and Reporting of Controlled Drugs (ERRCD) is used to record authorisations to prescribe as part of the NSW Opioid Treatment Program. It also records client admissions to and exits from treatment, the details of prescribers and dosing points.
Currently, QLD has a prescription drug monitoring program that collects dispensed schedule 8 (S8) prescription drug information on a weekly basis and provides a telephone enquiry service for doctors. However, the data isn’t available in real-time or automatically accessible to clinicians.
It is expected that from the second half of 2020, Queensland pharmacists and prescribers will have access to a real-time prescription monitoring, tentatively called QScript Its use will be mandated to monitor the prescribing and dispensing of all Schedule 8 (S8) products and several S4 medications including benzodiazephines, codeine, pregabalin, tramadol, gabapentin, quetiapine, zolpidem and zopiclone.
There is currently no mandatory real-time prescription monitoring system in place in SA. Schedule 8 prescription drug monitoring is carried out via monthly reporting of prescriptions dispensed.
In WA, there is no mandatory real-time prescription monitoring system in place. The Schedule 8 Medicines Prescribing Code governs the prescribing in Schedule 8 medicines State-wide.
The WA Department of Health authorises any prescription of S8 benzodiazepines or S8 opioid treatment that meets any of the criteria set out in Section 2.5.1 of the Code for each individual patient. Practitioners are required to contact the Schedule 8 Prescriber Information Service (available by phone) to obtain advice on a patient’s prescribing and dispensing history prior to prescribing any of the listed medicines under the Code.
There is currently no mandatory real-time monitoring system in place. Schedule 8 prescription drug monitoring via the Drug Monitoring System (DMS) database. Weekly reporting of prescriptions dispensed.
Before issuing a prescription for a high-risk medicine, a prescriber must take ‘all reasonable steps’ to check the information in their state and for the patient to whom the high-risk medicine may be prescribed or supplied.
For the latest position on real time prescribing in your State or Territory contact your local Department of Health
If you have any questions regarding your membership, please contact MIPS for Clinico-Legal Support on 1800 061 113.