Improving the safe use of monitored medicines – Real Time Prescription Monitoring
Many pharmacist locums travel widely and work across the States and Territories throughout Australia. With the recent implementation of SafeScript NSW, (a real-time prescription monitoring (RTPM) system), it highlights the importance of keeping abreast of regulatory changes and the differences between state and territory jurisdictions.
Although the Commonwealth, state and territory agencies are working together to implement the real time prescription monitoring systems across Australia, each state or territory is responsible for the management of controlled medicines in its jurisdiction.
The purpose of a RTPM system is to:
- identify patients who are at risk of harm due to dependence or misuse of controlled medicines.
- identify patients who may be diverting these medicines.
- limit ‘prescription shopping’.
- provide state and territory regulators with data to detect prescribers who are not complying with regulations.
With the misuse of opioid analgesics, benzodiazepines and other psychoactive medicines being a serious and increasing problem in Australia, RTPM provides information to prescribers and pharmacists about a patient’s history and use of controlled medicines, when they are considering prescribing or dispensing these medicines.
The most recent figures from ‘Australia’s Annual Overdose Report 2022’, indicates that one person dies of overdose every four hours. A concerning aspect of this report is the number of Australian overdose deaths involving fentanyl (along with two other synthetic opioids, pethidine and tramadol), where there has been a 1,275% increase in overdose since 2006. The majority of these opioid-induced fatalities were unintentional overdoses in middle aged males involving the use of pharmaceutical opioids, often in the presence of other substances.
If you are planning on working throughout Australia you will need to register to the appropriate RTPM system in each state or territory.
Australian Capital Territory (ACT)
Canberra Script was launched in February 2022 and it replaces the Drugs and Poisons Information System (DAPIS) Online Remote Access (DORA) RTPM system. The use of Canberra Script is voluntary for health practitioners.
Canberra Script training and resources
New South Wales (NSW)
SafeScript NSW was rolled out across the state using a phased approach, and in late May 2022 it was made available to dispensers and prescribers in all NSW areas. The use of SafeScript NSW is not currently mandatory.
SafeScript NSW education and training
Northern Territory (NT)
On 1 March 2022, access to NTScript became available for pharmacist and other Ahpra registered health practitioners. NTScript replaces the Schedule 8 monitoring system that has been in operation since 2004. NTScript continues the mandatory monitoring which has been in place since 1983.
NTScript Registration and training
QScript is available to all relevant health practitioners who are authorised to prescribe or dispense monitored medicines. Following the commencement of the Medicines and Poisons Act 2019 in September 2021, it is a mandatory requirement to check QScript for patient records before prescribing, dispensing, or giving a treatment dose of a monitored medicine.
South Australia (SA)
South Australia launched ScriptCheckSA in 2021 and is restricted to Ahpra registered pharmacists who are involved in a patients care and only for the purpose of determining if supply of a monitored drug is safe and appropriate. The use of ScriptCheckSA is currently voluntary, however it is expected that it will become mandatory.
ScriptCheck SA Registration and Training
Tasmania introduced the Drugs and Poisons Information System (DAPIS) Remote Access system in 2009. The clinician facing system DORA became available in 2011. In December 2021, the Poisons Act 1971 was amended to facilitate the implementation of a nationally consistent RTPM system in Tasmania that will be integrated into the National Data Exchange. This system will be known as TasScript.
Tasmania’s RTPM Information
From April 2020 it is mandatory to check SafeScript prior to writing or dispensing a prescription for a medicine monitored through the system. There will be exceptions in some circumstances, including when treating patients in hospitals, prisons, police gaols, aged care and palliative care.
Real-time prescription monitoring: Safescript
Western Australia (WA)
Western Australia currently operates a comprehensive prescription monitoring program that collects all dispensing data relating to Schedule 8 medicines from community pharmacies. The development of a new RTPM system has been halted due to COVID-19, however the intention is for access in 2022.