Real time prescription monitoring in Australia

In the past 20 years, more than 35,000 Australians have died from drug overdose.

Most of these deaths involved prescription drugs, in particular opioids and benzodiazepines.¹

And every two minutes, one person in Australia is hospitalised because of prescription medications.^2,3

Real Time Prescription Monitoring (RTPM) aims to help tackle these issues.

The prescription monitoring systems identify and alert GPs and pharmacists to:

• patients on high daily doses of high-risk medications
• risky medication combinations
• high-risk medications prescribed by multiple providers.

High-risk medications are those that have an increased risk of harm or death if not used correctly. These include opioids (e.g. oxycodone), benzodiazepines (such as Valium) and others determined by each state or territory.

Through prescription monitoring, health professionals can access real time information about a patient’s medication history before prescribing or dispensing high risk medications.⁴

What’s happening with RTPM in each state/territory?

Each state and territory is at different stages of implementing their prescription monitoring scheme.

In Queensland, South Australia and Victoria it’s mandatory for prescribers and pharmacists to participate in prescription monitoring, but it’s voluntary in other states and territories.

Click on the links below for state/territory specific information:

• Australian Capital Territory – CanberraScript launched in March 2022
• New South Wales – SafeScript NSW launched in May 2022
• Northern Territory – NTScript launched in March 2022
• Queensland – QScript launched in September 2021
• South Australia – ScriptCheckSA launched in March 2021
• Tasmania – DORA Tasmania was the first state to implement RTPM in 2009
• Victoria – SafeScript launched in April 2019
• Western Australia – ScriptCheckWA system will launch on 28 March 2023. All prescribers must adhere to the state’s Prescribing Code.

Helping prescribers better help their patients

Prescription monitoring systems provide real time reporting on medications that are high risk, dependence-forming (addictive) and commonly involved in drug-related hospitalisations and deaths. This includes sedatives, sleeping tablets, some pain medications and psychostimulant medications.

The system collects personal information to enable monitoring, including information about the prescribing and dispensing of medicines to patients. To find out more on how personal information is used and protected, you can visit this Australian government website.

The monitoring software integrates with the electronic health records doctors and pharmacists already use. As the doctor or pharmacist views a patient’s records, they receive alerts and notifications about the patient’s prescription history.

This helps:

• improve patient safety by helping to identify potential interactions between monitored medicines, and reduce the risk of overdose
• identify patients at risk of harm from drug dependence
• reduce the chance of patients selling their medications to others.⁴

Prescription monitoring can help health professionals make more informed decisions when prescribing. This means they can better support their patients, especially those who are on numerous medications or higher doses of high-risk medications.⁴

Alerting before harms occur

Prescription monitoring doesn’t stop doctors or pharmacists from prescribing or dispensing a medication when an alert has been raised, each health professional can still make that decision. But, it’s an opportunity for health professionals to start a conversation with their patient if they have any concerns about their use of medication.

To help GPs talk about substance use with patients, many states are providing voluntary GP training and support alongside the prescription monitoring roll out.5

GPs also have access to clinical advisors who can provide information on managing patients with complex needs, persistent pain and substance dependence.

It’s also an opportunity for doctors to empower their patients to be a part of shared decision making around their pain management options.

For patients who develop dependence to medications, doctors can provide referrals to drug treatment services and medications to help manage withdrawal symptoms.

Pharmacotherapy may also be an option for those experiencing an opioid dependence. This involves the use of medications such as methadone or buprenorphine to reduce withdrawal symptoms. You can read more about pharmacotherapy on our What is pharmacotherapy page.

How can I find out more?

If you want more information about managing medications, or if you’re concerned about substance dependence, there’s help available.

• Pharmaceutical Helpline – 1800-737-233 for support, advice and referral for people concerned about their use of medicines.
• Reconnexion 1300-273-266 for counselling and support for people dependent on benzodiazepines.
• National Alcohol and Other Drug Hotline - 1800 250 015 - for confidential information about treatment and support related to alcohol or other drugs.