For people living with pain conditions, medication is very often the most accessible and affordable form of treatment and one important component of managing pain. Access to medications for people living with chronic pain has been a significant issue with recent opioid changes making it even more important to ensure that consumers are not inappropriately denied access to necessary pain management options and ensuring that they have a range of available treatments. It is important that we achieve a balance between ensuring people have access to the medications they need to manage their pain and doing everything possible to guarantee the medications are being used safely and effectively.
The rollout of Real Time Prescription Monitoring (RTPM) programs across Australia is an opportunity to do both things. RTPM is a computer system that provides pharmacists and prescribers with medicine history information about a consumer’s use of monitored drugs (for example, diazepam and tramadol). Pharmacists and prescribers can use this information when considering prescribing or dispending these drugs.
If implemented well this system will be a valuable tool to find the right pathways for consumers enabling them to better use the medications they are taking. It should also facilitate a conversation between health professionals and consumers about medications within a holistic management approach.
Each state and territory in Australia is at a different stage of setting up and utilising RTPM. Safescript NSW is being rolled out in stages, by region across NSW. Prescribers and pharmacists in the Hunter New England and Central Coast regions will be the first to access the program from late October 2021, and the rest of NSW is expected to have access in the first half of 2022.
Canberra Script is a web portal that has been developed to provide doctors and pharmacists with a comprehensive history of the medicines that have been prescribed which may be considered high risk. This will help them make clinical decisions. It will launch in early 2022 and will replace the Drugs and Poisons Information System (DAPIS) Online Remote Access (DORA) real time prescription monitoring system for health practitioners launched by the ACT Government in 2019.
Painaustralia is proud to have played a more involved part in the current implementation of SafeScript NSW and Canberra Script in the ACT through developing, testing and evaluating messages with consumers and key stakeholders and participating in advisory groups overseeing implementation.
As part of the implementation of Safescript NSW and Canberra Script ACT, Painaustralia was able to provide feedback on the messaging from a consumer perspective with advice from our Consumer Advisory Group. In NSW, this followed extensive consultation undertaken by NSW Health with health professionals, consumers, and stakeholders.
In the ACT, Painaustralia has worked closely with ACT Health and our Consumer Advisory Group to develop sensitive and respectful communication that will be tested with a range of key stakeholders in the coming weeks before the planned first phase implementation of the program.
In all communications, consumers have emphasised that safety and efficacy of medication use is key to responding effectively to the needs of patients who may be at risk of harm from prescription medicines, and this is reflected in all messaging for these programs.
As part of Pain Awareness Month, Painaustralia hosted a webinar: SafeScript NSW: What Real Time Prescription Monitoring means for you? held on 29 September 2021 to provide information about how the program may affect consumers. The webinar included NSW Health’s Andrew Hargreaves, Dr Chris Hayes (Painaustralia board director and pain specialist) and Kim Allgood (Painaustralia CAG member). Questions asked by participants included:
If I live near a state or Territory border, can my RTPM records be accessed by pharmacies in both states/territories?
Will the SafeScript database identify “doctor shopping” and inappropriate prescribing?
Will pharmacy assistants be trained to use SafeScript?
Am I able to see the information on SafeScript NSW?
Is Safescript NSW linked to the MyHealth Record?
What happens if I move interstate, is there data sharing between RTPM programs?
Are there any legal ramifications for prescribing a medication flagged on the RTPM record?
What has been the experience overseas with prescription monitoring?
Consumers as the recipients of the programs must be the primary focus when implementing a system with such great potential to impact upon access to pain treatment. Painaustralia is pleased to say that both jurisdictions have prioritised the consumer voice in seeking to establish RTPM systems that while aiming to reduce harm related to pain medications also achieve the goal of ensuring safe and effective use of medications. They also acknowledge that people living with pain conditions should continue to access their medications.
Painaustralia will continue working with NSW and ACT Health and our Consumer Advisory Group throughout the rollout of these programs to make sure your voice is being heard and that the transition is as smooth as possible for people who rely on medication to manage their chronic pain.
In the coming days, NSW Health will be conducting a pre-implementation survey which will be available via our social media channels. If you are living in NSW and likely to be impacted by the implementation of Safescript NSW, we urge you to have your say.