Safescript NSW and Canberra Script are the Realtime Prescription Monitoring (RTPM) systems in NSW and the ACT. These systems provide information to health practitioners (prescribers) and pharmacists (dispensers) about a patient’s prescribing and dispensing history for certain high-risk medicines, known as Monitored Medicines, to improve clinical decision making and patient safety.
Misuse and abuse of Monitored Medicines is an increasing public health concern that can be addressed by prescribers and dispensers having more information about the use of these drugs by their patients. In 2019, there were 1,644 unintentional deaths due to drug overdoses in Australia. 429 (26%) deaths were due to pharmaceutical opioids and 582 (35%) deaths involved benzodiazepines.
SafeScript NSW and Canberra Script are part of the health department’s commitment to reduce harm from Monitored Medicines and help save lives.
The goals of RTPM are to:
- Identify patients who are at risk of harm due to dependence or misuse of Monitored Medicines
- Identify patients who may be diverting these medicines
- Limit ‘prescription shopping’ — visiting several doctors for the same prescriptions of a Monitored Medicine
- Provide state and territory regulators with data to detect prescribers who are not complying with regulations.
What should dentists do now?
- Register your details with the RTPM in your state, so you can start using it as soon as it becomes available in your area.
- Read the educational materials and watch the videos about RTPM in your state, so you are ready to make the most of this useful clinical tool.
To Register for RTPM visit:
To find out more about RTPM you can listen to an excellent podcast where Patrick Meaney interviews Geraldine Moses of PharmaAdvice.
What are 'SafeScript NSW' and 'Canberra Script'?
SafeScript NSW and Canberra Script are the RTPM systems in NSW and the ACT. They allow prescribers and pharmacists access to information about their patients’ prescription history of Monitored Medicines. These systems enable access to information for safe prescribing, clinical decision-making and reducing the risk of harm from the unsafe use of Monitored Medicines.
What are Monitored Medicines?
The list of Monitored Medicines in NSW and the ACT has been developed by experts in addiction medicine and pain management. Monitored Medicines include all Schedule 8 (Controlled) and some additional prescription medicines:
- Opioids,
- Benzodiazepines,
- Psychostimulants (prescribed for ADHD and narcolepsy) and
- all other Schedule 8 medicines
A full list of Monitored Medicines can be found in the NSW Poisons and Therapeutics Goods Regulation 2008 (Appendix E) and the ACT Medicines, Poisons and Therapeutic Goods Act 2008. These lists are likely to change over time, as misuse and abuse patterns are identified.
What is the point of RTPM?
The aim of RTPM is to protect and improve patient health and wellbeing and reduce patient harms arising from the misuse of Monitored Medicines, by encouraging early identification and appropriate management of Monitored Medicine-related health risks.
Is it mandatory for dentists to participate in RTPM?
No but, all prescribers and pharmacists are encouraged to use this service wherever possible. RTPM is likely to become mandatory as it already is in other states such as Qld, SA and NT. It is important to remember that it is against the legislation to prescribe or supply a Monitored Medicine to a person with a substance use disorder. So, using these systems to check before prescribing Monitored Medicines safeguards both patients and prescribers.
What can dentists prescribe?
Dentists have a limited range of PBS medicines that they can prescribe. To find out the medicines that you can prescribe go to PBS Dental Schedule – these items are identified by the ‘DP’ symbol. Most are unrestricted benefits, but there are a few restricted benefits on the Dental Schedule. For example, oxycodone 5 mg capsules are restricted to “Severe disabling pain only” with clinical criteria listed as: “The condition must be unresponsive to non-opioid analgesics”.
There are no repeats for dental items on the PBS and none requiring an authority prescription. PBS regulations stipulate that if a PBS item is normally administered in a particular manner it will not be considered a PBS benefit if it is administered another way. For example, eyedrops may not be prescribed on the PBS for intra-oral use. To stay up-to-date, dentists should review the PBS Dental Schedule regularly, be aware of PBS prescribing restrictions, and know how much patients will have to pay.
For further information about dental prescribing visit
https://www.ada.org.au/News-Media/News-and-Release/Latest-News/PBS-article
Is it still possible to prescribe Monitored Medicines if there is a warning?
Yes. Prescribers and pharmacists can still prescribe and dispense Monitored Medicines where there is a patient warning, if they believe it is clinically safe and appropriate to do so. However, where a warning exists, dentists should consult with a patient’s primary health practitioner before prescribing Monitored Medicines, to ensure that that the planned prescription is appropriate. Dentists in NSW can access the SafeScript NSW Clinical Advice Line for detailed advice and support from experienced Clinical Advisors.
What are the new date of birth requirements?
As part of the implementation of RTPM around Australia, there is a new requirement to enter a patient’s date of birth on prescriptions. This allows for accurate identification of patients on the portal. The NSW Chief Pharmacist has requested a field for date of birth to be included on Pharmaceutical Benefits Scheme stationery (prescription pads) going forward. Until that time, prescribers and pharmacists using paper prescriptions are asked to include this information so that it can be accurately recorded in the system.
What support is available for dentists using SafeScript NSW?
Prescribers and pharmacists are being supported via access to clinical advice, eLearning modules and other resources.
SafeScript NSW Clinical Advice Line: 1800 434 155
The SafeScript NSW Clinical Advice Line, is a free 24/7 telephone advice service, staffed by experienced Clinical Advisors and provides direct support to prescribers and pharmacists.
eLearning Modules
There are three eLearning modules available for dentists:
Module 1: The SafeScript NSW System – what, when and how?
Module 2: Monitored medicines and clinical practice for prescribers
Module 3: Communication and care for patients using monitored medicines.
Additional resources are available at www.safescript.health.nsw.gov.au including clinician and consumer brochures and demonstration videos to support health practitioners, register, log-in and use SafeScript NSW.
If you require more assistance – contact Advisory Services:
advisory@adansw.com.au or
(02) 8436 9944
