By Dr Jeannie Knapp
What is SafeScript?
SafeScript is a clinical tool that provides real time access to a patient’s prescription history for high risk medicines to enable safer clinical decisions. SafeScript facilitates early identification, treatment and support for patients who are developing signs of dependence.
SafeScript is quick and easy-to-use and can be integrated with prescribing and dispensing software.
What happens on 1 April?
From 1 April 2020 it will be mandatory to check SafeScript before writing or dispensing a prescription for medicines that are monitored through the system. This follows worldwide best practice – mandatory systems in other countries have been proven to reduce harm from high-risk prescription medicines.
The Drugs, Poisons and Controlled Substances Act 1981 specifies penalties that can be imposed on clinicians if they do not take all reasonable steps to check SafeScript when prescribing or dispensing a high-risk medicine. There will be exceptions in some circumstances, including when treating patients in hospitals, prisons, police gaols, aged care and palliative care.
The Victorian Department of Health and Human Services (DHHS) provides a range of compliance tools, including education and an advisory service, to assist practitioners to meet their regulatory obligations. DHHS will take individual circumstances into account before deciding to initiate prosecution.
Which medicines are monitored?
Medicines monitored in SafeScript include:
|Strong opioid painkillers||Buprenorphine, Codeine, Fentanyl, Hydromorphone, Methadone, Morphine, Oxycodone, Pethidine, Tapentadol|
|Strong medicines for anxiety or sleeping tablets (benzodiazepines)||Alprazolam, Flunitrazepam, Bromazepam, Clobazam, Clonazepam, Diazepam, Lorazepam, Midazolam, Nitrazepam, Oxazepam, Temazepam|
|Other strong sleeping tablets||Zolpidem, Zopiclone|
|Stimulants for ADHD or narcolepsy||Dexamphetamine, Lisdexamfetamine, Methylphenidate|
|Other high-risk medicines||Ketamine, Quetiapine|
Do GPs need patient consent to access SafeScript?
No. Consent from the patient is not required to access SafeScript if GPs are directly providing clinical care (including checking a new patient’s history prior to seeing them). Standing consent exists as part of providing safe care to that patient.
Note: Some patients have opted out of My Health Record, but SafeScript is a standalone system.
What if I have concerns about my patients?
SafeScript is likely to identify risky circumstances for some patients. It is then up to providers to determine whether those patients require treatment or whether they can continue to be prescribed high-risk medications.
This is likely to mean that GPs will have some difficult conversations with patients about their medication use. To support GPs, training sessions and resources are available:
- Online training and resources
- The General Practitioner Clinical Advisory Service (GPCAS) is a telephone hotline that has been set up for GPs to seek peer-to-peer advice on how to support patients. This service can be accessed through the Victorian Drug and Alcohol Clinical Advisory Service (DACAS) by calling 1800 812 804 and asking to be referred to GPCAS.
How do I get SafeScript in my practice?
Go to safescript.vic.gov.au to register. Registration is linked to your AHPRA number and email address.
More information and instructional videos to help you set up pop-up alerts in your clinical software are available on the health.vic website.
Where can I find further information?
HealthPathways Melbourne has a page on SafeScript that includes information on:
- Medicines monitored in SafeScript
- SafeScript patient notifications
- Technological requirements for practices and pharmacies
- Training and support
- Legal requirements
- Permit requirements
- Patient access
For access to HealthPathways please contact email@example.com
For the latest SafeScript information visit the DHHS website.
Free SafeScript training sessions for general practice