A question of safety

Questions were raised in Parliament this week about Australia’s medicines safety system and the role of pharmacists  

Australia needs to “get real on medicine safety”, Federal Parliament heard this week.

Speaking in the House of Representatives, Julian Hill (ALP, Vic) said “too many Australians are being seriously injured, sometimes with lifelong impacts or dying, because of the weakness in our pharmacovigilance system”.

Mr Hill, Deputy Chair of the Parliamentary Joint Committee of Public Accounts and Audit, referred to a recent study by the Pharmaceutical Society of Australia which “estimated the extent of the problem at 250,000 annual hospital admissions as a result of medication related problems and 400,000
additional presentations to emergency departments, likely because of medicine related problems.

There’s an annual cost of $1.4 billion, and yet 50 per cent of this harm is estimated to be preventable,” he said.

“I have spoken before about my concerns in this area, and so have many other advocates, but the  government is still not taking these issues seriously. Every day of inaction means Australians are at risk of death or serious harm from medicines when it could be avoided”.

Referring to his previous discussion in Parliament of his daughter’s experiences in off-label use of the “old and dangerous drug” Diane-35, he suggested “a system whereby pharmacists can simply be notified by a tick box from the doctor if a prescription is being given for a drug for a purpose for which it was not approved”.

“Other countries have this”, Mr Hill added.

He also suggested there should be an obligation for clinicians to notify patients of adverse events when prescribing.

“I’m not proposing to remove clinical discretion, but I do think that we should have informed consent. I think we need a proper look at the extent to which this is happening”.

“There are many examples, not just Diane-35. Firstly, there is the off-label prescription of antidepressants and youth suicide,” he said.

“There is not one antidepressant approved by the TGA for use in Australia among people under 18—not one. Yet, in 2017-18, nearly two per cent of Australian children were prescribed an antidepressant.

This practice is completely unregulated and outside the safety parameters established through the licensing process. Worryingly, there is now a statistical correlation in Australia between the rate of prescription of antidepressant drugs for young people and youth suicide”. 

“Australia needs to think critically about reform because the current system is not effective,” Mr Hill concluded. “If the health minister were serious about making medicine misuse and danger a national health priority, as he said he is, he would look at these more difficult issues”.

Meanwhile, Susan Templeman (ALP, NSW) has suggested that Parliament should support recommendations from the Royal Commission into Aged Care Quality and Safety on the role of pharmacy in reducing over-reliance on the use of medicines to restrain elderly patients. 

Ms Templeman put forward a motion for the House of Representatives to note the Commission’s interim report on 31 October 2019, including its identification of the need for urgent action to “respond to the significant over-reliance on chemical restraint in aged care, including through the seventh community pharmacy agreement.”

the same motion was also presented to the Senate during the week. Neither have been voted on at the time of writing.

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