Reducing the risk of violence

Pharmacy and medical groups have hailed legislation to introduce real time monitoring in QLD, although some have expressed concerns over potential patient backlash

Queensland Minister for Health Steven Miles has introduced the Medicines and Poisons Bill 2019 into state parliament, and it is currently being assessed by the State Development, Natural Resources and Agricultural Industry Development Committee.

The legislation sets out a framework to introduce real-time prescription monitoring for specific S4 and S8 medicines in the state.

Substances to be monitored by the system will include controlled drugs such as pharmaceutical opioids and other prescription-only medicines associated with abuse and drug-seeking such as sedatives, sleeping tablets and products that combine codeine with other medicines.

“Before dispensing or giving a treatment dose of a monitored medicine, dispensers will be required to check the database to see if the person has previously been prescribed or supplied a monitored medicine,” reads the Bill.

“Failure to check the database before taking one of these proposed actions will be subject to a maximum penalty of 20 penalty units.”

The Pharmacy Guild of Australia has welcomed the introduction of the legislation.

“We have seen the success of real time monitoring systems in Victoria, and know it has a positive impact on the community and helps to save lives,” said Guild Queensland Branch President Trent Twomey.

“The Guild looks forward to this crucial initiative and the expeditious passing of this important legislation.”

In a submission to the committee that is examining the legislation, medical advocacy group AMA said it is strongly supportive of changes to the Medicines and Poisons Bill 2019 to include real time prescription monitoring.

However it has also voiced concerns about the welfare of doctors, with fears the system may lead to an increase in assaults on GPs by patients unhappy with their doctor’s decision not to prescribe them monitored medicines after checking the database.

AMA Queensland president Dr Dilip Dhupelia wrote to the committee: “Our members have expressed concern about the possibility of an increase in assaults against general practitioners due to this new requirement and we recently wrote to the Health Minister expressing this concern.”

AMAQ council of general practice chairman Dr Richard Kidd told the Sydney Morning Herald that doctors were already facing violence from patients, including one colleague whose neck was broken after being thrown down the stairs by a man he was trying to help reduce the amount of medication he was taking.

Dr Kidd said there should be leniency in the system to allow doctors who were afraid of being assaulted to still prescribe the medication and then call the authorities to alert them of the case without being penalised.

PSA national president Dr Chris Freeman said pharmacists come across issues that have the potential to impact their safety “on a frequent basis”, and real-time monitoring could potentially increase this risk.

Reports from some time ago suggest that a third of pharmacists experienced or witnessed some type of violence within community pharmacy in the last month,” he told AJP.

“We see that this has the potential to increase if more people are being identified as being at risk of drug misuse, and if there are a lack of services to refer patients on to,” said Dr Freeman.

“This is why real time prescription monitoring should not be seen as the solution – it is part of the toolkit for pharmacists and doctors to be able to help patients.

“Significant investment is required to build capacity in services to help patients who are misusing drugs, including those at risk, with pharmacists empowered to directly refer patients.”

Dr Freeman said pharmacies should be prepared in order to secure the safety of their staff.

“From the Society’s point of view, pharmacists should have procedures in place to protect themselves and staff, and if they feel threatened or are threatened, then they should do whatever minimises the risk of personal harm to them and their staff,” he said.

A committee report on the Queensland legislation is due on 11 July 2019.

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1 Comment

  1. Christie Younger

    The concern held by doctors isn’t any different to when any pharmacist says no to dispensing an item when the patient only had it done recently and/or the script is annotated by a previous pharmacist outlining their reason for denying the script.

    Furthermore, doctors already do this. Doctors already do deny further prescriptions of a medication if they suspect misuse, I’m not sure how this is any different.

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