Investigations by the Medicines and Poisons Regulations Branch (MPRB), at WA Department of Health, have identified a number of recurring concerns in relation to Schedule 8 (S8) medicines:
- Prescribing of S8 medicines for patients who are recorded as drug-dependent or over-supplied, without the prescriber being authorised to prescribe for that patient as required by the S8 Medicines Prescribing Code
- Prescribing of S8 medicines for patients who are recorded as drug-dependent or over-supplied, without the prescriber being authorised to prescribe for that patient as required by the S8 Medicines Prescribing Code
- Prescribers not contacting the Branch to confirm a patient’s status and S8 history, particularly when prescribing S8 medicines for a patient who is new to their practice.
- Practices not confirming the identify of patients when they first attend the practice, which allows them to use different aliases at multiple practices
- Practice staff not understanding that the dispensing pharmacist must, by law, speak directly with the prescriber to verify S8 prescriptions, before these prescriptions can be dispensed for the patient
- Prescribers not meeting their obligation to provide the original paper-based S8 prescription directly to the supplying pharmacy, where they have previously used a digital image (such as via fax or email) to direct a pharmacist to dispense for their patient. The use of a fully electronic prescription means there is no requirement to mail prescriptions to pharmacies.
Until Real-Time Prescription Monitoring becomes available to prescribers through practice software in early 2022, WA Health recommends that GPs who are considering prescribing a S8 medicine, first contact the S8 Prescriber Information Service on 9222 4424 (Monday to Friday 8.30 to 4:30) to:
- Check whether the patient has been flagged as exhibiting high-risk behaviour, such as doctor-shopping or drug dependency; and
- Obtain information about their previous history of prescribed S8 medicines.
- MPRB also issues Patient Alerts for patients deemed to be at very high risk, because they are actively doctor shopping, using multiple aliases and/or forging prescriptions. Because MPRB only has verified contact details for registered pharmacies, these alerts are sent to pharmacies rather than general practices with the instruction to contact the Department if they receive a S8 prescription for a person who is subject to a Patient Alert and MPRB and the prescriber
See also the “Schedule 8 Medicines” HealthPathway.