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Prescription drug monitoring in Australia: capacity and coverage issues

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Recent years have seen increases in prescription of pharmaceutical opioids and benzodiazepines, and in the associated harms.1 This presents challenges for clinicians and governments regarding appropriate monitoring and responses. Real-time prescription drug monitoring programs (RT-PDMPs) are being considered in Australia2,3 to enable detection of drug diversion (when drugs are transferred from a licit to an illicit channel of distribution or use), and inappropriate prescribing or dispensing. RT-PDMPs are supported by professional bodies, but challenges exist for policy makers in terms of capacity and coverage.

Capacity

The success of RT-PDMPs requires clear delineation of what information will be collected, who will have access to it, and how long records will be kept to ensure patient and practitioner privacy. Tasmania’s RT-PDMP (currently the only Australian RT-PDMP) offers benefits over systems which do not provide real-time data,2 but other jurisdictional policy makers must determine whether their systems will be proactive (eg, identify those at risk of abuse), or reactive and rely on prescriber and dispenser requests once a patient is deemed at risk. There is also concern that patients with genuine needs may not receive appropriate prescriptions for fear that they, or the prescriber,…

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