Script Monitoring is a clinical tool that allows doctors, nurse practitioners, and pharmacists to access information about their patient’s prescription history for certain high-risk medicines. This information helps clinicians make safer clinical decisions and reduces the incidence of harm, including death, from the use of pharmaceuticals.
Each State in Australia maintains its own script monitoring database. SafeScript is used in Victoria and NSW for example whilst Queensland uses QScript and South Australia uses ScriptSA.
The system monitors prescription medicines that are causing the greatest harm to the community. Medicines that are monitored include:
- all Schedule 8 medicines
- Benzodiazepines, such as diazepam
- ‘Z-drugs’ (zolpidem, zopiclone)
- Codeine-containing products.
Script Monitoring checks all prescriptions for these medicines regardless of whether they receive a PBS subsidy or are private, non-PBS prescriptions.
It is important to note that MediRecords only checks the script monitoring software based on the Practice's location, not the provider's or patient's location. We do not currently undertake a nationwide check at this time.
How to Enable Script Monitoring in MediRecords
You will need to register for an account with SafeScript before enabling this feature in MediRecords.
1. Navigate to your user preferences - Click on the Person Icon, then click Preferences.
2. Select Prescribing > Select the check box for SafeScript > Save.
Script Monitoring is now enabled.
*NOTE: Despite being called SafeScript, this feature will check with any state script monitoring database
Using Script Monitoring
Script Monitoring notifications will appear when creating a prescription for S8 drugs and other high-risk medicines such as benzodiazepines, zolpidem or zopiclone, quetiapine, and codeine. Notifications will also appear when editing an existing prescription for one of these drug types under the Current Rx tab.
MediRecords will connect automatically to the relevant script monitoring database after filling out the prescription details.
A notification will appear on the top right corner of the prescriptions window. This notification will be automatically dismissed after three seconds or can be closed using the 'x' in the notification window.
A GREEN notification will appear in the following situations:
- When there has not been a prescription issued/dispensed for a monitored medicine in the last 6 months.
- When prescriptions for a monitored medicine in the last 6 months have been issued by the same prescriber/medical practice, and there are no alerts.
When the notification is green, prescribers/pharmacists will not be required to click on the notification to review the patient history.
An AMBER notification will appear in the following situations:
- When prescriptions for a monitored medicine in the last 6 months have been issued by more than one prescriber/medical practice, or 4 or more pharmacies.
- When the daily morphine equivalent dose (calculated based on an average over the last 90 days) is between 50mg and 100mg MED daily (i.e. a medium-risk dose).
A RED notification will appear when there is a current alert relating to the prescribing/dispensing history of a patient.
These alerts are:
- Multiple provider episodes: When prescriptions from 4 or more prescribers/medical practices have been recorded in SafeScript within the last 90 days.
High-risk drug combinations: When prescriptions for certain drug combinations have been recorded in SafeScript within the last 90 days.
- Methadone + a benzodiazepine
- Methadone + a long-acting opioid
- Fentanyl + a benzodiazepine
- Fentanyl + a long-acting opioid
- Opioid dose threshold: When the daily morphine equivalent dose (calculated based on an average over the last 90 days) exceeds 100mg MED daily (i.e. a high-risk dose).
For Amber and Red notifications, prescribers/pharmacists will be required to click on the notification to review the patient history to assess whether it is safe or appropriate to prescribe/dispense a medicine. The notifications include a URL that will open up in a new tab which allows you to view the patient's profile in the Health Professional Portal.
The 'Prescribe' button in MediRecords will remain greyed out until this URL is checked.
To prescribe a medication now you can check out the article here.