Victoria’s prescription drug monitoring program, SafeScript, has helped significantly reduce patients being prescribed high-risk medicines such as opioids and benzodiazepines by multiple doctors, new research has found.
The Monash University study, published in the Medical Journal of Australia, analysed over 6.7 million prescriptions for over 810,000 patients across 562 general practices in Victoria between 2017 and 2023, covering three Primary Health Networks representing about 52% of the Victorian population.
It is the first study to investigate the link between prescription drug monitoring program implementation and changes in multiple prescriber rates. Existing research shows patients who see multiple doctors for high-risk medicines face increased risk of dependence, overdose and death, as well as reduced continuity of care.
In Australia, prescription drug monitoring programs alert prescribers when a patient has been prescribed high-risk monitored medicines – including opioids, benzodiazepines and stimulants – from four or more doctors within a 90-day period.
The research team found that when SafeScript was introduced voluntarily in 2019, there was an immediate 15% drop in patients seeing four or more prescribers for monitored medicines, with further declines the following year.
The reductions maintained when SafeScript became mandatory in April 2020.
The study also found that 96% of multiple prescriber cases occurred within the same clinic. Eighty-five per cent of multiple prescriber episodes involved at least one opioid prescription, and people who were older, male, living in metro areas, or who had documented substance use disorder were most likely to have been seeing multiple prescribers before SafeScript was introduced.
Monash NHMRC Research Fellow Dr Louisa Picco, who led the study, said the findings point to clear benefits of prescription monitoring for patients prescribed high-risk medicines. Victoria was the first Australian jurisdiction to mandate real-time prescription monitoring.
“These findings highlight the important role prescription drug monitoring programs can play in helping doctors identify patients receiving high-risk medicines from multiple prescribers,” Dr Picco said.
“Combined with recent evidence of reduced opioid harms following SafeScript’s implementation in Victoria, these results suggest the program is contributing to meaningful improvements in patient safety.”
Dr Picco says that before SafeScript, it was difficult for prescribers to identify when multiple doctors were prescribing high-risk medicines to the same patient, even within the same clinic.
“Having visibility over a patient’s full prescribing history for high-risk medicines, via real-time alerts and information within the prescription monitoring programs, can support better continuity of care and we know that’s linked to improved patient outcomes and can ultimately reduce mortality,” said Dr
Picco.
“The goal of these alerts is to support a clinical conversation, not to cut people off from their medication.”
Read the full study here
