Changes made to recent opioid reforms

Matt Woodley

29/09/2020 5:25:10 PM

Annual secondary review requirements have been relaxed, easing access concerns for palliative care patients.

Oxycodone tablets
Palliative care patients were particularly concerned about being able to have ongoing access to pain-relief.

The changes, announced by the Pharmaceutical Benefits Advisory Council (PBAC), are designed to avoid placing an unnecessary burden on palliative care health practitioners, and reduce disruptions in the pain management for suffering palliative care patients.
From October, Pharmaceutical Benefits Schedule (PBS) listings requiring an annual secondary review will allow a palliative care nurse practitioner to conduct the review, while for very ill patients the requirement will be scrapped altogether.
Chair of the RACGP Specific Interests Palliative Care network Associate Professor Joel Rhee told newsGP the changes are ‘reasonable’.
‘It allows a more patient-centred approach in how we treat patients with palliative care needs by removing the requirement for annual secondary reviews for patients who are very unwell or otherwise not able to be reviewed by another doctor,’ he said.
‘The involvement of a palliative care nurse practitioner may be helpful, especially if they are already involved in patient care. Many palliative care patients are managed primarily by the GP with support from specialist palliative care nurses.’
Despite being broadly supportive of the original reforms brought in on 1 June, which also halved opioid pack sizes and put an end to repeats, GPs were blindsided due to a perceived lack of warning from health authorities, leading to calls for better communication.
Patients were particularly concerned about being able to have ongoing access to pain-relief, and Palliative Care Australia (PCA) has welcomed the changes it says will ‘optimise appropriate access to analgesic opioid medications’ for palliative care patients.
‘These changes … will help avoid an unnecessary burden [on] palliative care health practitioners and reduce disruptions in the pain management for suffering palliative care patients,’ a PCA release stated.
Australia has one of the highest rates of prescription opioid use in the world and more people die from overdose than car accidents, but PCA National Clinical Advisor and nurse practitioner Kate Reed said the medication is essential for palliative care patients looking to manage the pain and breathlessness associated with their life-limiting illness.
‘While recognising that safety regulations are required to avoid health risks linked to opioids, the issues of addiction and misuse are not critical factors for palliative care patients,’ she said.
‘We must continue to work together to support effective and timely pain management for these patients, helping to maintain their quality of life as much as possible.’
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Dr Urmila Sriskanda   30/09/2020 11:41:50 AM

I am surprised by the changes to pack sizes. I think these changes will help palliative care patients without creating a loophole for drug-seeking patients.

Dr Richard William Wright   30/09/2020 10:44:12 PM

every 3 month supply script for my palliative care patients in the last 2 months have been rejected .They are all long standing.
all have permits.
2 calls suggested the scripts took 3 weeks to be delivered.
When i called for a month script (patients have no supply), I was told my written scripts would be cancelled.
What to do ?
I have considered making my patients call every 2 weeks for telehealth and do a 2 week script.I could charge .Might this make the beaurocrats take notice if we all did it?
My latest rejection was for a non palliative care patient.12 month review was done by pain clinic ..letter sent to me , but no doctor name .Script rejected as no doctor was an initial on the letter so I could not provide a name.
What a joke
Are others having this trouble?