SafeScript prompts ‘sustained decline’ in multiple prescribers

Research into the use of a prescription-monitoring program at 562 general practices found it led to a significant reduction in patients being prescribed high-risk medicines by multiple doctors.
 
Published on Monday, the Monash University study analysed Victoria’s SafeScript initiative – a mandatory program in the state which records prescriptions for certain high-risk medications. 
 
Researchers analysed more than 6.7 million prescriptions for 810,000 patients between 2017 and 2023.
 
They found that when SafeScript was introduced voluntarily in 2019, it led to an immediate 15% drop in patients seeing four or more prescribers for monitored medicines.
 
A ‘sustained decline’ continued when the program became mandatory for Victorian GPs in 2020.
 
The research also found that 96% of multiple prescriber cases occurred within the same clinic, and 85% of multiple prescriber episodes involved at least one opioid prescription.
 
RACGP Specific Interests Addition Medicine Chair Dr Hester Wilson welcomed the findings and the program, but said it is important it does not lead to patients suddenly having their medications stopped ‘because that can cause harm itself’.
 
‘It’s about, if you do find something untoward, having a conversation with the patient, with the other prescribers, putting together a safety plan,’ she told newsGP.
 
‘I find the tool does give me more information and more opportunities to start conversations around what’s happening here, how can we make sure that patients are safe.
 
‘It’s a tool to help us with our safe prescribing, but we need to use our clinical acumen to make sure that we’re doing what’s appropriate for a patient.’
 
The Monash University research comes as the Penington Institute’s 2026 overdose snapshot found that opioids were the most common drug involved in unintentional deaths across 2023–24, contributing to 41.9%.
 
It also found that deaths involving stimulants increased by 25.1% in a single year, replacing benzodiazepines as the second-most common drug involved in unintentional overdose deaths.
 
The research team’s lead, Dr Louisa Picco, said the work suggested ‘gradual, patient-centred approaches are essential’.
 
‘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,’ she said.
 
‘The goal of these alerts is to support a clinical conversation, not to cut people off from their medication. 
 
‘Abrupt changes to a patient’s treatment have been linked to serious harms, including overdose and transition from prescription to illicit drugs.’
 
For Victorian GP and addiction medicine specialist Dr Eric Hadinata, the study is a ‘careful first Australian look’ at whether SafeScript has changed prescribing behaviour.
 
He describes it is a ‘tool, not a verdict’, and says mandatory monitoring must be paired with funded, accessible community addiction medicine treatment and specialist consultation pathways.
 
‘SafeScript is currently a clinician compliance instrument as much as a clinical safety tool, and the burden of behaviour change is falling on already cautious prescribers rather than on the high-risk prescribing that drives harm,’ Dr Hadinata told newsGP.
 
‘SafeScript is a clinical safety tool, not an evidentiary verdict. The right response to an alert is a conversation, not a refusal.
 
‘Used well, SafeScript supports patient safety. Used as currently configured, it is increasingly an instrument of clinician compliance, and cautious prescribers are paying the higher price for that drift.’
 
The research comes as the Federal Government progresses its plan to compel telehealth-only services to share patients’ medication information by default.
 
The changes, which will be in place next year, will see online prescribing services made to share prescribed and dispensed medicines-related information to My Health Record.
 
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