Changes to ‘redundant’ prescription monitoring services

UPDATED

The benefits of real-time prescription monitoring to identify ‘doctor shopping’ and as a harm minimisation model to reduce overdoses and deaths from medicines are becoming more evident as much of Australia adopts real-time monitoring databases.
 
Victoria was the first state to mandate the system in early 2020.
 
Services Australia’s Prescription Shopping Information Service (PSIS) is part of the same drive, helping prescribers to identify patients who may get more PBS-subsidised medicines than they need.
 
Available 24 hours a day for PBS medical prescribers, the hotline can be used by GPs to find out if their patient meets the Prescription Shopping Program (PSP) criteria to inform discussions around prescribing medication with patients.
 
While most GPs use the real-time prescription monitoring system in their state or territory, a small amount may still be using the PSIS registration form (PB131) to register for the PSIS.
 
For these GPs, Services Australia have announced that from 1 August, prescribers will no longer be able to register using the PB131.
 
Instead, prescribers can register for the PSIS via the phone hotline when calling to enquire about a patient’s eligibility criteria.  
 
Dr Rob Hosking, Chair of the RACGP Expert Committee – Practice Technology and Management, told newsGP that although the ‘vast majority’ of GPs will not be affected by the change, those that use the PB131 should be aware.
 
‘Most GPs are already using the real-time prescription monitoring system, and each state now has its own system for these restricted drugs,’ he said.
 
‘The majority of GPs will check those which gives them an instant view, while the prescription shopping hotline gives historical data and it takes a while to get the information.’
 
‘So it’s become pretty redundant.’
 
While some GPs may choose to continue using the hotline, Dr Hosking encourages adoption of real-time prescription monitoring systems.
 
‘Most are linked with practice’s clinical software such as Best Practice or Medical Director,’ he said.
 
‘Some of the others connect as well, depending on which state and how far advanced they are.
 
‘But they are by far and away the best options.’
 
Dr Hosking believes that removing the PB131 form also contributes to a step away from paper-based records and fax machines in general practice, which the RACGP has long advocated for.
 
In its 2021 position statement on Safe and effective electronic transfer of information to and from general practice, the college outlines the risks that come with using fax machines, saying that given their outdated and unreliable nature as a communication tool for private health information, phasing them out in general practice is preferable.

A spokesperson from Services Australia told newsGP that PSIS registration over the phone is processed in real time, and is quicker and easier than posting or faxing the PSIS registration form, of which ‘only a small number’ are received each month. 

While states and territories are implementing real-time prescription monitoring systems in different ways, Dr Hosking said GPs have a role in promoting more widespread uptake.
 
‘Some GPs may not like using the real-time prescription monitoring systems because they may be a bit clunky and they have to log in, but it’s really up to us GPs to keep pressuring each state to make the systems more user-friendly,’ he said.
 
‘Mostly they are far superior to any information on the prescription shopping hotline.
 
‘But there’s still an alternative for that small number of GPs who can phone up and do the application directly.’

Services Australia consulted with the RACGP ahead of decommissioning the PSIS registration form from 1 August.

This article was updated at 10.30 am on 14 July to include comments from Services Australia. 

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PBS Prescription Shopping Information Service real-time prescription monitoring