Unintended consequences of using real time prescription monitoring systems

Haines, Sarah; Savic, Michael; Picco, Louisa; Nielsen, Suzanne; Carter, Adrian

doi:10.5694/mja2.50616

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To the Editor: More Australians die of prescription medication overdose than of illicit drug use or motor vehicle accidents.1 Real time prescription monitoring systems have been recommended to track patients’ supply history for potentially high risk medicines, including strong opioids and benzodiazepines. These programs aim to assist in the early identification of high risk medicine use to inform clinical care, and have received broad support from pharmacy and medical professional groups.

1 Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC
2 Turning Point, Eastern Health and Monash University, Melbourne, VIC
3 Monash Addiction Research Centre, Monash University, Melbourne, VIC

Correspondence: Sarah.Haines@monash.edu

Competing interests:

No relevant disclosures.

1. Department of Health and Human Services. Regulatory impact statement — proposed drugs, poisons and controlled substances amendment (real‐time prescription monitoring). Melbourne: Victoria State Government, 2018. https://www2.health.vic.gov.au/about/publications/ResearchAndReports/rtpm-regulatory-impact-statement (viewed Apr 2020).
2. Fink DS, Schleimer JP, Sarvet A, et al. Association between prescription drug monitoring programs and nonfatal and fatal drug overdoses: a systematic review. Ann Intern Med 2018; 168: 783–790.
3. James JR, Scott JM, Klein JW, et al. Mortality after discontinuation of primary care‐based chronic opioid therapy for pain: a retrospective cohort study. J Gen Intern Med 2019; 34: 2749–2755.
4. Tsai AC, Kiang MV, Barnett ML, et al. Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS Med 2019; 16: e1002969.
5. Bauer M, Monteith S, Geddes J, et al. Automation to optimise physician treatment of individual patients: examples in psychiatry. Lancet Psychiatry 2019; 6: 338–349.

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