GPs to access patient’s prescription histories

BEGINNING in July, GPs around Australia will be able to access a patient’s entire prescription history during consultation, as part of a bid to curb doctor shopping and improve quality use of medicine.

Along with detailed information on doses and types of drugs a patient has been prescribed, they’ll receive alerts if there’s evidence of drug dependency, a conference has heard.

The real time reporting software, called DORA, is already being piloted successfully in Tasmania at five general practices, Dr Adrian Reynolds, clinical director of Tasmania’s Drug and Alcohol Services, told attendees at the Royal Australian and New Zealand College of Psychiatrists congress in Hobart yesterday.

The software, which will have the capacity to be integrated with existing medical software programs, has been licensed to the Commonwealth, which will fund a rollout to all prescribers from July.

The software includes a ‘hover’ function to hide sensitive information should a patient look over your shoulder, the conference heard. And while a patient’s entire history is available, the name of the prescribing doctor will be withheld – at least for now.

“This is going to make a big difference in your clinical decision making,” Dr Reynolds told the conference delegates.

“It’s to assist in the quality use of medicines; it’s not for punitive purposes like in North America.”

An independent review of opioid use in Tasmania highlighted the need for such real time reporting.

“Up to 30% of morphine prescribed in Tasmania is being used illicitly,” Dr Reynolds said.

“Patients are being prescribed heroic doses for unclear purposes… the combinations and doses are dangerous and they continue in the long term.”

Other speakers cited a marked increase in patients taking diazepam and alprazolam, as well as a documented rise in emergency call-outs for patients overdosing on quetiapine.

There were also high rates of patients diverting their drugs, on-selling, and using them for unintended purposes.

Professor Dan Lubman of Monash University’s Turning Point Alcohol and Drug Centre said realtime reporting would have far ranging use.

“We need to treat everyone as though they are at risk because anyone can get into trouble,” Professor Lubman said.

Dr Reynolds said preliminary feedback from GPs in the pilot study had been “wonderful”.