It identifies patients who may get more PBS-subsidised medicines than they need. Show
The PSP has a Prescription Shopping Information Service (PSIS) and a Prescription Shopping Alert Service (PSAS). PSP criteriaPatients meet the PSP criteria if they received any of the following within a 3 month period:
We use PBS data to know when the patient received PBS medicine from an approved pharmacy. The data can take up to 24 hours to update. Patients who meet the PSP criteriaIf your patient meets the criteria, we’ll give you a summary of the PBS items supplied to them. This information is accurate up to the last 24 hours. We can also send you a Prescription Shopping Patient Summary Report. The report is a list of PBS medicines supplied to your patient in a 3 month period. You can use this information to talk to your patient about medication and their prescriptions. Medical practice staff can’t call the PSIS on your behalf. Pharmacists, dentists, nurse practitioners and midwives can call the PSIS from Monday to Friday, 9 am to 5 pm AEST. Patients who don’t meet the PSP criteriaIf your patient doesn’t met the PSP criteria, we’ll only tell you they don’t meet the criteria. We can’t give any additional information. If you’re worried about your patient, you can contact the health department in your state or territory. You can ask about statutory reporting requirements or other programs to help you manage your patient. What we can’t tell youWe run the Prescription Shopping Program based on privacy and legal guidelines. We can’t tell you the PBS medicines supplied to someone who isn’t your patient. We also can’t tell you the PBS medicines supplied to your patient if:
Fraudulent activityIf you suspect your patient could be committing fraud, you need to report it. Read more about reporting fraud. Request PBS claims informationYour patients can:
Quick guide
People from all walks of life can develop a problematic use of drugs of dependence. These drugs have properties which make them addictive, with a high potential for misuse. Recognising behaviours which suggest misuse of drugs is crucial to ensure patients are kept safe. This can be difficult because drug-seeking behaviour is often sophisticated, manipulative and demanding. There are unique clinical considerations and legal obligations for doctors when prescribing drugs of dependence. A failure to comply with these could lead to disciplinary action. What is drug-seeking behaviour?The term ‘drug-seeking behaviour’ describes a range of actions a patient may use to obtain a particular drug. It is important to consider these actions with the other circumstances surrounding the patient and the consultation. These considerations should help you determine whether or not a patient has a legitimate need for the drug. Some patient behaviours which may raise your suspicion are: Requests and complaints
Common behaviours
A drug-seeking patient is less likely to be a long-term patient of your practice. However, long-term patients may also present to you with similar reasons or excuses. You may see such a patient when their usual doctor is not available, or they may present to emergency departments. They may have also refused or failed to attend appropriate specialists for review and advice on managing their pain or addiction. How can I identify a doctor shopper?‘Prescription-shopping’ or ‘doctor-shopping’ is when patients deliberately obtain more medicines than are clinically needed. This is often done by visiting many doctors, without telling them about their other consultations. It is not only patients who are drug-dependent who are at risk of becoming doctor-shoppers. Patients in financial need may attempt to sell their medicines. Some states and territories have real-time prescription monitoring services to help doctors understand their patients’ prescribing history outside of their practice. Doctors should access this information where available to help identify circumstances where a patient may be at risk of harm from the use of a medicine. Increasingly, software and computer programs limit multiple scripts being prescribed. In some jurisdictions, it is mandatory for doctors to check a patient’s prescription history in the jurisdiction's prescription monitoring service before prescribing a ‘monitored medicine’. Make sure you are aware of the legislative requirements in your state or territory. A patient’s My Health Record may also have information about past prescriptions. Doctors in all states and territories can use the Australian Government’s Prescription Shopping Programme. It allows doctors to check a patient’s prescription history to help make more informed prescribing decisions for their patients. The program includes an information service and an alert service. You can call the information service 24 hours a day, seven days a week on 1800 631 181. It is important to note that patients will only be flagged in this system if they have visited six or more doctors and received 25 prescriptions in total from these doctors. Therefore, only frequent drug-seeking behaviour is identified. The service does not monitor private scripts or those from the Department of Veterans’ Affairs. Practice management and clinical strategiesPatient safety and high-quality care and empathy should be the underlying principles when discussing clinical strategies. Although sudden withdrawal from a drug of dependence may expose the dependent patient to risk, continuing to prescribe can perpetuate problem behaviours and jeopardise the patient’s safety. It also exposes you to professional and legal consequences if you fail to comply with your jurisdiction’s prescribing guidelines and legislation. To help manage these requests, it is important to develop a consistent approach within your practice. You could place a sign in your waiting room or on the front door. Suggested wording includes: Strong painkillers and sleeping pills policyExcept for terminal cancer, our policy is that we will not prescribe these types of medicines (e.g. oxycontin or temazepam):
This does not mean you cannot prescribe a drug of dependence on the first appointment if the situation requires, but it might limit drug-seeking behaviour. If you refuse a patient's request, the presence of the sign or practice policy indicates that it is a policy decision, not a personal one. Ideally, a patient should be seen by the same doctor in the practice to manage their requests, provide consistent care and help monitor and adhere to any plans in place. Try also to encourage patients to go to a local pharmacy, again for consistency. Before prescribing, you should complete a detailed clinical assessment and fact-checking exercise such as:
All doctors and practice staff should be made aware of practice policies to ensure consistent adherence to them. Doctors should also make detailed notes in a patient’s medical record about requests, management plans and adherence. This will help with continuity of care within the practice in the long term. How do I say "no”?"You need to say “no” in a respectful and clear way so there is no room for misinterpretation and ambiguity. Give a reason for not prescribing, such as: “It’s my choice not to prescribe this to you today” or “It’s clinic policy we don’t prescribe to patients I haven’t seen before”. Ideally, do this early in the consultation. Consider non-pharmacological alternatives or offering to refer the patient to a colleague with an interest or expertise in this area. Sometimes, declining to provide a prescription can trigger an aggressive or threatening response from a patient. It is paramount that you have personal safety measures in place in your practice should a situation such as this arise. These measures should already be in place (e.g. positioning the office furniture so a patient cannot block your exit, placement of readily accessible duress alarms, use of the internal phone or messaging systems). In addition, trust your judgement and take additional measures such as leaving the consulting room door open, or finding a reason to leave the room if you feel uncomfortable. Other servicesEach state and territory has alcohol and drug advisory services which you can contact. This will give you the opportunity to discuss the situation with a specialist and receive advice on the management of drug-dependent patients. Additional resources
IMPORTANT: Avant routinely codes information collected in the course of assisting member doctors in medico-legal matters into a standardised, deidentified dataset. This retrospective analysis was conducted using this dataset. The findings represent the experience of these doctors in the period of time specified, which may not reflect the experience of all doctors in Australia. This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision-making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published (June 2021). © Avant Mutual Group Limited 2021. How can I get off all medicines?How can I plan for withdrawal?. Find out about your medication.. Don't stop suddenly.. Choose a good time to start.. Talk to your GP or health care team.. Make a tapering plan.. Give yourself time.. Come off one medication at a time.. Tell people close to you.. Is Doctor Shopping illegal in Australia?Doctors in all states and territories can use the Australian Government's Prescription Shopping Programme. It allows doctors to check a patient's prescription history to help make more informed prescribing decisions for their patients.
How do you spot a doctor shopper?How do you identify a doctor shopper?. have lost or misplaced their medications.. are a long way from home.. request a drug by its specific name or a specific dosage – and refuse all other therapeutic options.. seek opioids, benzodiazepines or stimulants.. display signs of anxiety or agitation when discussing their prescriptions.. How do I stay away from medication?6 ways to live medication-free. Eat a healthy, balanced diet. ... . Exercise. ... . Take steps to reduce stress. ... . Avoid toxins, pollutants and chemicals: There are toxins and pollutants all around us, so avoiding them may be nearly impossible. ... . Get some vitamin D.. |
How do I get off the doctors shopping list?
Postagens relacionadas
direito autoral © 2024 cemle Inc.
