Real Time Prescription Monitoring
Real Time Prescription Monitoring (RTPM) is a digital system which provides information about a patient’s use of potentially high-risk medicines to the prescribing doctor and dispensing pharmacist at the point of care.
The aim of RTPM is to support clinicians to make an informed decision about whether to prescribe or dispense a monitored medicine to a particular patient, based on the patient’s prescription and dispense history.
In April 2018, State and Territory Health Ministers agreed to a federated model for the national RTPM system to accommodate jurisdictional differences in regulatory requirements. States and Territories will eventually develop or adapt their RFTPM systems so they are interoperable with this national system.
Individual states and territories are responsible for ensuring appropriate regulations are in place to support the national RTPM system. The list of monitored medicines may vary between jurisdictions.
With the implementation of RTPM solutions in each State and Territory work is continuing on the implementation to be able to capture and share information across all state and territory RTPM systems in the future.
RTPM promotes stewardship and monitoring of Schedule 8 drugs including (depending on the state or territory) oxycodone, morphine, fentanyl, and some prescription Schedule 4 drugs such as benzodiazepines, codeine and tramadol.
The benefits of RTPM system include:
- identifying patients at risk of harm due to dependence or unsafe use of high-risk medicines
- assisting to identify inappropriate requests for drugs of dependence; and
- detection of clinicians who fail to comply with regulations.
State and Territory RTPM systems
Some states have mandated that a prescriber MUST check the RTPM system before prescribing and others have not.
While the implementation of RTPM is beneficial, the practicalities and consequences of identifying prescription drug-related abuse must be carefully considered. Patients who are using such medicines should not be unnecessarily made to feel stigmatised and their medical issues and requirements should be acknowledged and managed according to their needs. To support GPs in addressing these issues, the RACGP has developed the following resources:
Prescribing drugs of dependence in general practice
This guidance covers clinical governance, the use of benzodiazepines in primary care, opioid prescribing, and the role of opioids in pain management.
Drugs of dependence: Responding to requests
This fact sheet, outlines behaviours suggesting problematic or unsafe use of monitored medicines, considerations for responding to requests, available prescription monitoring services and resources, and practice wide approaches which may assist in managing requests for drugs of dependence.