Pharmacists have admirably navigated the changes to the provision of the Opioid Therapy Program (OTP) in 2023, overcoming numerous challenges whilst maintaining uninterrupted service to their patients.
With pharmacists now becoming accustomed to these changes, the PDL Professional Officers wanted to take the opportunity to highlight some common incidents involving the OTP that have been reported to PDL.
- Dose calculation errors – where a methadone dose has been expressed as xmg, but xmL has been supplied, leading to the patient ingesting five times the prescribed dose.
- Wrong patient in collection of doses – where subsequently the wrong dose is given to the patient.
- Wrong quantity provided to patient – for either observed or takeaway doses.
- Regulatory breaches – such as dosing patients from an expired prescription, not reporting missed doses/concerning behaviour to the prescriber, inadequate record-keeping and discrepancies with stock on hand.
To reduce the risk of an incident, the Professional Officers recommend the following:
- Check the prescription each time you supply OTP medicines, including confirmation that the prescription is valid and in date.
- When measuring methadone, ensure that doses in mg have been converted correctly to mL.
- Refer to the patient photo and identification documents before dosing, and ensure the photo is recent.
- Verbally confirm the dose with the patient each time regardless of how long you have known them.
- Ensure patient contact details are up to date so they can be contacted in case of an incident or emergency.
- Discuss the supply of take-home naloxone and encourage the patient’s family and friends to be trained in its use, including signs of overdose.
- Communicate missed doses and other concerns to the prescriber as recommended by the NSW Clinical Guidelines: Treatment of Opioid Dependence 2018.
- Provide locums with clear communication on patients and instructions for using any electronic drug register or software.
- Stock checks are legally required in March and September each year; however, it is strongly recommended to complete these checks at more frequent intervals such as weekly or monthly depending on the volume of OTP medicines supplied at the pharmacy.
- Complete the pharmacy self-audit tool annually.
- Bookmark the NSW Health OTP web page to stay up to date with current legislation and OTP changes.
For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7.
