As pharmacists working in Queensland should be aware, integration of the QScript system into practice became mandated on Thursday, 28 October 2021.
Legal and professional responsibility
It is a pharmacist’s legal and professional responsibility to understand and comply with the new legislative and regulatory framework for the supply of monitored medicines. This applies to any pharmacist dealing with a monitored medicine in any location or practice setting in Queensland.
While all pharmacists dealing with monitored medicines should now be registered with QScript, PDL encourages pharmacists and pharmacy owners to be aware of situations where a pharmacist may not be registered. Such examples include:
- An intern pharmacist recently approved for provisional registration
- A pharmacist returning to practice from leave
- A pharmacist moving to Queensland to work in the state.
Applying QScript in practice
QScript is a decision-making tool; it is an aid to assist practitioners to make the best decisions for their patients. QScript information needs to be incorporated with all other available information to make the best decision possible at the time of an interaction with a patient.
Pharmacists should not rely solely on QScript to identify high-risk clinical scenarios or patients at risk of harm, because:
- QScript does not contain all relevant clinical information about patients.
- Risk of harm or drug-seeking behaviours may arise before a patient reaches the level of triggering an alert in QScript.
- QScript is not a substitute for obtaining clinical history or undertaking clinical assessments of patients.
QScript is a read-only, real-time prescription monitoring system that can be accessed via the system integrated with dispensing software programs. In locations without an integrated dispensing software system, such as some public health facilities or at times of dispensing system outage, QScript can be accessed via a web browser.
An audit trail is created for all QScript interactions; both to demonstrate engagement but also to identify if QScript was not viewed or viewed in cases with no link to the person’s immediate care.
Compliance monitoring and enforcement
While 28 October 2021 is the date when QScript became mandatory, Queensland Health has identified in supporting documents an educative approach in the early phase of compliance monitoring. For further information, see the “Compliance, monitoring and enforcement” document provided by Queensland Health.
An important regulatory change regarding self-prescribing
It is now an offence for a prescriber to self-prescribe a high-risk medicine, with exception for very limited circumstances, as set out in section 40(1) of the Medicines and Poisons (Medicines) Act 2019.
High-risk medicines are currently the same medicines categorised as monitored medicines i.e., all S8 medicines and the S4 medicines containing codeine, tramadol, all benzodiazepines, gabapentin, pregabalin, zolpidem, zopiclone and quetiapine.
A prescriber who requires these medicines for their own therapeutic use must ensure another practitioner has prescribed the medicine for them.
It is not lawful for a pharmacist to dispense a prescription for a high-risk medicine where the prescriber is also the patient. Section 40(2) of the Medicines and Poisons (Medicines) Act 2019 indicates this also relates to self-prescribed prescriptions for high-risk medicines written prior to the introduction of the Act.
Compliance with these sections of the Act will be monitored via the QScript system.
Key actions for pharmacists
- Register for QScript immediately.
- Register for the QScript eLearning portal immediately and start the training modules as soon as possible.
- Before dispensing any monitored medicines, check QScript to see whether the information in the database shows that the person has previously been prescribed, dispensed or given any monitored medicines.
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, Australia-wide.