National real time monitoring needed

A NATIONAL real-time prescription drug monitoring system should be rolled out to help prevent medication-related deaths, and cross-border doctor-shopping, the Australian Capital Territory Chief Coroner believes.

The call for an integrated nationwide system came as part of ACT Chief Coroner, Lorraine Walker’s inquest report into the death of Jay Alan Paterson, in Sep 2017, as a result of a polypharmacy overdose.

The Coroner’s Court heard Paterson had developed a physical dependence and tolerance to prescription pain medications following a work-related injury sustained in 2007.

In 2014 he came to the attention of the ACT Chief Medical Officer, as a result of attempted doctor-shopping for prescription opioids.

Despite living in the ACT, Paterson started to see a GP based in Queanbeyan, NSW, in Apr 2017, who prescribed opioid medication.

The Coroner reported that Paterson misled the GP as to the amounts of opioid medication in his possession, falsely claiming a friend had stolen the painkillers on one occasion and another time saying his wife had confiscated the drugs.

In the month leading up to his death, Paterson had nine scripts for a total of 296 oxycodone tablets filled at pharmacies in NSW and the ACT.

The Coroner noted that one of the Queanbeyan GPs called the Commonwealth ‘doctor shopping line’, but was told Paterson “was not a patient of concern”.

Walker noted she had previously called for the ACT’s real-time prescription medication monitoring system to be mandatory in the territory (PD 11 Jun).

“I share the view of NSW Deputy State Coroner Grahame, and other Australian coroners, that there is a pressing need for a real-time prescription monitoring system in NSW, ideally as part of a national system,” she said.

“A national real-time prescription monitoring system might have enabled Mr Paterson’s Queanbeyan doctors to have seen the amounts of medication prescribed to him in the ACT, and to ensure that Paterson could not leverage off the differences in regulation to obtain opioid medication in NSW that he was, or would have been, denied in the ACT.”

MEANWHILE the Pharmaceutical society of Australia has called on the South Australian Government to implement plans for a real-time monitoring system.

“Real-time prescription monitoring was included in the state’s 2018-19 Budget but as yet we haven’t seen any progress,” PSA SA/NT Branch President, Robyn Johns, said.