How and when to use SafeScript NSW

​​​​​​​​​​​​​​​SafeScript NSW is available to:

  • eligible health practitioners (prescribers and pharmacists) in NSW and interstate
  • nominated public OTP clinic and correctional centre employees.

Who has access to SafeScript NSW

Prescribers (medical practitioners, nurse practitioners and dentists) and pharmacists registered with Ahpra are eligible to access SafeScript NSW, once they have registered for the system.

Nominated correctional centre and public OTP clinic employees are invited to use the system by a prescriber to support with the management of the NSW Opioid Treatment Program. For information on how to provide access to these employees, view the following quick reference guides on how prescribers can invite these employees to use SafeScript NSW and how these employees can gain access.

Interstate practitioners

Health practitioners who have a primary place of practice recorded in Ahpra that is outside of NSW are eligible to register for SafeScript NSW if treating patients who live in NSW or receive treatment from NSW practitioners.

For more information, view the factsheet or view the interstate practitioners help page.

The rules for collection of prescribing and dispensing transactions are different in each state and may result in some duplication across systems. Practitioners should ensure that they consult the relevant state/territory system for information that relates to prescribing or dispensing in another state or territory.

When to use SafeScript NSW

SafeScript NSW is a clinical tool that provides prescribers and pharmacists with real time information about their patients' prescribing and dispensing and approval histories for monitored medicines. This information will support them to make safer clinical decisions and help health practitioners to work with their patients to ensure appropriate use of monitored medicines. SafeScript NSW has the potential to help save lives and reduce harm in the community and therefore all prescribers and pharmacists in NSW are encouraged to use the system.

How to use SafeScript NSW

Using SafeScript NSW with integrated software

SafeScript NSW is designed to be integrated into clinical workflow when reviewing patients' prescribing and dispensing histories. This enables prescribers or pharmacists who have registered for SafeScript NSW, and using integrated clinical software, to receive a pop-up notification on their desktop prescribing or dispensing system warning them when a high-risk scenario is detected within the database. These scenarios include:

  • multiple prescribers involved - where a patient has received prescriptions for monitored medicines from four or more prescribers within the last 90 days
  • use of high doses of opioids - where the average daily dose exceeds 100mg oral morphine equivalent over a 90 day period, excluding medicines used for opioid replacement therapy
  • concurrent prescribing of potentially harmful substances - for example certain long acting opioids (fentanyl and methadone) and benzodiazepines.

Prescribers and pharmacists can click on the notification to access the SafeScript NSW portal to view the patient's full monitored medicine history.

Once logged into SafeScript NSW, the prescriber can apply for an approval to prescribe and/or supply high risk medicines via SafeScript NSW.

Note: Approval applications to prescribe (and/or supply) medicines under the NSW Opioid Treatment Program (OTP) and psychostimulants (dexamfetamine, lisdexamfetamine and methylphenidate) are available via SafeScript NSW. Pathways for online applications for other medicines will be introduced over the coming months. For other approval forms, please visit the Pharmaceutical Services website.

Using SafeScript NSW without integrated software

Prescribers and pharmacists who are not using integrated software are still able to access SafeScript NSW to view their patients' monitored medicine and approval histories by logging into the SafeScript NSW portal directly.

Pop-up notifications and alerts

To learn more about pop-up notifications and alerts, click on the information below or view the Pop-up notifications and alerts Quick Reference Guide.

  • Where a prescriber or pharmacist is using integrated clinical software, a pop-up notification will be displayed on their desktop. The prescriber or pharmacist can click on the pop-up notification and be taken directly to the patient record in the SafeScript NSW system.

    Green pop-up notifications don’t require any action and will fade away after a few seconds. Amber and red pop-up notifications will be displayed until the prescriber or pharmacist clicks on the notification.​

    Pop-up notification Colour - Green​​

    There are no prescribing/dispensing records in SafeScript NSW for ‘Patient Name’ within the last 90 days.

    Pop-up notification Colour - Green

    Medicines prescribed to ‘Patient Name’ within the last 90 days are from the same prescriber or the same medical practice.

    Pop-up notification Colour - Green

    Medicines prescribed to ‘Patient Name’ within the last 90 days involve more than 1 prescriber at different medical practices. Check SafeScript NSW for more information.* ​

    Pop-up notification Colour - Red

    The medicines supplied to ‘Patient Name’ within the last 90 days have resulted in a potentially high-risk situation that requires review. Check SafeScript NSW for more information.

     

    * In some instances, SafeScript NSW is not able to recognise when prescribers are from the same medical practice. This may result in unexpected multiple provider episode alerts and pop-up notifications. SafeScript NSW is working towards a solution.​​​​

  • Alerts in SafeScript NSW will be displayed where a high-risk situation has been detected in an individual’s record. Alerts will be red or amber, depending on the severity of the risk. Red alerts will trigger a red pop-up notification to be sent to prescribers or pharmacists using integrated clinical software.

    Alert Colour - Red

    Alert Rules

    Concurrent prescribing of potentially harmful medicines in a 30-day period

    • Combination Rule 1 - Fentanyl + a long acting opioid*
    • Combination Rule 2 - Fentanyl + a benzodiazepine / zopiclone or zolpidem
    • Combination Rule 3 - Methadone (pain products) + a long acting opioid*
    • Combination Rule 4 - Methadone (pain products) + a benzodiazepine / zopiclone or zolpidem.
    • Does the alert trigger a pop-up notification?

    Does the alert trigger a pop-up notification?

    Yes, a red pop-up notification is sent.

    Alert Colour - Red

    Alert Rules

    Multiple Prescriber Episode – this is where an individual has received a prescription for any monitored medicine from 4 or more prescribers across 4 or more medical practices in a 90-day period.^

    Does the alert trigger a pop-up notification?

    Yes, a red pop-up notification is sent.

    Alert Colour - Red

    Alert Rules

    Opioid Dose Threshold – where an individual has an average daily opioid dose of more than 100mg per day, averaged over a 90-day period.*

    Does the alert trigger a pop-up notification?

    Yes, a red pop-up notification is sent.

    Alert Colour - Amber

    Alert Rules

    Multiple Pharmacist Episode – where an individual has had any monitored medicine dispensed in 4 or more pharmacies within a 90-day period.^

    Does the alert trigger a pop-up notification?

    No, a pop-up notification will not be sent about this alert. Information about the alert will be available in SafeScript NSW.

    *Excluding medicines on the opioid treatment program.

    ^In some instances, SafeScript NSW is not able to recognise when prescribers are from the same medical practice. This may result in unexpected multiple provider episode alerts and pop-up notifications. SafeScript NSW is working towards a solution.

    Visit the Evidence behind pop-up alerts page for more information about red alerts in SafeScript NSW, including clinical evidence supporting each alert, or view the fact sheet.

 

Clinical decision making remains with the health practitioner

A notification or alert does not mean prescribers and pharmacists are not allowed to prescribe or dispense a medicine, but it indicates that some clinical risk with the use of monitored medicines has been identified. Steps should be taken to review and manage appropriately. Ultimately, the clinical decision remains with the prescriber or pharmacist to determine whether the medicines prescribed continue to be the safest and best option for the patient’s individual needs.

Prescribing or dispensing monitored medicines if a warning is received in the system

Prescribers and pharmacists may still prescribe and dispense monitored medicines even if there is a notification or alert if they believe it is clinically safe and appropriate to do so. The SafeScript NSW system provides health practitioners with improved quality of information at the point of care that is intended to aid clinical decision making and ensure appropriate use of monitored medicines.

If deciding that a medicine is no longer the safest treatment, it’s important to remember good clinical practice involves ensuring that appropriate continuity of care is provided for the patient. Abruptly discharging the patient or suddenly stopping treatment of patients who have been taking high-risk medicines over a long period of time is contrary to patient safety.

Additional resources

Current as at: Thursday 30 May 2024
Contact page owner: Pharmaceutical Services