What is SafeScript NSW
SafeScript NSW is a real time prescription monitoring system. It allows prescribers and pharmacists to access real-time information about their patient’s prescription history for certain high-risk medicines, known as monitored medicines. This information helps prescribers and pharmacists to make safer clinical decisions and reduces the incidence of harm, including death, from the unsafe use of monitored medicines.
The increasing harm from unsafe use of monitored medicines is a major public health concern. In 2019, there were 1,644 unintentional deaths due to drug overdoses in Australia. 429 (26%) deaths were due to pharmaceutical opioids and 582 (35%) deaths involved benzodiazepines. To learn more about these statistics, view the Penington Institute Australia's Annual Overdose Report 2021.
SafeScript NSW is part of NSW Health’s commitment to reduce harm from monitored medicines and help save lives.
List of monitored medicines
An expert panel of academics, pharmacologists and experts in addiction medicine and pain management was established to provide advice to NSW Health when determining the medicines that will be monitored in SafeScript NSW. The panel also considered approaches in other states and territories when determining the monitored medicines list for NSW. To learn more about the criteria used to select the list of monitored medicines view the FAQ section below or view the Monitored Medicines Quick Reference Guide.
Monitored medicines include:
Including but not limited to buprenorphine, codeine, fentanyl, hydromorphone, methadone, morphine, oxycodone, pethidine, tapentadol, tramadol
Benzodiazepines (prescribed for anxiety or sleep)
Including but not limited to alprazolam, bromazepam, clobazam, clonazepam, diazepam, flunitrazepam, lorazepam, midazolam, nitrazepam, oxazepam, temazepam
Other sleeping aids
Psychostimulants (prescribed for ADHD and narcolepsy)
Dexamfetamine, lisdexamfetamine, methylphenidate
Ketamine, pregabalin, quetiapine, cannabis based medicines in Schedule 8
A full list of monitored medicines is included in the Poisons and Therapeutic Goods Regulation 2008 (Appendix E).
Future inclusions in the monitored medicines list
NSW Health will monitor usage trends of medicines that were considered but ultimately not included in the monitored medicines list, and any emerging evidence may warrant reconsideration of their inclusion in the SafeScript NSW system.
How SafeScript NSW works
SafeScript NSW is a computer software system that provides prescribers and pharmacists with real-time information about a patient’s prescription history for certain high-risk medicines, so they can make safer clinical decisions at the point of care.
The SafeScript NSW system collects prescribing and dispensing information about monitored medicines via the electronic prescription exchange services (PES) that are already connected to most prescribing and dispensing systems.
Using SafeScript NSW with integrated software
Prescribers or pharmacists who have registered for the SafeScript NSW system and using integrated clinical software will receive a pop-up notification on their desktop 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.
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 patient’s monitored medicine history by logging into the SafeScript NSW portal directly.