Opioid safety push follows truck driver impacts study

Guide to prescription and use for outpatients or after hospital now available

Opioid safety push follows truck driver impacts study
Opioid prescriptions are in sharp focus


A new push in the national effort to help reduce the number of Australians experiencing harm from pharmaceutical opioids has been welcomed by a lead researcher into the effects of drugs’ over-prescription on truck drivers.

A new patient guide to managing pain and opioid medicines has been released by the NPS MedicineWise Choosing Wisely Australia initiative.

NPS MedicineWise is a not-for-profit organisation whose programs are funded by the national Department of Health.

Hospital staff will be encouraged to provide the two-page patient guide to people prescribed opioids as inpatients, or on discharge to raise awareness about opioids use for short-term pain, their side effects and the risks of dependence.

The impact of over-prescription of opiods on truck drivers is the subject of a critical Monash University report released this week.

"I believe that any method to educate people on how opioid medications should be used is to be applauded Dr Ross Iles, from the School of Public Health and Preventive Medicine at Monash University, says.

"It is very important for the person being prescribed opioid medications to know the answers to some important questions, as long as that responsibility is not wholly shifted to the person receiving treatment.

"Hopefully resources like this mean medical practitioners have important conversations with their patients that include expectations of pain management and the risks of the medications they are taking.

"These conversations need to be individualised and take into account the specific characteristics of certain patient groups, such as truck drivers, who may have limited opportunities to have a regular reviews with their usual GP." 

Read about the Monash University opioids study, here

The guide, Managing pain and opioid medicines, developed in consultation with the Queensland Clinical Senate with testing supported by the Queensland Opioid Stewardship Program and the Society of Hospital Pharmacists (SHPA), has three key elements to support people who are prescribed opioids:

  • five questions people are encouraged to ask their health professional before leaving hospital with opioids. This has been modelled on Choosing Wisely Australia’s 5 questions to ask your doctor resource to guide better conversations with health professionals about tests, treatments and procedures
  • tips for taking and storing opioids at home
  • a personal pain management plan that should be developed in conjunction with a health professional.

"With statistics showing three lives are lost, 150 people are hospitalised and 14 people present to emergency departments every day due to harm caused by pharmaceutical opioids, we need to ensure more information is available to people at the point these medicines are prescribed," NPS MedicineWise’s  CEO, adjunct associate professor Steve Morris, says.

"This is the first time in Australia the Choosing Wisely 5 Questions model has been used to drive conversations about a specific treatment in a format that can be distributed in hospitals, in primary care and can be accessed directly by consumers and carers.

"Ultimately, we hope to see this practical guide provided to everyone in Australia who is prescribed an opioid medicine."

Queensland Clinical Senate chair and emergency physician Dr Alex Markwell says education is critical in keeping patients safe and giving them choices.

"We need to support and empower our patients and healthcare providers to discuss what care is needed based on what matters to the patient and their family," Markwell says.

"This patient guide on opioid medicines is a really important step in enabling this to happen."

Echoing the findings in the Monash report, SHPA chief executive Kristin Michaels says many Australians leave hospital with more opioids than they need, which has the potential to lead to preventable harm.

"SHPA’s landmark 2018 Reducing opioid-related harm report revealed opioid de-escalation plans at hospital discharge are rare and supplying opioids for patients to take home ‘just in case’ is still common practice.

"Among its 33 recommendations, the report highlighted the need for patient-centred tools for self-assessment and management of pain and the need for consumer health organisations to educate patients regarding managing pain expectations, so we are delighted to see the release of the Managing pain and opioid medicines resource.

"As medicines experts working in acute settings, hospital pharmacists play a central role as a safeguard to reduce the risk of inappropriate medicine prescription, supply and use."

The new opioids resource has been released to coincide with a new NPS MedicineWise national education program, Opioids, chronic pain and the bigger picture, which aims to equip health professionals and consumers with tools and resources to reduce the harms of opioids, while ensuring adequate pain management and quality of life for people with chronic non-cancer pain.

The program includes a Choosing Wisely Australia recommendation from the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (ANZCA).

The dean that faculty, Dr Meredith Craigie, welcomes the release of the new patient guide.

"Helping medical practitioners and consumers to develop pain management plans that work is essential to achieve changes in attitudes and behaviours that will lead to safe and appropriate prescribing and use of opioids," Craigie says.


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