Simulated patient study on the supply of codeine from Australian pharmacies

25 October 2019
Mitigating risks associated with non-prescription codeine
Investigation on the effectiveness of drug monitoring in pharmacies, though two initiatives; regulatory changes restricting their availability, and voluntary live-recording supply of non-prescription codeine combination analgesics (CCAs).

Researchers from Sydney Pharmacy School at the University of Sydney have recently published research in The International Journal of Drug Policy , investigating the effect of the government’s decision to restrict codeine-containing products available only with a prescription from a doctor. Simulated patients entered pharmacies to request codeine-containing pain relievers before and after the decision to move these medicines to prescription-only (‘up-schedule’).

The researchers found that voluntary recording of codeine sales was limited, however the majority of pharmacists were compliant with legal requirements with further improvement in rates of compliance with legislation after the announcement to up-schedule codeine.

Jack Collins, PhD candidate said, “Our findings demonstrate that the voluntary system introduced had limited use. Despite the best intentions and endorsement of pharmacy organisations, the voluntary nature of the system resulted in lower use as compared to pre-existing mandatory monitoring systems for pseudoephedrine-containing medicines. This highlights the need for mandatory recording systems for medicines subject to inappropriate use.”

Co-lead author Joel Hillman stated, “Now all opioids are in the hands of prescribers, this research emphasises how essential it is to establish a mandatory, real-time, and national prescription monitoring programme. Whilst recent research at the University of Sydney has shown that codeine use has decreased post-upscheduling, there are many other strong pain drugs that should be monitored in real-time to optimise best practise and patient outcomes.”

Currently, Tasmania and Victoria are leading the implementation of real-time monitoring systems for opioid analgesics and other medicines considered to have a higher risk of misuse, with the Federal Government intending to introduce a nation-wide system in the coming years.

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