PLANS to rollout real-time prescription monitoring (RTPM) of opioid medications will change clinical practice, but could deliver unintended consequences, new research warns.
In an article published in Australian Prescriber, the authors noted that while RTPM could identify patients using high daily doses of opioids, high-risk combinations and those with treatment that is not coordinated, moves to abruptly cease treatment could lead to adverse health risks.
"Activities intended to prevent harm can result in unintended consequences if they are not supported by the right clinical approach," the authors said.
"The tapering of opioid doses requires special care, especially given that many patients taking opioids have a history of mental health disorder or substance use disorder.
"Patients rapidly or involuntarily tapered from opioids may have an increased risk of overdose so discussions of risk and ensuring patient agreement before tapering starts are high priorities."
When a RTPM system identifies a patient who has potentially been misusing medications, the authors urged health professionals to confirm the use of the products with the patient, or contact the prescriber to establish whether or not they prescribed the medication.
They added that discussions with the patient should be framed as "an expression of concern about the patient's safety and the need to coordinate treatment with high-risk drugs."
"RTPM will identify people not previously known to have a substance-related disorder," they said.
"There is a need to avoid unfairly stigmatising these patients and to act to provide potentially life- saving treatment.
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