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Associate
Professor Carolyn Hullick .
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Rachel Carter PSYCHOTROPIC medications
should only be prescribed as a “ last resort ” for behaviours of concern in patients with intellectual disability , according to a new clinical care standard .
Doctors are also urged to obtain informed consent , where possible , and to clearly document the reason for use at the time of prescribing .
The Australian Commission on Safety and Quality in Health
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Care released the standard last month in a bid to curb inappropriate prescribing of psychotropic medications in the aged care and disability sectors .
This included the prescribing of antipsychotic , antidepressant and anxiolytic / hypnotic medicines “ at excessive doses ; for long periods ; often off label ; and with no clear clinical justification , adequate monitoring or review ”.
It pointed to a 2020
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‘ It is imperative that these meds are used judiciously .’
Australian study that found 74 % of people with intellectual disability were subject to longterm
use of psychotropic medicines
for five years or more .
The commission ’ s chief
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medical officer Conjoint Associate Professor Carolyn Hullick said it was “ imperative ” that psychotropic medications were used “ judiciously and with a clear understanding of their purpose ”.
The new standard , which also applies to older adults with cognitive impairment , sets out eight quality statements on how care should be offered . It recommends that medicines only be prescribed after a
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“ reasonable trial of non-medication strategies ” has failed .
In cases where a mental health diagnosis may be suspected but difficult to assess , a time-limited trial of psychotropic medicine may also be appropriate .
Where an adult lacks capacity , consent should be sought in line with relevant state or territory legislation , but the patient should still be asked for their views and wishes .
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Junior doctors ‘ misled ’ Rachel Carter TELEHEALTH corporates and cannabis clinics are misleading early-career doctors who do not realise they are prescribing inappropriately , AHPRA is warning .
The watchdog also announced a crackdown on doctors , pharmacists and nurses who “ are cashing in ” on patient demand for cannabis or compounded medicines , such as semaglutide .
It said clinics built around prescribing one “ predetermined ” medicine risked putting profits ahead of patient safety .
It was also concerned that potentially vulnerable , inexperienced practitioners could be “ misled ” into thinking the scripts were appropriate .
“ While the delivery of telehealth services is supported by AHPRA and the national boards , we do not support practitioners or health services taking advantage of patients or ignoring their obligations to provide appropriate care and follow-up when needed ,” said its CEO Martin Fletcher .
A spokesperson told Australian Doctor it was concerned junior doctors working in the private sector were receiving “ unhelpful or misleading ” advice , such as “ being told it is okay to use their prescriber number to automatically generate medical certificates ”.
In a joint statement with medical , pharmacy , and nursing and midwifery boards , AHPRA announced a new regulatory unit focusing on practitioners who “ may not be complying with their codes and obligations ” as part of these new health business models .
The spokesperson said the new unit would be similar to its specialised cosmetic surgery unit .
Last month , AHPRA said it had received 309 complaints about medicinal cannabis prescribing .
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