6 resources to help you prescribe safely

The Code was developed by the Medical Board of Australia and sets out the expectations of all registered medical practitioners in Australia.

This includes your obligations around prescribing, good medical practice, medical records and more.

This is not legislation, but it does inform the regulators, and if you receive a complaint, they will want to know how you’re working with the Code.

This includes any best practice guideline. It may be set by a speciality training college, the local health districts, or an authoritative expert body in that speciality.

An example could be the Australian Medicines Handbook or the Therapeutic Guidelines.

Treat these guidelines as a useful resource, like a textbook, for a specific area of information

The Joint Statementopen_in_new was developed between Ahpra and the Medical, Nursing and Midwifery and Pharmacy Boards of Australia. 

The Joint Statement spells out the obligations of all practitioners, but particularly those involved in direct-to-consumer models of care. For example, telehealth businesses targeted to individuals wanting to lose weight that only prescribe weight loss medications, or medicinal cannabis business models.

The statement emphasises that irrespective of what you are doing, you have an obligation to assess the patient, formulate a management plan, and only recommend treatments when there is an identified therapeutic need and reasonable expectation of benefit to the patient. The statement also outlines the importance of effective communication, consent, and comprehensive medical records

In NSW this refers to the Poisons and Therapeutic Goods legislation (currently the Poisons and Therapeutic Goods Act 1966open_in_new and Poisons and Therapeutic Goods Regulation 2008open_in_new). The Pharmaceutical Services Unit (PSU) administers this legislation.

This legislation governs the storage, supply and prescribing of medicines and aims to regulate activities around substances and prescribing to ensure public health and safety.

In NSW, there are specific approval and authority requirements to prescribe certain medications, for example psychostimulants or S8 medications to drug dependent persons.

These approval processes are reviewed regularly and are due to change in the coming months.

You should familiarise yourself with your obligations and stay updated via the PSU prescribers webpage hereopen_in_new.

These include your obligations governed by federal legislation regarding the rules around prescribing medications that are subsidised by the Pharmaceutical Benefits Scheme (PBS).

The PBS details the recognised indication/s for each medication. Prescribing outside of those indications (‘off-label’ prescribing) requires a private script, for example prescribing a low dose antipsychotic medication to assist with agitation without the PBS-listed indication (e.g. schizophrenia or bipolar I disorder).

The PBS also sets out other requirements of prescribing. This includes the need for PBS authority in certain situations, for example a second medical practitioner review of a patient being prescribed certain analgesia medications for more than 12 months).

Your medical record software will usually assist you in understanding the PBS requirements, however you can always go to the source on the PBS websiteopen_in_new.

This covers the prescribing of medications that require special approvals. These mostly come under the Authorised Prescriberopen_in_new or Special Access Schemeopen_in_new with the Therapeutic Goods Administration (TGA).

These schemes allow practitioners to obtain authority to prescribe unapproved therapeutic goods in certain circumstances, e.g. medicinal cannabis, or certain medicines or biologicals for patients who are seriously ill.

You should understand your obligations under any of these schemes and ensure you have the appropriate authority before considering prescribing these types of medications.