GP North

General Practice North has an experienced trained NPS Facilitator, Danielle Truscott. The National Prescribing Service is not affiliated with Government, the pharmaceutical industry nor does it have access to doctors prescribing data.

One-on-one educational visits or small group discussions on therapeutic topics are a time to update and reinforce prescribing choices. The clinical information discussed is based on best practice guidelines and evidence-based medicine principles.

Current NPS Therapeutic Topic: "Opioid therapy in chronic pain: used a planned approach"

• Identify patients who may benefit from an opioid
• Initiate a short-term trial of an opioid
• Assess response to an opioid regularly
• Encourage self-monitoring and non-drug strategies.  

Why participate?

• Unique opportunity to discuss up-to-date, accurate and balanced information
• Visits provided at a time and place to suit you
• Sessions are tailored to meet your needs
• Concise and practical information
• Reliable and trustworthy material Improved patient management and outcomes
• Access to therapeutic advice, not necessarily NPS focused
• Discussion with GP colleagues
• Resources to keep
• Gain RACGP and ACCRM QA & CPD points

Educational Visiting : "Evidence Informed Medicine"

What is it?

An opportunity to ask, question what evidence is available and reflect on your practice.

• Is it a teacher/student interaction?
• Is it a didactic lesson on Quality Use of Medicine?
• Will you learn something new?
• Will all your clinical questions be answered?
• Is it clear cut where science and evidence based medicine interact with medical practice?
• Is your prescribing being scrutinised?
• Are cheaper medicines preferred?

The answer to all these questions is no. In an educational visit current researched therapeutic management or best practice medicine is reviewed and discussed in an interactive manner. Information is independent, concise and honest. You can explore the benefit versus harm and how to explain that to your patient. Expect to build on your knowledge and be assisted to find out more information in order to better manage your patients. An alternative viewpoint on prescribing will expose new ideas and everyone is always hungry for information, especially comparative information on new drugs.

There is trust and mutual respect developed between the educational visitor and doctor. They will be flexible in order for your objectives to be fulfilled and will certainly learn from you. They won't pretend to know something they don't.

Are there limitations?

Yes, your clinical experience will need to be merged with the 'guidelines'. Time is limited to respond to specific questions about individual patients and the generalisability of the evidence cannot be guaranteed. There may be controversial issues and gaps in knowledge. Keep your eyes out for advertisement of the next therapeutic topic. Only a handful of divisional GPs are yet to get involved.

Ensuring Drug Safety in Australia

Do you report suspected adverse drug reactions? Remember you don't have to be certain just suspicious.

In Australia, adverse reaction reporting is coordinated by the Advisory Committee on the Safety of Medicines (ASCOM) which is established by the Therapeutic Goods Administration (TGA).  The system for monitoring adverse reactions in Australia is by voluntary reporting by health professionals and consumers. Each year they receive approximately 12,000 reports of suspected adverse drug reactions, about one-third of these come from GPs.

The TGA publication on medicines safety issues is contained within Australian Prescriber.   Past reports can be found at TGA.

What should you report?

• ALL suspected reactions to new drugs, especially drugs of current interest (printed on back page of bulletin)
• ALL suspected drug interactions Unexpected reactions, i.e. not consistent with product information or labelling
• Reactions to other drugs or vaccines which are suspected of significantly affecting a patient's management, including reactions suspected of causing
  • Death
  • Danger to life
  • Admission to hospital
  • Prolongation of hospitalisation
  • Absence from productive activity
  • Increased investigational or treatment costs
  • Birth defects

The reporting of all suspected adverse reactions to drugs, vaccines and other medicinal substances, including OTC and complementary medicines (CAMs) is required. No report is irrelevant; reporting of seemingly insignificant or common adverse reactions can highlight a widespread prescribing problem.

Requirements for the report are; an identifiable medicine (including other medicines), an identifiable reaction (dates, starting and ceasing medications), an identifiable patient (initials, age, gender), details of any treatment and outcome and an identifiable reporter. The more data the better (e.g. medical history, relevant laboratory data, AUST L or AUST R numbers).

How to report:

Reports of suspected adverse drug reactions are best made by using a prepaid reporting form ("blue card") which accompanies Australian Prescriber.  Reports can also be reported electronically at TGA website and clicking on "report problems" on the left.

Before registration and marketing of a medicine in Australia, its safety and efficacy experience is based primarily on the use of the medicine in clinical trials. These trials mainly detect common adverse reactions. Some important reactions, such as those which take a long time to develop, or those which occur rarely, may not be detected in clinical trials. In addition, the controlled conditions under which medicines are used in clinical trials do not necessarily reflect the way they will be used in practice. So in order to gain a more comprehensive safety profile of a medicine, a continuous post-marketing monitoring system is essential.  

The Quality Prescribing Initiative (QPI):  How can your practice benefit?

Are you or your GPs participating in quality prescribing activities with NPS? Is your practice accessing the QPI payment?

QPI is one of the incentive programs of the Practice Incentive Program (PIP). The program recognises general practices that provide comprehensive, quality care and are either accredited or working towards accreditation under the Royal Australian College of General Practitioners' Standards for General Practices.

Program incentive payments are paid to practices for completion of activities that contribute to quality care including better prescribing.  Many practices are not participating in QPI and therefore not accessing the incentive.

In addition to independent, evidence-based information and services, NPS provides a number of QPI activities that GPs can do. NPS also provides participation data to Medicare Australia to facilitate eligibility checks and processing of payments. For an NPS brochure on QPI, detailing our range of activities for GPs including educational visits, clinical audits and case studies please ring our NPS Facilitator.

If you would like to know more about how QPI can work for your practice, please contact Medicare Australia on 1800 222 032. For updates on QPI recognised activities visit the National Prescribing Service (QPI Activities), call NPS on (02) 8217 8700 or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Participating in NPS activities may allow you to qualify for QPI payments under PIP (a program intended to recognise and reward GPs that provide comprehensive, quality care). For more information about PIP or to register your practice in the program, call the PIP Enquiry Line on 1800 222 032 (free call) or go to Medicare Australia. 

On-line Resources

Guiding Principles to Achieve a Continuity in Medication Management to achieve the continuum of quality use of medicines between hospital and community.   Guidelines consisting of broad principles upon which standard procedures for individual institutions or settings can be based.

Guidelines for medication management in residential aged care facilities  Guidelines which aim to ensure the implementation of individual professional standards, in a multidisciplinary manner which will facilitate quality outcomes for residents.

Consumer perspectives on managing multiple medicines - A report which outlines the findings of a series of consultations with consumers who use multiple medicines on a long-term basis. The report's findings highlight a range of important issues regarding the quality use of medicines from a consumer perspective that should inform the activities of all stakeholders in the quality use of medicines arena.

Australian Medicines Handbook - An independent, evidence-based reference providing comparative drug information.

Medicines Talk - Aims to inform consumer groups about policies and activities related to the wise use of medicines and to encourage them to be involved in associated activities.

National Strategy for Quality Use of Medicines - Addresses the challenges and barriers to realising all the benefits of QUM and integrating it with the other arms of the National Medicines Policy.

Quality Use of Medicines: a decade of research, development and service activity 1991-2001 Report which documents a decade of research, development and service activity in quality use of medicines in Australia and the significant achievements that have resulted.

Quality Use of Medicines Map - Provides a comprehensive map of current major quality use of medicines (QUM) initiatives in Australia. The project provides a resource to inform people working in the QUM area of existing resources, expertise and complementary work.

Manual of Indicators to measure the Quality Use of Medicines component of Australia's National Medicines Policy - Provision of indicators to monitor the implementation and effect of Australia's National Strategy for Quality Use of Medicines

Australian Consumers Medicines Information - A guide for consumers and health professionals.  Consumer Medicine Information (CMI) is designed to inform consumers about prescription and pharmacist-only medicines. 

Web Links

• National Prescribing Service Limited- the website contains information about NPS, QUM, NPS News and PPRs, clinical audits and case studies. It also includes media releases and links to other sites.
• RADAR is an on-line service, developed by NPS providing helpful, timely and independent information on new medicines, revised PBS listings and new research relevant to primary care.
• Schedule of Pharmaceutical Benefits (effective 1 February 2007), is a listing of the medicines subsidised by the Australian Government. The Schedule is part of the wider Pharmaceutical Benefits Scheme administered by the Department of Health and Ageing and Medicare Australia.
• Full text of Australian Prescriber is available free on the website
• Adverse Medicines Line - consumer reporting of adverse drug reactions
• Adwatch - misleading drug information
• Veterans' Mates therapeutic advice & information
• Australasian Cochrane Centre
• MedLine (via PubMed)
• NPS - Cardiovascular Risk Calculator
• Therapeutics Letter, Therapeutics Initiative The Therapeutics Initiative is an independent organization at The University of British Columbia dedicated to providing up to date, evidence based, practical information on rational drug therapy. The Initiative is at arms length from government, pharmaceutical industry and other vested interest groups.
• Prescribing Evidence Based Therapies. This website, developed in the USA, has very thought provoking information relevant for us in here in Australia. It is a publicly-funded educational program developed to improve awareness of drug development and pharmaceutical marketing practices. It is an innovative, multi-media, interactive web-based pharmaceutical curriculum which may be of interest to GPs. Module 1 can be overlooked due to its applicability here but the other short videos are educational and entertaining. The documentary also explores solutions as to how to improve practice methods in order to help practitioners make better informed, more objective prescribing choices.
• Independent Drug Information Service (iDiS). This is an innovative program designed to provide physicians with an evidence based, non-commercial source of the latest findings about the drugs they prescribe (Boston, USA).
• NEW Guidelines to medicines information resources.  Following the discontinuation of TAIS, a guide to medicine information sources has been made available on the NPS website and includes links to evidence-based sources relevant to Australian practice.  It's here:  www.nps.org.au/health_professionals/guide_to_medicines_information_resources.  It can also be accessed from the What's New at www.nps.org.au? on the Facilitators website front page.

NPS Medicines Line and Therapeutic Advice Call: 1300 633 424. Medicines line is a national telephone information service for consumers which provides access to independent, accurate and up to date information about medicines including prescription medicines, over-the-counter medicines, complementary medicines and herbal and natural therapies. 

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