Prescribing has featured heavily in the dental press over the last few weeks. Dr Annalene Weston, dentolegal adviser at Dental Protection, highlights the potential pressure points and how we can best manage our risk when prescribing or issuing medications to patients
Three critical matters have occurred in the pharmacological space in the last few weeks that members need to be aware of.
Firstly, the Oral and Dental Therapeutic Guidelines, aka ‘the clown book’, have been overhauled, with the anticipated release of the updated guidance set as December 2019. Naturally, it is critical to be familiar with the current guidance, and we would encourage all dental practitioners to have access to an updated version of this valuable resource, whether in its paper or digital form (it is also available as an app).
Next, the recently released AHPRA 2018-2019 Annual Report highlights that 10.7% of all complaints received by AHPRA related to “medication related issues”, making it the second highest reason for notification. While this stat relates to ALL complaints received by AHPRA, it does serve to highlight that medication related issues are commonplace, and will also be occurring in dentistry.
Perhaps then this contextualises the recent commentary from the Dental Board of Australia relating to the concerns that have been raised with them about the direct dispensing of drugs to patients, omitting to utilise a pharmacist. In this communiqué, the Dental Board highlights how practitioners dispensing directly to patients may inadvertently breach the Code of Conduct, reminding us of our obligations which include:
• ensuring the care of the patient is the primary concern for health professionals in clinical practice
• providing treatment options based on the best available information and not influenced by financial gain or incentives
• conforming to the legislation in the relevant states and territories, including about self-prescribing
• maintaining adequate records, including being mindful of additional informed consent requirements when supplying or prescribing products not approved or made in Australia..
Exploring this in even more simplistic terms, the pharmacist acts as our ‘double checker’ when issuing medications to patients, regarding dose, potential drug interactions and allergies. Perhaps those practitioners considering dispensing directly may like to reconsider removing this safety backstop when issuing drugs to patients.
 AHPRA 2018-2019 Annual Report