PHARMACEUTICAL Defence Limited (PDL) has shared the most reported medicines in the 2024-2025 financial year, and the contributing factors for the incidents.
The top 10 medicines are:
1. Oxycodone (immediate and slow release, individually and in combination)
2. Semaglutide
3. Tapentadol
4. Methylphenidate
5. Prednisone/prednisolone
6. Tirzepatide
7. Oestrogen (oral and patches, individually and in combination but excludes oral contraceptives)
8. Lisdexamfetamine
9. Paracetamol and codeine combinations
10. Levothyroxine.
PDL noted that Schedule 8 medicines feature prominently in the top 10 list, potentially due to higher reporting rates for incidents involving an S8 medicine.
“However, PDL Professional Officers are concerned that the supply of S8 medicines might not be handled with consideration for the extra risks and responsibilities these medicines have for patients and pharmacists,” the organisation stated.
Increased prescribing of S8 medicines, psychostimulant supply shortages, and smaller opioid quantities are major contributors.
Other factors include:* multiple strengths and forms causing selection errors* limited storage space for large S8 stock* fraudulent prescriptions* missed checks in real-time monitoring* aggressive patient behaviour* managing overuse or overprescribing* prescribers lacking authority for psychostimulants.
The frequency of incident reports around semaglutide and tirzepatide highlights several challenges with prescriptions, including confusion caused by prescribing and dispensing software formats that leads to incorrect doses or strengths being supplied.
Ongoing supply shortages force prioritisation of limited stock and create heightened patient expectations, while brands of semaglutide are not interchangeable and are approved for different indications, adding complexity.
For prednisone/prednisolone incidents, wrong or unclear directions transcribed in dispensing, paediatric dosage conversion errors and short-term therapy prescribed but continued as regular therapy in DAAs were recurring themes.
Dosage errors, active ingredient mix-ups, incorrect drug selection and giving medication to the wrong patient were also behind notable incidents.
PDL also reminded Queensland community pharmacists that their name must appear on the Queensland community pharmacy prescriber register in order to prescribe medicines.
“This is a regulatory requirement and must be completed prior to prescribing any Schedule 4 medicines,” they explained. KB
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