The Royal Australian College of General Practitioners. (2015) Prescribing drugs of dependence in general practice, Part A – Clinical governance framework. Melbourne: The Royal Australian College of General Practitioners.
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This guide on clinical governance is a starting place for general practice to be a solution to problematic prescription drug use. The guide is a living document and will be regularly updated.
1. Introduction
1.1 Aims
1.3 Why do we need this guide?
1.4 Developing an environment for quality improvement in prescribing of drugs of dependence
2 Laws and regulations
2.2 Regulatory, professional bodies and monitoring bodies
3. General practice systems of care
3.1 The medical home model of care
3.3 Clinical leaders
3.4 Staff education and competency
3.5 Balancing patients’ needs with practice capacity (risk stratification)
3.8 Using information – Government resources
3.9 Quality improvement activities
4. Accountable prescribing
4.1 Being an accountable prescriber of drugs of dependence
4.2 Assessment of patient risk
4.3 Providing patients with other (often better) management options
5. Patient Focus
A. Key terms and definitions
A.1 Drugs of addiction and drugs of dependence
A.2 Tolerance, dependence, substance use disorder and withdrawal
A.3 Misuse, non-medical use and abuse
B. Drug scheduling
B.1 Drug schedule
B.2 S8 terminology variations across Australia
C. State and territory legislation and contacts
C.1 Non drug-dependent persons – Legislative requirements when prescribing S8 drugs
D. Example practice policies
D.1 Practice policy – Opioid prescribing policy for patients
D.2 Practice policy – Restriction of prescribing rights for drugs of dependence
D.3 Practice policy – Handover standards
D.5 Practice policy – Drugs of dependence therapy agreement
D.6 Practice policy – Requests for repeat scripts for drugs of dependence
D.7 Practice policy – Risk assessment for patients with complex needs
D.8 Practice policy – Approach to drug seeking patients
D.9 Practice policy – Opioid dosing thresholds
D.10 Practice policy – One-year review of opioid prescribing
D.11 Practice policy – Opioid reduction policy
D.12 Practice policy – Benzodiazepine fact sheet for patients
D.13 Practice policy – Opioid fact sheet for patients
Practice letters
Assessment of current drug and alcohol use
Resources
I.1 Staff safety
I.2 Risk assessment
E Concepts in biomedical areas > Medical substance > Prescription drug (medicine / medication)
G Health and disease > Substance use disorder (addiction) > Drug use disorder > Drug withdrawal / craving
J Health care, prevention, harm reduction and treatment > Patient / client care management
J Health care, prevention, harm reduction and treatment > Health care delivery
J Health care, prevention, harm reduction and treatment > Health care programme, service or facility > Community-based treatment (primary care)
J Health care, prevention, harm reduction and treatment > Health care administration > Health care quality control
T Demographic characteristics > Doctor / physician
VA Geographic area > Australia and Oceania > Australia
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