The purpose of email discussions is to share information about medicines and practice in NSW public hospitals. NSW TAG members are encouraged to respond to email discussion requests for information. However, it should be noted that information is only a current snapshot at the time the response is sent. The responses received are only representative of the hospitals participating in the discussion at the time (which may be small depending on the topic) and do not indicate a complete picture of current practices. It is recommended that email discussion topics are regularly brought to the attention of DTC meetings as they are likely to facilitate discussion of contemporary and emerging medicines and practice.
Open email discussions
Please provide email discussion responses to NSW TAG
Guidelines for Opioid Stewardship and Choice of Opioids used in Pain Management (acute & chronic)
A member is enquiring whether any hospitals/districts/networks have guidelines regarding:
- Opioid Stewardship and
- Choice of Opioids used in Pain Management (acute and chronic).
Please respond to NSW TAG by COB 13th May 2021.
Background: We are aware of published work by SHPA (Reducing Opioid-related Harm: A hospital pharmacy landscape paper) and that the ACSQHC are currently working on support for opioid stewardship. The NSW TAG document Preventing and managing problems with opioid prescribing for chronic non-cancer pain (July 2015) also assists in the management of chronic pain.
HYDROmorphone standard and potential development of tools
As you are all aware, DTCs in NSW have been asked to assess the compliance with the new HYDROmorphone Standard in the HRM Policy using the HYDROmorphone Policy Standard Checklist.
1. A member has requested information regarding the following:
- What starting doses of HYDROmorphone are included in other LHD protocols for patients with risk factors such as asthma, obstructive sleep apnoea or on other medications that can potentiate the effects of HYDROmorphone? (Requirement No. 6)
- What specific monitoring parameters and required frequency are included in other LHD protocols? (Requirement No. 11)
- What education and training are clinicians required to complete on HYDROmorphone Safety (Requirement No. 22)?
- Have any LHDs made the Safe Use of HYDROmorphone learning module a CE directed module for medical officers, nurse practitioners, nurses and pharmacists?
Given HYDROmorphone’s safety profile and continuing incidents, NSW TAG is also wondering the following:
2. Would sites find a new opioid poster useful given the discontinuation of Dilaudid Oral Liquid? Some sites may have already designed a new one and if they have, we would appreciate them sharing it with us so that we could provide to others with acknowledgments. We would envisage that the poster might be useful for the front of the safe.
3. In addition, would members find a poster/one-pager regarding the appropriate and safe use of HYDROmorphone useful? (i.e. from a QUM perspective similar to posters/ one –pagers we have previously developed for opioid skin patches and oral mucosal fentanyl https://www.nswtag.org.au/high-risk-medicines/ ) They could also be handed out with in-services.
4. We note CEC’s HYDROmorphone slide presentation made available for in-services. Would hospitals like post-inservice questions for recipients to test their understanding? (The questions could also be useful for pre-inservice to test knowledge and for change in knowledge post inservice).
Please respond to NSW TAG by 7/5/21 (extended)
Completed email discussions can be found here (members only).
Access to completed email discussions is only available to NSW TAG members. Please note, members should not share or pass on identifiable information to non-NSW TAG members. Non-NSW TAG members who are interested in an email discussion topic may obtain de-identified email discussions by contacting NSW TAG at firstname.lastname@example.org
A list of the recently completed email discussions is shown below.
Recently Completed Email Discussions
- Safe use of Fleet enema
- Oral budesosnide provision to outpatients
- Evidence of non-pharmacist medication review during hospitalisation
- Anaesthetic failures with bupivacaine
- Oral paediatric phenobarbitone & diazepam products
- Availability of medical grade freezers and storage of Cervagem
- Familiarity with use of NSMC during downtime
- Life Saving Drug Register (LSDR) feedback
- Use of aromatherapy in active labour
- Use of brentuximab
- Formulary Status of IR Tapentadol
- Acquisition and Use of IM Clozapine
- High rate of rituximab ADRs in dermatology patients?
- Medication errors due to confusing labelling on SAS or ex-SAS products
- Use of depot antipsychotics in severe, treatment resistant anorexia nervosa
- Use of Uridine Triacetate (Vistogard™)
- Third party Medicines Access Programs
- Use of biosimilar trastuzumab
- Problematic access to previously registered medicines
Click here to access the email discussions running list of topics (last updated 16/04/2021).
Click here to access the completed email discussions page (members only).
Page last updated 29 April 2021