Alert Rules

When certain risk conditions occur, ScriptCheckSA raises an alert against a patient's profile to draw attention to the risk. A patient's alerts can be viewed against their Medication History, and in a historic alerts list.

Alert rules are triggered when a prescriber or a dispenser performs a pre-check on the patient's medication history (in ScriptCheckSA) from their clinical software.

  • High-Risk: The patient has been prescribed monitored medicines from four or more unique prescribers at four or more clinics in the last 90 days.

    When two or more of the prescribers are at the same clinic, they only count as one prescriber.

    A new High alert is raised in ScriptCheckSA and the following message is displayed on the patient profile in ScriptCheckSA

    High-risk clinical scenario: [Patient name] has obtained monitored drug prescriptions from at least 4 different prescribers in the last 90 days. Take action to coordinate treatment to ensure patient safety.

  • Medium-Risk: The patient has been dispensed monitored medicines from 4 or more unique pharmacies in the last 90 days.

    A new Medium alert is raised in ScriptCheckSA and the following message is displayed on the patient profile in ScriptCheckSA

    Medium-risk clinical scenario: [Patient name] has obtained monitored drugs from at least 4 different pharmacies in the last 90 days. Take action to coordinate treatment to ensure patient safety.

This rule is also triggered when completing the dispensing. The same alert message is displayed on the patient profile in ScriptCheckSA.

If a prescribe or dispense event meets the criteria for both alerts, the High alert is displayed.

Exemptions from alert rule: The patient is 70 years old (or above) and/or is flagged as NPCP (Palliative Care).

  • High risk: The patient has been prescribed opioid drugs that cause their calculated average daily MED to exceed the high-risk threshold of 100mg.

    High-risk clinical scenario: [Patient name] is receiving an average total daily opioid dose of 100mg MED or greater, and may be at increased risk of harm. Take action to ensure patient safety.

  • Medium risk: The patient has been prescribed opioid drugs that cause their calculated average daily MED to be between 50mg and 100mg.

    Medium-risk clinical scenario: [Patient name] is receiving an average total daily opioid dose of 50mg MED or greater, and may be at increased risk of harm. Consider action to ensure patient safety.

Exemptions from alert rule: The patient is 70 years old (or above) and/or is flagged as NPCP (Palliative Care).

Refer to Monitored Drug List > Drug Groups

In the last 90 days the patient has been dispensed:

  • an opioid and a benzodiazepine/z-drug

    — or —

  • an opioid—and it is proposed they are prescribed/dispensed a benzodiazepine/z-drug

    — or —

  • a benzodiazepine/z-drug—and it is proposed they are prescribed/dispensed an opioid.

A new High alert is raised in ScriptCheckSA and the following message is displayed on the patient profile in ScriptCheckSA:

High-risk clinical scenario E: [Patient name] is receiving an opioid and a benzodiazepine / z-drug and may be at increased risk of harm. Reassess the need for this combination.

This rule is also triggered when completing the prescribing or dispensing. The same alert message is displayed on the patient profile in ScriptCheckSA.

Exemptions from alert rule: The patient is 70 years old (or above) and/or is flagged as NPCP (Palliative Care).

This rule is triggered when a prescriber with an active S57 Prohibition Order on their profile is prescribing a monitored drug to the patient.

See Practitioner Profile

The alert message is displayed on the patient profile in ScriptCheckSA.

High-risk clinical scenario: You are subject to a section 57 order and is PROHIBITED from prescribing, supplying, administering, using or possessing specified drugs. Review conditions of Order before prescribing.

This rule is also triggered when completing the dispensing a monitored drug to the patient.

High-risk clinical scenario: [Prescriber name] is subject to a section 57 order and is PROHIBITED from prescribing, supplying, administering, using or possessing specified drugs. Contact Drug Dependence Unit.

This rule is triggered when a patient who is currently listed on the S58 Privileged Circular is receiving a prescription for a monitored drug.

The alert message is displayed on the patient profile in ScriptCheckSA.

High-risk clinical scenario: [Patient name] is listed on the Privileged Circular. Continued supply of monitored drugs may increase risk of harm. Take action to ensure patient safety.

This rule is triggered when a pharmacist is proposing to dispense a prescription from a prescriber who has one or more active stolen or fraudulent prescription incidents recorded on his/her profile.

The alert message is displayed on the patient profile in ScriptCheckSA.

High-risk clinical scenario: Prescription may be stolen, forged or altered. Verify details with prescriber before dispensing.

This rule is triggered when a prescriber (proposes to) prescribe an S8 medicine to a patient who already has a current authority for a different S8 medicine.

See Authorities

Medium-risk clinical scenario: The section 18A authority DOES NOT permit this drug of dependence to be prescribed to this patient. Contact DDU.

Exemptions from alert rule: The patient is 70 years old (or above) and/or is flagged as NPCP (Palliative Care).

If you prescribe a Schedule 8 medicine to a patient for whom you do not hold a current authority to prescribe that medicine, the Unauthorised Prescriber alert is triggered.

Medium-risk clinical scenario: A section 18A authority is required to prescribe drugs of dependence to this patient. Contact authorised prescriber, or seek authority before prescribing.

If the patient has no authority for the S8 drug about to be prescribed, the following alert is displayed:

Medium-risk clinical scenario: A section 18A authority is required to prescribe drugs of dependence to this patient. Seek authority before prescribing.

The alert is not triggered if a prescriber holds an authority and DDU have recorded you as a locum for that prescriber, or have identified that you work at the same practice.

Exemptions from alert rule: The patient is 70 years old (or above) and/or is flagged as NPCP (Palliative Care).