MOH central registry to weed out drug abusers

SINGAPORE - The Ministry of Health (MOH) is proposing to make it mandatory for doctors to key in the details of patients and prescriptions into a central registry when dispensing benzodiazepines, a family of drugs that have tranquillising properties.

MOH said it will be able to monitor prescription patterns through a Web-based Central Drug Prescribing Registry, which can also help doctors detect potential drug abusers.

"There is a need to monitor such prescriptions because (benzodiazepine) is a controlled medicine and people can get addicted to it," said Dr Daniel Wee, a general practitione at Healthway Punggol Clinic.

Other general practitioners also support the idea of having a registry, but hoped that it would not create a hassle for them.

"It shouldn't be too troublesome, though, if the registration is done through a website and is paperless," said Dr Wee.

Through the proposed system, a doctor can check records of a patient's use of benzodiazepine, including prescriptions from other clinics.

This will help physicians identify "doctor-hoppers", that is, patients who visit different clinics to get their fix.

"There are quite a few patients who doctor-hop so, hopefully, this system will prevent that from happening," said a general practitioner from a clinic in the western part of Singapore who declined to be named.

Drugs in the benzodiazepine family include sleeping pills and are used to treat insomnia, anxiety and muscle spasms. However, abusers have been known to use these drugs for non-medical purposes to achieve a "high".

Besides allowing doctors to make informed decisions when dispensing medication, the system will also counter the problem of errant prescriptions.

Under the Singapore Medical Council's (SMC's) ethical code and ethical guidelines, a doctor shall "prescribe, dispense or supply medicines only on clear medical grounds and in reasonable quantities as appropriate to the patient's needs".

The SMC has also seen cases where doctors prescribed possibly addictive drugs to patients for profit.

Just last month, Dr Tan Teck Hong, a general practitioner at Excelsior Clinic and Surgery, was suspended for three months after pleading guilty to 16 charges of professional misconduct, which included the inappropriate prescription of benzodiazepines.

SMC noted that Dr Tan's patients could have become addicted to the drugs or that he was "simply fuelling an existing addiction".

Dr Tan was also fined $5,000, censured and made to give a written pledge to say that he will not repeat his actions.

From 2007 to last year, the SMC saw 64 complaints regarding excessive or inappropriate prescription of drugs, although not all the cases involved benzodiazepines.

MOH is seeking public feedback on the implementation of the proposed system. The feedback should be mailed to the ministry or addressed to moh_info@ moh.gov.sg by Jan 7 next year.

The public-consultation paper can be accessed at www. moh.gov.sg/econsultation/benzo and also at www.reach.gov.sg

shong@sph.com.sg

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