How do I enter an Oral Opioid Replacement script?

You can add an Oral ORT script from the incoming prescription queue or from the patient's profile.

The easiest way to add an ORT script to a patient's profile is from the incoming prescription queue

Entering an OTP Script from the incoming prescription queue:

1. Dispense the patient's script or scripts. (If a patient is on multiple strengths of Suboxone or Subutex and is covered under the PBS, dispense each script for each strength of these medications. Each script for each strength will be added into StrongER separately).
2. Navigate to Prescriptions tab at the top of the screen
3. Find the patient's script/s (The script will be highlighted in gold and have the OTP tag) and select the first script to add by putting a tick next to the script and select Add or Continue.
4. The Add New Prescription pop-up will display
5. The Script Number, Drug and Strength and Script Quantity will be pre-filled, and PBS Script will already be selected. Untick PBS Script if it is a private prescription
6. Enter the dose in mg (milligrams) in the Dosage field.
   
   For Suboxone and Subutex patients: the dosage for you will enter in is for that strength of the drug, i.e. for a patient who is on 20mg of Suboxone a day, the dosage in milligrams for the 8mg script will be 16 and for the 2mg script the dosage will be 4. StrongER will then combine these scripts and dosages together for the patients' total dose of 20mg.
7. Enter the Start Date of the script, any dates covered by a previous script will be highlighted in red. In most cases you want to add the script to start at the end of the previous script, so select the first day after the days highlighted in red. If the new script is replacing the current script, you can choose the start date you require and StrongER will present a pop-up asking for you to confirm this. 
   
   The End Date will be automatically calculated as 28 days after the start date. If the script has end that is shorter than the 28 days you can adjust the end date to what is required. 
   1. For PBS scripts, you will add each dispensing/repeat into StrongER, as the maximum PBS quantity on a script is 28 days, the default length of a script is 28 days and can be reduced
   2. For Private scripts, you can set script range to be what is on the prescription
      
      
8. Use the Notes field to record any pertinent information for example:
   1. Takeaway allowances
   2. Public Holiday/Pharmacy Closure allowances
   3. Script Expiry
   4. Dose Changes/allowances
9. (Optional) Takeaway doses: If the patient has takeaway doses, otherwise skip to step 10
   
   1. Select Specific Days: If the patient has set days that they are allowed to have takeaways doses, or has a preference for specific days e.g. the patient has 4 takeaway doses per week on a Tuesday, Thursday, Saturday and Sunday, select each of these days under Select Specific Days
   2. Public Holidays: Automatically sets a public holiday (denoted by a black triangle in the top right corner of a day on the calendar) as a takeaway dose
   3. Select Alternate Days: For when a patient alternates a supervised dosing with a takeaway dose
   4. Variable Days per Week: If a patient varies which days they receive their takeaway doses, set the maximum allowed number of takeaway doses e.g. 4 takeaways per week
   5. Max Consecutive Takeaways: Is the limit of how many takeaway doses a patient may receive in a row e.g. a patient with 4 takeaway doses allowed per week, but can only collect a maximum of 2 in a row, the Maximum Consecutive Takeaways is 2
   6. Combination: If a patient must have a takeaway dose on a Sunday each week as the pharmacy is closed on that day, but has 3 other takeaway doses available each week, it is possible to Select Specific Days as Sunday and the remaining 3 takeaway doses may be variable. Max Consecutive Doses and Public Holidays can also be set
10. (Optional) Dose Types: You can Select Specific Days, Alternating Days or Variable Days per Week that a dose type is taken. If the patient does not receive a Dose Type of a Double Dose, Triple Dose, Split Dose or Dose Range, skip to step 11
    1. Double Dose: twice the daily dose is taken and the patient dose not receive a dose for the next day. Double doses are available only for Suboxone and Subutex. 
    2. Triple Dose: thrice the daily dose is taken and the patient dose not receive a dose for the next two days. Triple doses are available only for Suboxone and Subutex. 
    3.  Split Dose: For patients that receive part of their dose in the morning and part in the evening. Split Dosage Part 1 may be edited and Split Dosage Part 2 will automatically calculate the dose based on the dosage set in Step 6
    4. Dose Range: For patients that may choose what dose the receive each day, within a specific range specified by the prescriber
11. (Optional) Edit the calendar directly: To change a Dosage, Dose Type or Dose Attendance on the calendar, you can select Multiple days on the calendar to edit. Selecting Multiple Days:
    

    Ctrl + Click	This allows you to select multiple days on the calendar. Hold down the Ctrl key and click on each item you want to select
    Shift + Click	This selects a range of items. Click on the first item, hold down Shift, and then click on the last item in the range you want to select. All items between the two clicks will be selected

     

    1. Dosage: Allows the dose on day to differ to what the dosage in step 6 was entered as, this is useful for when a patient is on a reducing or increasing dose schedule, the dose changes can be entered in at the point of add the script in or can be added in later by editing the script
    2. Dose Type: Here you can specify the dose type as in step 10, you can also mark a dose as a No Dose, where a patient may not receive a dose on that day e.g. if a patient is in hospital or receives a dose at another pharmacy that day
    3. Dose Attendance: Supervised dose or Takeaway dose may be edited here
12. Review the script details, and add the script onto the patient's profile, by entering your credentials and selecting Add. You can then dose the patient: How do I supply Oral Opioid replacement doses?
13. If the patient has another script or script 

Entering an OTP Script from the patient's profile:

If your dispensing software does not connect to StrongER, you can add an Oral OTP script from the patients profile

1. Navigate to the patient's profile using the Patient Search field in the top left-hand corner or if the patient does not have a record, you can create a profile for them (How do I add a new patient in StrongER?)
2. Once of the patient's profile, navigate to the Opioid Replacement tab
3. Select the + Script button and the Add New Prescription pop-up will display
4. Enter in Script Number, PBS Status, Prescriber, Drug and Product
5. Follow on from Step 6 from Entering an OTP Script from the incoming prescription queue above