Medication formulary and prescribing practices for prison health services
Guideline number: QH-GDL-501:2022
Effective date: 7 November 2022
Review date: 7 November 2025
Supersedes: Nil - first issue
On this page:
1. Purpose
This guideline provides recommendations regarding best practice to support consistent prescribing practices in Queensland Health provided prison health services.
2. Scope
This guideline applies to all Queensland Health employees and contractors (including primary care, specialist mental health and dental providers) who are authorised medication prescribing health practitioners treating people in the custody of Queensland Corrective Services (QCS).
Compliance with this guideline is not mandatory, but sound reasoning must exist for departing from the recommended principles within a guideline.
3. Related documents
Standards, procedures and guidelines
- This guideline supports the List of Approved Medicines (LAM), which is the official statewide formulary for all medicines and pharmaceutical preparations approved for use in all Queensland public hospitals and institutions and it associated guidelines, including the Formulary notes for the List of Approved Medicines.
- Quality use of medication principles
- Prisoner self-managed medication guideline
4. Medication formulary and prescribing practices
Queensland Health is committed to the safe, evidence-based and cost-effective use of therapeutic substances to benefit patients, including people in custody in Queensland Corrective Services (QCS) correctional centres.
Correctional centres pose specific challenges to the delivery of health care due to the environment and the unique needs of people in custody. People in prison generally experience a poorer level of health than people in the general population and experience high rates of mental illness, foetal alcohol spectrum disorder (FASD), autism spectrum disorder (ASD), substance misuse, and chronic disease. In addition, they tend to have attained lower levels of education and many have maladaptive coping mechanisms.
Inconsistent prescribing practices can create angst and frustration for prisoners. Establishing consistency in prescribing practices between clinicians in correctional centres will assist in improving continuity of care and contribute to the good order of the prison environment. Medication prescribing practices should be guided by the following three principles.
4.1 Key principles
4.1.1 Clinical need
Medications should be prescribed based on the clinical need of the patient following careful assessment of their physical and psychological needs.
4.1.2 Equivalence to the community
Prescribing decisions should be commensurate with that applied in non-custodial settings. Due to the risk of diversion and medication misuse prescribers need to consider factors such as the frequency of dosing and administration route. The custodial setting alone must not determine whether a medication is prescribed.
Prescribers should consider the full list of LAM medications. Where an individual patient’s clinical needs can only be met using a non-LAM medicine, approval should be sought through the local approval processes. Approval of non-LAM medications must not be restricted solely because a person is in custody.
4.1.3 Person-centred
Whilst a person is deprived of liberty by being in custody, their right to high-quality and safe health care that is responsive to their needs, preferences and respects their individual values should not be diminished. Decisions to change medications must only be done following meaningful consultation with the patient in a manner which they understand.
5. Approval
Approving officer
Director, Office for Prisoner Health and Wellbeing, Clinical Excellence Queensland
Approval date: 7 November 2022