Kimberley Standard Drug List (KSDL)

 

In consultation with a number of key stakeholders, KAMS and WA Country Health Service developed a standard drug list for use in the Kimberley; the first edition of the Kimberley Standard Drug List (KSDL) was published in November 2005.

This standard drug list is largely defined by best practice guidelines and is intended to be used by Aboriginal community controlled health services and remote government clinics. It is also intended to be reflected in hospital imprest systems. It is hoped that this process of drug rationalization promotes consistency in care across health services and consequently, have widespread benefits for both clinicians and patients.

In order to establish a regional consensus, the first stage of development involved circulation of a comprehensive drug list to Kimberley clinicians. The drug list included therapeutic classes relevant to the health priorities of the Kimberley population. Clinicians were asked to select their preferences in each therapeutic class and provide rationale for these preferences.

 
 

A 3-part format for the standard drug list was established as follows:

 

1. Essential drug list

This list consists of drugs that the steering committee recommends should be easily accessible to the Kimberley population and hence, included in all clinic medication imprests.

 
 
 

2. Supplementary list

This list consists of drugs that should be able to be accessed across the Kimberley, but will not be required by all clinics.

Therefore, it is at the discretion of the senior clinicians as to whether or not these drugs are included on the clinics imprest. Drugs on the supplementary list are included for specific indications.

 
 
 

3. Emergency drug list

This list consists of drugs to be included in Emergency drug kits.

A KSDL Review Committee has been established to facilitate the updating and ongoing maintenance of this standard list. The committee meets once a year to review any new drugs which have been added to the PBS, new clinical data that has been reported, and also to review any KSDL modification request forms submitted by clinicians.

The review takes into account the following criteria:

  • Evidence based medicine/clinical trial data

  • Regional preferences

  • PBS indications and authority status (if applicable)

  • Familiarity

  • Drug costs

  • Side Effect Profile/Interactions

  • Patient Compliance

  • Other Resources

 
 

KSDL FAQ

 

What is it?

It is a list, or formulary, of medicines that are routinely available across both State controlled clinics and Aboriginal Community Controlled Health Services.

Why was it developed?

  • To help clinics select a suitable and standard range of medication to manage acute and chronic conditions

  • To minimise duplication of drug classes e.g. clinics stocking 6 different ACE-Inhibitors

  • To help reduce wastage and expired medicine at clinics

  • To ensure a highly mobile patient group are able to access their medication across all Kimberley clinics

Who selects the medicines for inclusion?

The List is updated each year by a review committee including medical, nursing and pharmacy representatives from WACHS and ACCHSs

What criteria are used to determine inclusion on the KSDL?

  • Availability on the PBS and approved indications (and hence through Section 100)

  • Availability of suitable alternatives on the KSDL

  • Patient issues – does it improve adherence? Is it more efficacious? Does it cause less side-effects than alternatives? Is it suitable for packing in a Websterpak?

Who should use it?

All clinic staff and all medical officers attending these clinics.

Visiting specialist service providers and providers in referral hospitals discharging clients back to Kimberley communities.

What if I want to prescribe something that is not on the KSDL?

You can order non-KSDL items on a prescription. If the item is PBS then on a PBS prescription sent to the contracted private pharmacy.

If it is not on the PBS then seek advice from the Regional Pharmacist (WACHS clinics). All prescriptions should be accompanied by an “Individual Patient Supply Form” detailing why a non-KSDL drug is necessary and the form faxed to the Regional Pharmacy.

In ACCHSs non-KSDL PBS and non-PBS items require prior approval by the SMO before an order is placed with the commercial pharmacy, no prescription is necessary. An “Individual Patient Supply Form” is faxed to the KAMS pharmacist and details are entered in MMEx.

 

Why do I have to complete an “Individual Patient Supply Form” or include details in “reason for selecting off KSDL” in MMEx for non-KSDL drugs?

This information is used to consider drugs for inclusion at each review meeting. We rely on your input to improve the KSDL!

I think a drug (or any other change) should be included on the KSDL, how do I let the review committee know?

We welcome feedback, please complete a Modification Request Form and send onto the Regional Pharmacist or the KAMS Pharmacist. Please include a rationale for inclusion and any supporting evidence.

What is the difference between the “essential” list and the “supplementary” list?

The Essential list includes all medicines that should be available at all clinics.

The Supplementary list includes medicines that each clinic can elect to stock – usually dependent on whether there is a patient attending the clinic on the particular medicine. It is not expected that all clinics stock every Supplementary item.

I have a patient on a non-KSDL ACE-Inhibitor, how do I switch them to a KSDL listed ACE-Inhibitor?

At the end of the KSDL are the Drug Transfer Protocols, these provide guidance based on the available evidence for switching between alternatives in a drug class.

Where can I find a copy of the KSDL?

All clinics and hospital wards should have a hard copy.

Electronic copies (in pdf) are available on the WACHS Intranet here or on the KAMS website here .

What about an app for my iPhone?

At this time we don’t have an app – however the committee is investigating the costs of developing an app through an IT provider.

I use MMEx, how do I preferentially choose KSDL medicines?

When adding a new medicine to a patients order, select the “KSDL” search option – this only allows you to select KSDL listed medicines.