Medicines Optimisation
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Quinine - QT prolongation risk & interactions

Despite repeated warnings about an unfavourable balance between risks and benefits, prescribing of quinine salts in NECS stakeholder CCGs has remained remarkably constant in recent years. The MHRA have issued a reminder about the potential for quinine to effect the QT interval,  along with updated information about interactions - particularly with anticonvulsant drugs. Advice for healthcare professionals: be aware of …

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NHSE & NHC CC OTC QRG

NHS England & NHS Clinical Commissioners have published a quick reference guide (QRG) to Conditions for which over the counter items should not routinely be prescribed in primary care. The OTC QRG sets out the reasons for recommending that certain treatments of limited clinical effectiveness, or used for conditions that are either self-limiting or suitable for self-care, should not be routinely prescribed in primary care - with …

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Ulipristal for uterine fibroids - safety update

In February 2018, the European Medicine Agency Pharmacovigilance Risk Assessment Committee (PRAC) issued temporary recommendations that no new patients should be started on Esmya (ulipristal acetate), following reports of serious injury. The PRAC has completed its review of Esmya. The Committee has now concluded that new patients can start treatment in line with the above recommendations to minimise the risk of liver …

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National Medication Safety Dashboard

Following recommendations in the report of the Short Life Working Group on reducing medication-related harm, the Department of Health & Social Care Medicines Safety Programme has developed an open-access Medication Safety Dashboard with a series of preliminary prescribing indicators. A more granular & detailed version of the Medication Safety Dashboard is available via EPACT2. The aim of the indicators is to: support local …

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Influenza Season 2017/18: Antiviral Medicines No Longer Recommended

The Department of Health & Social Care has issued the following advice via the Central Alerting System: The most recent surveillance data from Public Health England (PHE) indicates that circulation of influenza in the community has returned to baseline levels.   GPs and other prescribers working in primary care should no longer prescribe antiviral medicines, for the prophylaxis and treatment of …

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AHSN Atrial Fibrillation Card Deck_2018 Refresh

The Academic Health Science Network for the North East & North Cumbria have refreshed the Anticoagulant Treatment in Atrial Fibrillation Card Deck distributed to GPs across the region in 2017. The refreshed Card Deck, produced jointly with Northern England Clinical Networks and endorsed by the Atrial Fibrillation Association and the Stroke Association, has been designed to help GPs manage AF more effectively. The cards contain …

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Department of Health Supply Issues Bulletins

The Department of Health and Social Care has a team responsible for managing medicine supply issues, including shortages and discontinuations. The team produces monthly updates on supply issues affecting primary care. Registered users can access the updates via PrescQIPP or the Specialist Pharmacy Services website (when logged-in - please log-in before using the links): https://www.prescqipp.info/resources/category/413-out-of-stock-intelligence https://www.sps.nhs.uk/articles/department-of-health-and-pharmaceutical-market-strategy-group-pmsg-supply-updates/ 

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Valproate Pregnancy Prevention Programme

The MHRA has determined that valproate medicines should now be contraindicated in women & girls of childbearing potential unless the conditions of a new Pregnancy Prevention Programme are met. The April 2018 edition of the MHRA Drug Safety Update includes the following advice for healthcare professionals: GPs must identify and recall all women and girls who may be of childbearing …

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New Guide to Prescribing Specials

The NECS MO Quality and Governance group recently approved a comprehensive guide to the use of pharmaceutical specials in primary care. The guide includes general advice on governance issues - including establishing special need, sharing decision making and making arrangements for monitoring & review - as well as practical tips - such as where to find information on alternatives to …

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MHRA Warning - Watch out for look-alikes & sound-alikes

The MHRA have recently highlighted the dangers associated with medicines with look-alike or sound-alike names - including cases with fatal outcomes, in which patients received the wrong medicine due to confusion between similar names. Drugs pairs known to have been linked to errors include: Clobazam / Clonazepam; Atenolol / Amlodipine; Propranolol / Prednisolone; Risperidone / Ropinirole; Sulfadiazine / Sulfasalazine and Amlodipine / …

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Reducing Medication-Related Harm

The Department of Health and Social Care have published a Short Life Working Group report on reducing medication-related harm. The report, which was informed by a review of the evidence on medication errors in England produced by the Policy Research Unit in Economic Evaluation of Health and Care Interventions (EEPRU), makes recommendations for a programme of work to tackle medication error and improve …

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Medicines Use and Safety Update - March 2018

The Medicines Use and Safety Division of the Specialist Pharmacy Service (SPS) have published a March 2018 update on the SPS website with information on a range of topics, including: Recent Resources Collaborative Audits Work in Progress Network Events Publications The Network Events section includes details of a forthcoming meeting dedicated to Delivering the WHO “Medication With Out Harm” Patient Safety Challenge to …

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NICE Bites - Asthma

The North West Medicines Information Service publish monthly "NICE Bites" bulletins summarising key points from NICE Clinical Guidelines and Technology Appraisals in the Implementation Section of the Specialist Pharmacy Service website - and on the East Lancashire Medicines Management site. The most recent bulletin distills 39 pages of recommendations from NICE NG 80 Asthma: diagnosis, monitoring and chronic asthma management into …

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NICE Key Therapeutic Topics 2018

The 2018 update of NICE 'medicines optimisation: key therapeutic topics' has been published. The evidence context for all the current topics has been updated in the light of new guidance and important new evidence. 14 topics from 2017 have been retained: multimorbidity and polypharmacy psychotropic medicines in people with learning disabilities whose behaviour challenges safer insulin prescribing medicines optimisation in long-term pain biosimilar …

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RCGP TARGET Antibiotic Newsletter

The team responsible for the RCGP TARGET Antibiotic Toolkit have just published the second in their new series of quarterly newsletters. The March 2018 edition of the RCGP TARGET Toolkit Newsletter includes draft UTI diagnosis flowcharts amd information about a new Treating Your Infection UTI leaflet for older adults and those who care for them due to published very soon.

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RCGP/CPRD Quality Improvement Project

The Royal College of General Practitioners (RCGP) and the MHRA Clinical Practice Research Datalink (CPRD) have developed confidential bespoke practice and patient-level drug prescribing reports, available for free for GP practices contributing to CPRD. The reports focus on prescribing and patient safety, allowing practices to benchmark themselves against others contributing to CPRD. The reports can be used for appraisal (under Domain 2 …

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NHS England Guidance on responsibility for prescribing between primary and secondary/tertiary care

NHS England has published guidance on Responsibility for prescribing between primary and secondary/tertiary care The guidance has been produced in partnership with NHS Clinical Commissioners, the BMA, the RCGP, the RCN and the National Association for Patient Participation. It aims to "provide clarity on the responsibilities of all professionals involved in commissioning and prescribing across primary, secondary and tertiary care, and …

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Controlled Drugs: Learning from Incidents Issue 10

Controlled Drugs: Learning from Incidents Issue 10 Issue 10 covers: Burglaries to pharmacies Delivery errors Alcohol-free phenobarbital liquid for children Post-dated prescriptions Denaturing reminder Dealing with lost or stolen prescriptions

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Unblocking EPS2

Are you struggling to send some prescriptions by EPS2? The NHS Dictionary of Medicines and Devices (dm+d) is the standard for transferring medicine and medical device information between clinical systems and is required for all EPS2 prescribing. Some entries in the prescribing databases used by GP clinical systems cannot be directly matched to a unique dm+d code - and therefore …

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eRD Support

DDES CCG have been working with NECS MO, NECS Business Change & Benefits and NHS Digital to develop resources to support preparation for, implementation of and growth in electronic Repeat Dispensing (eRD). The first tranche of support materials are now ready for use. The pack includes: a presentation, outlining background and benefits, with advice on process and practical tips; an …

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