Medicines Optimisation
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COVID-19 - Warfarin

The NHS Specialist Pharmacy Service have published a guide to Management of patients taking warfarin during the COVID-19 pandemic. The guide recommends a stepwise approach: For patients with prior DVT or PE with low risk of recurrence, consider stopping warfarin. For other patients, consider switching to a DOAC - using a phased approach over a 12 week cycle to protect …

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COVID-19 - Drug Monitoring Guidance

The NHS Specialist Pharmacy Service have published Guidance on management of drugs requiring monitoring during COVID-19 - supported by background advice on General Factors to Consider when making Monitoring Decisions. The objective of the guidance is to protect patients from unnecessary health care visits and help preserve capacity in primary care.  The SPS guide recommends that drug monitoring during the COVID-19 …

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COVID-19 - Professional Resources & Guidance

NHS England COVID-19 Guidance - NHS England COVID-19 Specialty Guides  UK Government COVID-19 resources - NHS COVID-19 resources NICE COVID-19 resources - NHS SPS COVID-19 resources HEE e-Learning for Health COVID-19 Courses Alphabetical List - with thanks to SPS Several Professional, Academic & Representative Bodies have compiled collections of COVID-19 guidance and information. The following may be helpful for Medicines Optimisation teams: …

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COVID-19 - Smoking Cessation Services & Advice

The UK Government & Public Health England have highlighted that emerging evidence from China shows smokers with COVID-19 are 14 times more likely to develop severe respiratory disease. Quitting now may reduce risk for individuals and those exposed to second-hand smoke. Public Health England note the following immediate and short-term benefits: After 48 hours Carbon monoxide is eliminated from the …

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COVID-19 - Renin-Angiotensin System Drugs

A BMJ Editorial on Drugs and the renin-angiotensin system in COVID-19 published 02/04/20 includes the following advice about decisions on continuing treatment during the pandemic (supported by a suggested algorithm):

The balance of potential benefits and harms from continuing ACE inhibitor or ARB therapy during an acute infection depends on the reason for prescribing. Many people taking these drugs long term—for example, those with mild hypertension—will gain benefit over years, rather than weeks or months. During the covid-19 epidemic, the people most likely to be infected—household contacts of infected people and healthcare workers—might choose to adopt the precautionary principle, deferring long term cardiovascular benefit to reduce a theoretical short term risk from continuing treatment while they are infected.

Patients who may deteriorate rapidly if treatment with ACE inhibitors or ARBs is stopped, including those with heart failure or poorly controlled hypertension, should probably continue to take them, even during active infection.

Most patients, however, will be able to take their medications as usual during the pandemic, only considering withholding treatment if they get an infection.

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COVID-19 - Medicines for End of Life & Critical Care - RESOURCES

Resources to Support Appropriate & Equitable Supply & Use of Medicines for End of Life & Critical Care during the COVID-19 Emergency: NICE NG163: Managing symptoms (including at the end of life) in the community Scottish Palliative Care Guidelines: Alternatives to regular medication normally given via a syringe pump when this is not available Association for Palliative Medicines of Great …

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COVID-19 - NICE Rapid Guidelines & Evidence Summaries

NICE have updated their collection of COVID-19 Rapid Guidelines & Evidence Summaries - The collection now includes the following: critical care in adults managing symptoms (including at the end of life) in the community managing suspected or confirmed pneumonia in adults in the community bone marrow transplant kidney dialysis radiotherapy rheumatological autoimmune, inflammatory and metabolic bone disorders severe asthma systemic …

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COVID-19 - Educational Resources

e-Learning for Health e-LfH have developed & published a comprehensive suite of educational resources for Healthcare Professionals engaged in managing and tackling the COVID-19 pandemic. The resources include: Essential Guidance ; PPE; Infection Prevention & Control; Critical Care; End of Life Care; Primary & Community Care; Up-skilling & Redeployment; Resources for Pharmacy Staff, and; Staff Wellbeing. Future Learn - Managing …

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COVID-19 - Anticoagulant Services Clinical Guide

NHSE&I have published a Clinical guide for the management of anticoagulant services during the coronavirus pandemic - as part of the NHSE&I COVID-19 Collection of Specialty Guides  Patients receiving warfarin requiring management in outpatient or community settings - Anticoagulation service provision should consider the following: Is warfarin still required? Can patients on warfarin be switched to an alternative oral anticoagulant, …

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COVID-19 - Critical Care Medicines Demand/Supply Management

In order to manage additional demand for medicines in critical care and anaesthesia during the on-going COVID-19 pandemic, the Royal College of Anaesthetists, Association of Anaesthetists, Faculty of Intensive Care Medicine, Intensive Care Society and UK Clinical Pharmacy Association have worked closely with the Chief Pharmaceutical Officer at NHS England to publish the following Drug demand-supply clinical guidance and patient-focussed …

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