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Gateshead Update October 2014

Prescribing guidelines for atrial fibrillation in primary care

Updated guidelines for Gateshead practices for the management of AF in primary care are now available. They include information on the use of the newer oral anticoagulants (NOACs) and incorporate the latest recommendations from NICE. Click here to view the guidelines.

Reminder: appropriate use of emollients and topical corticosteroids

NICE recommend a stepped approach to the management of atopic eczema. Emollients should form the basis of atopic eczema management and should always be used, even when the atopic eczema is clear. Management can then be stepped up or down, according to the severity of symptoms, with the addition of other treatments (NICE CG57).

The Gateshead emollient formulary quick reference guide outlines emollient choices from the North of Tyne emollient formulary. General principles for prescribing emollients:

  • Prescribe by brand to aid identification and prevent dispensing errors
  • Suitable quantities – 250g per week for children and 500 – 600g per week for adults
  • Patients should use the cheapest emollient that is effective, cosmetically acceptable and which they are prepared to use regularly
  • Start with small packs until the patient finds a suitable product
  • Prescribe pump dispensers where possible
  • There is little evidence to support the routine use of bath emollients. Bath and shower emollients offer no advantages over emollients and they should not be used in place of products which are directly applied to the skin after washing
  • Repeat prescriptions for emollients should be reviewed on a regular basis
  • Ointments can cause folliculitis due to occlusive effect – stop and switch to a cream
  • Paraffin containing products are highly flammable and bath products may cause a slip hazard