An alert was issued advising against use of Dermapen 3 and Dermapen Cryo Sterile single use needle cartridge tips for Dermapen 3 since their safety cannot be verified.
A letter was sent to advise healthcare professionals about a restriction to the indication and route of administration for Mitomycin-C Kyowa 40 mg following the observation of increased sub-visible particles in the drug product on storage. A letter was also sent to notify healthcare professionals of a risk of medication error with various Santen eye drop products during the period of transition to new bottles.
Prescribers should be alert for neuropsychiatric reactions in patients taking montelukast and carefully consider the benefits and risks of continuing treatment if they occur.
There is a growing number of people who need access to high-quality endof-life care in the home setting. This requires timely assessments of needs, ensuring good symptom management and recognising the roles undertaken by carers. For some patients, a range of medications may need to be put in place to relieve end-of-life symptoms, using ‘anticipatory prescribing’. District nurses must ensure that they acknowledge the patient's voiced preferences and be mindful of the safety issues that arise with the supply of controlled drugs in the home. This article highlights the challenges faced by district nurses providing or dealing with anticipatory prescribing during end-of-life care. To read the full article, log in using your MPFT NHS OpenAthens details.
The article discusses changes to the way the module was taught that can enhance student learning within the NMP module and facilitate wider success and confidence among community nurse prescribers. The move from Nursing and Midwifery Council standards for prescribing to a single competency framework from the Royal Pharmaceutical Society (RPS) has encouraged academics to revisit teaching strategies and consider an approach that offers wider student participation in learning. The use of technology-enhanced learning (TEL) in HEIs is part of national recommendations to improve the student experience and increase success. To read the full article, log in using your MPFT NHS OpenAthens details.
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Polypharmacy: Getting our medicines right provides a summary of the scale and complexity of the issue of polypharmacy. It outlines how healthcare professionals, patients and carers can find solutions when polypharmacy causes problems for patients and points to useful resources that can help.
We've added 10 new Be Aware updates following your suggestions:
Musculoskeletal ; Osteoporosis ; Nutrition and obesity ; Falls ; HR ; Research Methods ; Information Governance ; Bladder, bowel and pelvic healthcare ; Rheumatology ; Medicines and healthcare products regulatory agency (circulated email)
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This guideline sets out an antimicrobial prescribing strategy for acute exacerbations of chronic obstructive pulmonary disease (COPD). It aims to optimise antibiotic use and reduce antibiotic resistance.
It's very important that these findings aren't taken out of context. Many people across the UK are prescribed statins and the reports may cause undue alarm that everyone should be on a higher dose. People who have risk factors for heart disease and a raised cholesterol, but who have no history of heart attack or stroke, are recommended to start on a low-dose statin (usually 20mg atorvastatin).
The people in this study were specifically high-risk patients, most of whom had already had a heart attack or stroke. Current UK guidelines already recommend that these people are given a high-dose statin (usually 80mg atorvastatin).
This article provides an insight for clinical nurse prescribers who may have limited knowledge of the implications of autistic spectrum disorder (ASD) on their practice. It will provide an insight into the common characteristics of the condition, alongside an overview of contextual and situational issues of direct relevance to sensory overload and underload. Through this, awareness is raised of how specific adaptations to practice might be made to support and empower those people living with the condition, and their families and carers. The need for individualised, holistic care is emphasised alongside information of specific relevance to the practicalities of nurse prescribing in practice. The article also outlines the issues of polypharmacy and pharmacotherapy of relevance to patients with ASD and the precursors to these, which can be readily identified in practice. To read the full article, log in using your MPFT NHS OpenAthens details.
Prescribing medications in the custodial environment is rewarding, but intrinsically challenging. Multiple chronic and acute illnesses co-exist for a substantial proportion of the patients. Many patients have engaged poorly with health services before entering custody. Polypharmacy and neglect are common; and there is a constant threat of contraband medications entering prison, medication hoarding, and on-distribution of prescribed medications for non-prescribed purposes. To read the full article, log in using your MPFT NHS OpenAthens details.
This guidance is to help GPs and healthcare staff to treat infections and use antibiotics responsibly.
Public Health England (PHE) and the National Institute for Health and Care Excellence (NICE) jointly produced the summary tables which are hosted on the NICE website.
The context, references and rational document explains the PHE content in the joint tables.
RCPCH responds to new research which suggests these drugs may alter gut microbes associated with weight gain.
Young children prescribed antibiotics and, to a lesser extent, drugs to curb excess stomach acid, may be at heightened risk of obesity, suggests research published online in the journal Gut.
GPs will be handing out postcards explaining why they are not prescribing antibiotics for a range of common conditions such as coughs and colds, minor ear infections and sore throats.CCG lead pharmacist Dr Manir Hussain, Deputy Director for Primary Care and Medicines Optimisation said: “There is no doubt that in the past too many antibiotics have been prescribed and now some patients expect to come away from an appointment with a prescription for them.
The ‘Keep Antibiotics Working’ campaign returns to alert the public to the risks of antibiotic resistance, urging them to always take their doctor, nurse or healthcare professional’s advice on antibiotics.
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Treating the behavioural and psychological symptoms of dementia with antipsychotics can cause detrimental side‐effects but their use in care homes remains problematic with the views of professionals not fully explored.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
To provide national consensus on the range of conditions community practitioner nurse prescribers manage and for which it is considered important that they can prescribe.. To read the full article, log in using your SSSFT NHS OpenAthens details. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
A series of indicators to inform safer prescribing practice, helping pharmacists, clinicians and patients to review prescribed medication and prevent avoidable harm.
Curbing routine prescribing for minor, short-term conditions, many of which will cure themselves or cause no long term effect on health, will free up NHS funds for frontline care.
The guidance will not affect prescribing of over the counter items for longer term or more complex conditions or where minor illnesses are symptomatic or a side effect of something more serious.
New laws will allow hundreds of advanced paramedics to prescribe drugs, improving care for patients, speeding up access to treatment and preventing unnecessary visits to hospitals and GP practices.
This guidance aims to provide clarity on the responsibilities of all professionals involved in commissioning and prescribing across primary, secondary and tertiary care, and to provide support in developing shared care agreements and in the transfer of care.
Open access. Much discussion has focused on how to increase the supply of primary care physicians. But, despite rapidly accelerating changes in the composition of the primary care workforce and its practices, far less attention has been given to understanding the teams that support physicians in primary care and how these individuals work together. Grant and Guthrie4 draw back the veil in an intriguing ethnographic study that shows how eight heterogeneous primary care practices in England and Scotland implement team approaches to the work of prescribing.
The report, which reflects on 36 studies that details medication error rates in primary care, care homes and secondary care, showed that the most errors with potential to cause harm happen in primary care (71%), which is where most medicines in the NHS are prescribed and dispensed.
This study adds a great deal of new and useful information to our understanding of the effects of antidepressants when used to treat depression in adults. The overall message is encouraging: these drugs are more effective than a placebo, and most of them are at least as tolerable as a placebo.
This was a very large, well-conducted review. However, it has a number of limitations
The Parliamentary Under Secretary of State for Public Health and Primary Care has commissioned Public Health England (PHE) to review the evidence for dependence on, and withdrawal from, prescribed medicines. Withdrawal is more accurately defined as discontinuation syndrome in relation to anti-depressants.
Herbal remedies can affect the way drugs act on the body, either blocking their action or increasing their potency. Problems reported in the review included liver and kidney damage, bleeding, nausea, vomiting and diarrhoea, mental health problems, seizures and muscle pain.
Many combinations of drugs and herbal remedies caused interactions, but the most commonly mentioned drugs were warfarin and statins.
In its response, the RCN welcomed the NMC’s view that all nurses, whatever their field of practice, should be able to undertake full assessments of patients, while also calling on the regulator to increase the amount of assessed simulation in the training of nurses to 600 hours, up from 300.
Pillboxes can be an effective strategy to improve medication adherence. Improvements in device prescription, training, research, and design are needed to understand the mechanisms and size of effects of this intervention. SSSFT - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
As interesting as this review is, it's important to be aware of the type of research this was. It is a narrative review, which means it was a review that discusses evidence about a particular topic.
It is unclear how the authors picked the evidence that informed this piece. Reviews of this type are always vulnerable to accusations of "cherry-picking", where researchers include evidence that supports their argument while ignoring evidence that doesn't.
Following the recent launch by the publishers of the British National Formulary (BNF) and British National Formulary for children (BNFC) of a new, faster, easier to use and access app, NICE has confirmed that its BNF app will be withdrawn later this year.
For the first time NICE is giving specific advice for doctors and nurses about when and how to prescribe antibiotics for conditions such as sore throats and colds.
The consultation proposes initial action to limit prescribing of products for minor self-limiting conditions which currently cost taxpayers £50-100 million a year. The products include cough mixture and cold treatments, eye drops, laxatives and sun cream lotions.
Occupational therapy practitioners enable clients to improve performance in everyday occupations. As health care reform precipitates changes across health care service organizations, occupational therapy professionals must seize the opportunity to apply their unique skills and perspective to meet the changing needs of clients and other stakeholders. In this article, we explore the role and distinct value of occupational therapy practitioners in one area of changing need: medication management. SSSFT staff - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
We’ve just heard that SSOTP will not be renewing their agreement with SSSFT LKS for library services for this financial year. Because of this we will be reviewing our Be Aware bulletins. Sadly we won’t be accepting any new sign-ups from SSOTP staff and will be withdrawing some of the physical healthcare bulletins that we…
Prescribing by suitably-trained pharmacists and nurses offers similar outcomes to prescribing by doctors, at least in the management of chronic conditions.
This Cochrane review pooled clinical outcomes and patient satisfaction across 45 studies of nurse or pharmacist prescribing compared with doctor prescribing.
To explore community nurses’ decision-making processes around the prescribing of anticipatory medications for people who are dying. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
In March 2017, changes were made to update the format of this guideline and a recommendation was removed because it was out of date. Some changes were also made to make recommendation 1.5.4 clearer and to update recommendation 1.1.10.
This novel approach involves people attending a group session on medicines, and then having the option of reviewing their medicines individually in a 3/4-hour session with two health professionals (e.g. a prescriber and a pharmacist).
So far we have found that over two thirds of the attendees get all they need from the group sessions.
This study showed an association between taking ibuprofen or diclofenac and an increased risk of a cardiac arrest in the following 30 days, but no association was found with the other NSAIDs investigated.
But this study does have its limitations
This document summarises the evidence-base on asthma: medicines optimisation priorities (previously titled: high-dose inhaled corticosteroids in asthma). It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
This document summarises the evidence-base on type 2 diabetes mellitus: medicines optimisation priorities. It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
This document summarises the evidence-base on medicines optimisation in long-term pain. It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
This document summarises the evidence-base on safer insulin prescribing. It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
Resource lists for each topic include a list of books and E-books that the library currently stocks and a list of suggested titles.
Surveys are available for each topic, so you can vote for titles that you think the library should purchase and also suggest additional titles.
We found 115 studies through surveillance of this guideline.
This included new evidence on patient involvement in decisions about medicines, supporting adherence and reviewing medicines that supports current recommendations. We asked topic experts whether this new evidence would affect current recommendations on NICE guideline CG76. Generally, the topic experts thought that an update was not needed.
We did not find any new evidence on communication between health professionals.
None of the new evidence considered in surveillance of this guideline was thought to have an effect on current recommendations.
In addition, no major ongoing studies or research due to be published in the next 3–5 years was identified.
In November 2016 a footnote about 2 MHRA drug safety alerts was added to recommendations in section 1.6 covering angiotensin-converting enzyme (ACE) inhibitors. These alerts cover ACE inhibitor use during pregnancy and breastfeeding.
A new report from Public Health England (PHE) shows that for the first time fewer antibiotics are being prescribed by GPs and clinicians. A decline in the use of antibiotics has occurred across all healthcare settings, including in the community and hospitals. This is the first time a reduction has been seen in antibiotic use across the whole healthcare system.
Health leaders in Stafford are urging people in the area to be aware of the proper uses of antibiotics and ensure that they take them responsibly.
Ahead of European Antibiotic Awareness Day, on Friday 18th November, doctors and NHS managers are raising awareness about the risks of taking antibiotics inappropriately and calling on patients to learn about the proper treatment of common winter conditions like coughs, colds and the flu.
This briefing provides information on the Medicines Use Review (MUR) service in a 2-page guide, answering five common questions about MURs as well as providing information on the national target groups. It may be a useful resource to provide to other healthcare professionals to increase awareness and understanding of the MUR service.
We have become aware of a fault affecting the British National Formulary and British National Formulary for Children apps on some Apple devices. Some content may be out of date.
NICE’s advice is to uninstall the app and then reinstall it from the App Store, and we would strongly recommend you do this with both apps.
A small amount of content may be out of date. Please delete the app and reinstall it from the App store. Android devices and all online web versions of the BNF and BNFC are unaffected.
This paper reports the latest in a series of national surveys of nurse prescribing in mental health organizations in England. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Developed by the Royal Pharmaceutical Society in collaboration with NICE, the Framework sets out competencies central to effective performance needed by all prescribers, regardless of their professional background.
When prescribed and used effectively, medicines can significantly improve health and quality of life. However, prescribing medicines is becoming increasingly complex as more become available and the number of people with several long-term conditions increases. Between 30% and 50% of medicines prescribed for long-term conditions are not taken as intended, according to the World Health Organisation.
Our report for 2015 highlights local and national initiatives to promote the safe use of controlled drugs and to reduce harm from their misuse. The report also includes an overview of data for 2015 on prescribing of controlled drugs across England in the primary care sector and identifies any trends in prescribing, and highlights key changes to legislation.
Come and visit our first pop-up library at Severn Fields, Shrewsbury 19th July 11.00am-3.00pm. Join the library, borrow and return books, get help finding information and evidence, set up an Athens account, find out what the library can do for you and your team.
Prescribing nurse
There has been much discussion about when and for whom we should use dual bronchodilators but some degree of confusion persists, not helped by conflicting national and international guidelines. Practice Nurse provides some clarity
By the end of this article you should be aware of:
- The GOLD ABCD algorithm as a method of categorising patients' symptoms and exacerbation risk
- How to identify which patients are likely to benefit most from ICS/LABA versus single or dual long acting bronchodilation
- How to recognise each of the four dual bronchodilators currently available
- How to help patients to choose the most appropriate inhaler for them
The NHS is introducing new ways of making care more effective and accessible.
New legislation announced on 26 February 2016 will extend prescribing responsibilities to therapeutic radiographers and dietitians as well as enabling orthoptists to supply and administer some medicines without the need for a prescription.
By enabling more health professionals to become involved in the use of medicines, new ways of delivering care will be facilitated which will create a more positive experience for patients.
Therapeutic radiographers, dietitians and orthoptists will undertake additional training to enable them to join doctors, nurses, pharmacists, physiotherapists, podiatrists, dentists and others, who are already involved in contributing to more timely and appropriate access to medicines.
NHS England has today launched the world’s largest healthcare incentive scheme for hospitals, family doctors and other health service providers to prevent the growing problem of antibiotic resistance.
Launched against the backdrop of the International Patient Safety Conference taking place at Lancaster House in London today, funding will be made available to hospitals and other providers that reduce the inappropriate use of antibiotics.
The Allied Health Professions Medicines Project Lead at NHS England gives her views on the impact new legislation relating to prescribing, supply and administration of medicines will bring to the quality of care patients receive from eligible Allied Health Professions (AHPs):
Patients under the care of a suitably trained and qualified Dietitian, Orthoptist or Therapeutic Radiographer will shortly be able to access some of their medication without visiting a doctor, thanks to changes in legislation.
Following an announcement today by George Freeman MP, Minister for Life Sciences, patients will have timely access to the medicines they need and more choice in how they obtain them.
The changes to legislation will introduce independent prescribing responsibilities for Therapeutic Radiographers and supplementary prescribing responsibilities for Dietitians. They will also enable Orthoptists to supply and administer medicines under exemptions within Human Medicines Regulations.
Key results
We found no evidence of benefit of the interventions with respect to reducing adverse drug events (harmful effects caused by medicines) or death. One study led to residents having fewer days in hospital; however, the majority of studies did not show a benefit in relation to reducing hospital admissions. One study led to a slower decline in health-related quality of life. Problems relating to medicines were found and addressed through the interventions used in the studies. Prescribing was improved based on criteria used to assess the appropriateness of prescribing in five studies.
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Nursing and medical staff recorded the time it took to prescribe and administer medication electronically and in paper form. A structured questionnaire was used to assess staff experience and attitudes to e-prescribing after the pilot had ended. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Over the years, there have been many reports on the under-treatment of pain in vulnerable older people, especially in persons with dementia. Starting with the study of Ferrell et al. [1] in 1995, again and again lower rates of pharmacological pain treatment have been found for older people and especially for people with cognitive impairment. This holds for studies in the community, in residential settings and nursing homes, and even in post-operative hospital patients [2–5]. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
potentially inappropriate prescribing (PIP) is a significant problem in health care today. We hypothesise that if doctors were given a single indicator of PIP and adverse drug reaction (ADR) risk on a patient's prescription, it might stimulate them to review the medicines. We suggest that a frailty index (FI) score may be such a suitable indicator. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
'A small study suggests the widely used painkiller does not help combat the overall effects of infection. The trial specifically looked at whether paracetamol had any effect on the amount of flu virus in the body (viral load). But it should be stressed this is something paracetamol is not designed to do. Paracetamol is designed to relieve symptoms, not cure any underlying infection.'
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