Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Nutrition Action Plan Launched

The Department of Health has launched a Nutrition action plan that aims to tackle malnutrition and ensure the nutritional needs of older people in hospitals and care homes are better met.

The action plan contains five priorities:

  • To raise awareness of the link between nutrition and good health and that malnutrition can be treated
  • To ensure that accessible guidance is available across all sectors and that the most relevant guidance is appropriate and user-friendly
  • To strongly encourage nutritional screening for all people using health and social care services; with particular attention to those groups who are known to be vulnerable
  • To encourage provision and access to relevant training for frontline staff and managers on the importance of nutrition for good health and nutritional care
  • To clarify standards and strengthen inspection and regulation

In order to support these priorities a training programme on nutritional care and assistance with eating will be available to all NHS and social care staff from May 2008.

Action: Clinicians should be aware of the importance of good nutrition and adequate hydration for health outcomes and be able to advise patients about their diet.

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HPV accepted to immunisation programme

The Department of Health has accepted the Human Papilloma Virus (HPV) vaccine into the NHS immunisation programme after completion of a cost benefit analysis. This announcement has been reported by the BBC and wider media.

The vaccine will be introduced into the national programme in Autumn 2008 for girls aged 12-13 years with a catch up campaign starting the following year for girls aged up to 18 years. The vaccine will be funded nationally for both of these initiatives.

There is no indication at this stage if both of the vaccines, Gardasil® or Ceravix®, will be part of the programme however the Department of Health are expected to negotiate the price down from the current level of £240 per patient.

Action: Clinicians should be aware of this announcement as it may increase demand for the vaccine. Prescriptions issued prior to the national campaign will need to be funded from existing budgets.

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Two COCs discontinued

According to a report on the National Electronic Library for Medicines Minulet® and Tri-Minulet® have been discontinued with immediate effect.

Both products have been in short supply for some time and the decision has now been made to cease production entirely due to low demand and the availability of alternative treatments.

Action: Clinicians should be aware of these discontinuations and ensure that any remaining prescriptions and change to alternative treatments.

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October NICE Guidance

The National Institute of Health and Clinical Excellence has published new guidance for the month of October.

Included in this months guidance is a public health programme guideline on behaviour change. The quick reference guideline (QRG) contains advice applicable to front line practitioners in terms of selecting interventions that will motivate and support people by:

  • planning changes and making easy steps over time
  • planning 'if-then' coping strategies
  • setting goals to undertake clearly defined behaviours
  • sharing their change goals with others

Action: Clinicians who aim to change behaviour in individual patients will find this guideline a useful resource.

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Safety review of glitazones complete

The Medicines and Healthcare products Regulatory Agency have announced the outcome of a Europe wide safety review of the glitazones.

The review found a positive benefit-risk balance for both pioglitazone and rosiglitazone. However, prescribing information should be updated for the latter drug to indicate that it should only be used in patients with ischaemic heart disease only after a careful evaluation of the patient's individual risk and that it should only be used in combination with insulin in exceptional cases and under close supervision.

Action: Clinicians should be aware of the outcome of this review and the new cautions added to the prescribing information for rosiglitazone. Metformin and sulphonylureas remain the oral hypoglycaemics of choice, pioglitazone may be an alternative to these drugs in case of intolerance or where contraindications exist.

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