Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Antiviral medication guidance

The Department of Health has published a guidance document (PDF) regarding the authorisation of antiviral medicines during the H1N1 (swine) 'flu pandemic.

The document indicates that the majority of patients access antiviral medication via the National Pandemic Flu Service (0800 1 513 100 or https://www.pandemicflu.direct.gov.uk/). It is also noted that the Flu Service will refer certain cases to their own doctor, for example:

  • Children under 1 year old
  • People with language difficulties and those who cannot or prefer not to use the internet or telephone
  • Hard-to-reach groups, looked-after children or people requiring adjustment of their treatment due to side effects
  • Occasions when additional clinical judgement is required

The document also clarifies the situations where use of Antiviral Authorisation Vouchers or standard prescription forms (FP10SS) should be used to access antiviral medication and informs that the existing vouchers are being replaced. When FP10SS forms are used to access antiviral medication the right-hand side (white section) of the form should be used and endorsed 'ACP' and the green portion of the form should be voided.

Action: Any clinician who may be involved in arranging access to antiviral medication during the H1N1 pandemic should read this document to ensure that correct procedures are being followed.

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BNF 58

The 58th Edition of the British National Formulary is currently being printed and distributed.

New or revised content in this version includes updated Prescribing information for:

  • Management of arrhythmias
  • Management of acute and chronic asthma
  • Clostridium difficile infection
  • Hospital-acquired pneumonia
  • Influenza
  • Adjustment of drug dosages in renal impairment
  • Wound management products and elasticated garments

The web version has already been updated and printed version is available for purchase.

The print version is distributed by the Department of Health to Dentists, Doctors, Nurses and Pharmacists providing NHS services.

Action: All clinicians should start using BNF 58 as soon as the print version arrives. The web version can be used to access the latest information if necessary.

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September CKS Update

Clinical Knowledge Summaries (CKS) has been updated in September 2009 for the following clinical areas:

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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September NICE Guidance

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

There is one guideline that impacts on primary care. The reducing differences in the uptake of immunisations public health guideline (PDF) provides advice to help increase immunisation uptake among children and young people aged under 19 years in groups and settings where immunisation coverage is low.

Action: Clinicians who are involved in any aspect of delivering immunisation services should consider this guideline to be required reading.

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Prevalence of autism appears stable

The NHS Information Centre has issued a press release and published the results (PDF) of a study that aimed to assess the prevalence of autism spectrum disorders (ASD) among adults in England. This study has been reported in the general media (BBC).

Previous studies have reviewed prevalence of autism, including Asperger syndrome, in children but little was known about prevalence in adults. It has been theorised that rates of autism in older people may decline due to recovery or premature death. This study found a prevalence of 1% among adults which is approximately the same as the rate for children. It was also noted that prevalence rates were approximately the same across all age groups.

The press release states that this latter finding "fails to support suggestions of a link between the mumps, measles and rubella (MMR) vaccine and the condition". MMR was introduced in 1990/91 so it would be expected that the prevalence of autism would be higher among children if there were a link. However, this conclusion is based upon a small sample size and the age group bands used are wide (16-44, 45-74 and 75+).

Action: These results are encouraging and are the first data assessing autism rates among adults. While these results do not support a link between MMR use and development of autism they do not conclusively disprove a link either. Additional research into autism rates in adults would be useful.

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