Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Additional NICE Guidance - June 2010

The National Institute of Health and Clinical Excellence has published additional new guidance for the month of June 2010.

Earlier this month guidance was issued relating to alcohol-use disorders and reducing alcohol related harm.

NICE has now issued further public health guidance relating to quitting smoking in pregnancy and following childbirth (QRG) and prevention of cardiovascular disease (QRG).

There is also an updated clinical guideline detailing the diagnosis and management of adults with chronic obstructive pulmonary disease (COPD) (QRG).

This update introduces some significant changes compared to the previous guideline including:

  • Diagnosis should be confirmed on post-bronchodilator spirometry assessment
  • Pulmonary rehabilitation should be more widely available to include those who have had a recent hospitalisation for an acute exacerbation
  • Grading of the severity of airflow obstruction for COPD is now aligned with other international organisations (ATS, ERS and GOLD)
  • Changes in the recommended positioning for inhaled treatments

Action: Clinicians should be aware of these guidelines. Clinicians who see patients with COPD should ensure they are familiar with the changes introduced in the updated COPD guidance.

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Mixtard 30 being discontinued

The manufacturer of Mixtard® 30 has announced that this product will be discontinued by the 31st December 2010 due to declining demand.

Mixtard 30 is the only remaining Mixtard preparation since the discontinuation of the other presentations in 2007. Patients are being advised to contact their doctor or nurse to discuss treatment options.

This move has caused some concern according to the Pharmaceutical Journal with Diabetes UK, the charity for people with diabetes, stating that they asked the manufacturer to reconsider as it estimates some 90,000 people are currently using this product. A longer withdrawal period was also declined.

Diabetes UK has also made available a list of alternative products (PDF) which will aid clinicians and patients during this transition.

Action: Clinicians should be aware of this announcement and the additional workload it will involve. Alternative treatment options should be considered based upon patient factors and acquisition cost.

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NICE Guidance - June 2010

The National Institute of Health and Clinical Excellence has published new guidance for the month of June 2010.

This month there is a clinical guideline and public health guidance that have an impact on primary care. The clinical guideline details the management of physical complications arising from alcohol-use disorders in adults and young people while the public health guidance promotes strategies that could be employed to reduce alcohol related harm.

Additionally, a clinical guideline was issued late in May following the UK elections that describes the diagnosis and management of idiopathic childhood constipation.

Action: Clinicians should be aware of these guidelines. They will be a useful resource for clinicians who see children or adults and young people who are exhibiting physical complications associated with alcohol use.

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