Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - March 2015

The National Institute of Health and Care Excellence (NICE) has published new guidance for the month of March 2015. This month there are four guidelines and two technology appraisals that impact upon primary care.

The Medicines optimisation guideline offers best practice advice on the care of all people who are using medicines and also those who are receiving suboptimal benefit from medicines. The recommendations include topic areas such as medication review, medicines reconciliation and patient decision aids.

The Excess winter deaths and morbidity guideline makes recommendations on how to reduce the risk of death and ill health associated with living in a cold home. Clinicians may find this guideline useful when consulting vulnerable people.

The Maintaining a healthy weight guideline makes recommendations on behaviours that may help people maintain a healthy weight or prevent excess weight gain. The recommendations aim to:

  • encourage people to make changes in line with existing advice
  • encourage people to develop physical activity and dietary habits that will help them maintain a healthy weight and prevent excess weight gain
  • encourage people to monitor their own weight and associated behaviours
  • promote the clear communication of benefits of maintaining a healthy weight and making gradual changes to physical activity and diet
  • ensure messages are tailored to specific groups
  • ensure activities are integrated with the local strategic approach to obesity

The Depression in children and young people guideline has been updated in sections 1.5 and 1.6 where new recommendations on psychological therapies and antidepressants have been added.

The Empagliflozin technology appraisal recommends this treatment for type 2 diabetes, in combination with metformin, only if the person cannot take a sulfonylurea or is at significant risk of hypoglycaemia or its consequences. It can also be used in triple therapy in addition to metformin and a sulphonylurea or a glitazone, and finally use in combination with insulin, with or without other antidiabetic drugs is also allowed.

The Rivaroxaban technology appraisal recommends this treatment as an option within its marketing authorisation, in combination with aspirin plus clopidogrel or aspirin alone, for preventing atherothrombotic events in people who have had an acute coronary syndrome with elevated cardiac biomarkers. The risk of bleeding needs to be assessed before treatment is started and a decision on continuation of treatment should be taken no later than 12 months after starting treatment.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'NICE Guidance - March 2015' on Email Share 'NICE Guidance - March 2015' on Delicious Share 'NICE Guidance - March 2015' on Digg Share 'NICE Guidance - March 2015' on Facebook Share 'NICE Guidance - March 2015' on Google+ Share 'NICE Guidance - March 2015' on reddit Share 'NICE Guidance - March 2015' on StumbleUpon Share 'NICE Guidance - March 2015' on Twitter

NICE Guidance - February 2015

The National Institute of Health and Care Excellence (NICE) has published new guidance for the month of February 2015. This month there are three guidelines that impact upon primary care.

The Bladder cancer guideline offers evidence-based advice on the diagnosis and management of bladder cancer in adults.

The Diabetes in pregnancy guideline offers evidence-based advice on managing diabetes and its complications in women who are planning pregnancy and those who are already pregnant. It focuses on areas where additional or different care should be offered to women with diabetes and their newborn babies.

The Irritable bowel syndrome in adults clinical guideline is an update to the original guideline from 2008. It contains advice on the diagnosis and management of irritable bowel syndrome and details the circumstances when people need to be referred to a specialist. Recommendations for ovarian cancer screening as well as dietary and lifestyle advice and pharmacological therapy have been added to and updated.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'NICE Guidance - February 2015' on Email Share 'NICE Guidance - February 2015' on Delicious Share 'NICE Guidance - February 2015' on Digg Share 'NICE Guidance - February 2015' on Facebook Share 'NICE Guidance - February 2015' on Google+ Share 'NICE Guidance - February 2015' on reddit Share 'NICE Guidance - February 2015' on StumbleUpon Share 'NICE Guidance - February 2015' on Twitter

NICE Guidance - January 2015

The National Institute of Health and Care Excellence (NICE) has published new guidance for the month of January 2015. This month there is one clinical guideline that impacts upon primary care.

The Gastro-oesophageal reflux disease: recognition, diagnosis and management in children and young people clinical guideline offers evidence-based advice on the recognition, diagnosis and management of gastro-oesophageal reflux disease in children and young people. This is also the first guideline issued in a new number system introduce this year.

This guidance notes that that reflux is very common in well infants and does not require treatment, but that clinicians should be alert to red flag symptoms which may suggest GORD or other disorders.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

Share 'NICE Guidance - January 2015' on Email Share 'NICE Guidance - January 2015' on Delicious Share 'NICE Guidance - January 2015' on Digg Share 'NICE Guidance - January 2015' on Facebook Share 'NICE Guidance - January 2015' on Google+ Share 'NICE Guidance - January 2015' on reddit Share 'NICE Guidance - January 2015' on StumbleUpon Share 'NICE Guidance - January 2015' on Twitter

Key therapeutic topics 2015

The Medicines and Prescribing Centre at NICE has published the 2015 update to Key therapeutic topics - Medicines management options for local implementation (PDF).

This publication summarises key therapeutic areas where there are potential opportunities for maintaining or improving quality and improving value.

This update has retained the previous 14 therapeutic topics. All the topics have been reviewed and updated in the light of new guidance and important new evidence. Changes include:

  • KTT2: Renin-angiotensin system drugs. The addition of a table summarising NICE recommendations on the use of renin-angiotensin system drugs in various indications
  • KTT3: Lipid-modifying drugs. Updated to reflect recommendations in the NICE guideline on lipid modification, published in July 2014
  • KTT4: Omega 3 fatty acid supplements. Updated to reflect recommendations in the NICE guideline on MI – secondary prevention, published in November 2013 and the NICE guideline on lipid modification, published in July 2014
  • KTT9: Antibiotic prescribing – especially broad spectrum antibiotics. Updated in line with Public Health England guidance on managing common infections, which was updated in November 2014
  • KTT10: Three-day courses of antibiotics for uncomplicated urinary tract infection. Updated in line with Public Health England guidance on managing common infections, which was updated in November 2014

Action: Clinicians and Commissioners should be aware of this document. The key topic areas can be reviewed and prioritised based upon local need and current performance.

Share 'Key therapeutic topics 2015' on Email Share 'Key therapeutic topics 2015' on Delicious Share 'Key therapeutic topics 2015' on Digg Share 'Key therapeutic topics 2015' on Facebook Share 'Key therapeutic topics 2015' on Google+ Share 'Key therapeutic topics 2015' on reddit Share 'Key therapeutic topics 2015' on StumbleUpon Share 'Key therapeutic topics 2015' on Twitter

PHE Advice on Gabapentin and Pregabalin

Public Health England (PHE) has recently issued advice (PDF) for prescribers on the risk of misuse of pregabalin and gabapentin.

The advice was produced by an expert group and contains suggestions for a balanced and rational use of these medicines. It is noted the majority of patients will use these medicines appropriately but that in some cases they can lead to dependence and may be misused or diverted.

It is suggested that less harmful, alternative drugs can often be first-line treatments for the indicated conditions for which pregabalin and gabapentin are now used, and may be tried preferentially in higher risk settings or in patients who may be more likely to be harmed by the drugs.

Action: Clinicians should be aware of the potential for misuse and diversion of these medicines and the recommendations made to reduce these risks.

Share 'PHE Advice on Gabapentin and Pregabalin' on Email Share 'PHE Advice on Gabapentin and Pregabalin' on Delicious Share 'PHE Advice on Gabapentin and Pregabalin' on Digg Share 'PHE Advice on Gabapentin and Pregabalin' on Facebook Share 'PHE Advice on Gabapentin and Pregabalin' on Google+ Share 'PHE Advice on Gabapentin and Pregabalin' on reddit Share 'PHE Advice on Gabapentin and Pregabalin' on StumbleUpon Share 'PHE Advice on Gabapentin and Pregabalin' on Twitter

« Older Posts

Prescribing Advice for GPs is powered by WordPress.
Subscribe for Free to our RSS or Atom Feeds for New Entries.
Akismet has protected Prescribing Advice for GPs from 787,935 spam comments.

atomic-wealth
fond-illness
summer