The Department of Health has announced several changes to the national vaccination programme to include protection against flu, shingles and diarrhoea.
The JCVI has previously recommended the addition of rotavirus vaccine to the childhood vaccination schedule. This infection currently causes around 140,000 cases of diarrhoea in the under 5s each year with 10% of these cases being admitted to a hospital. Use of this vaccine is expected to start from July 2013.
The shingles vaccine will be offered to people aged 70 years from September 2013. A catch up campaign will also be operated which will offer vaccination to anyone aged up to 79 years old. Shingles affects 30,000 people aged over 70 each year and it is hoped that this vaccine will prevent 40% of those cases.
A nasal influenza vaccine will be offered to 2 year old children from September 2013. The following year the programme will be rolled out to include all pre-school and primary school children and the year after that the programme will be extended again to include secondary school children.
Additionally, the current meningitis C booster vaccine given at 4 months old will be replaced with a vaccine given to those aged 12 and 13 years old.
Action: Clinicians should be aware of these changes to the national vaccination programme. Anyone involved with the delivery of the vaccination programme should ensure they familiar with the changes and the new vaccines.
The National Institute of Health and Care Excellence (NICE) has published new guidance for the month of April 2013. This month there are four technology appraisals that impact upon primary care.
The Asthma (severe, persistent, patients aged 6+, adults) - omalizumab (Xolair®) technology appraisal recommends this treatment as an option for treating severe persistent confirmed allergic IgE‑mediated asthma in individuals who need continuous or frequent treatment with oral corticosteroids. This recommendation is made provided the treatment is made available with the discount agreed in the patient access scheme.
The Gout - canakinumab (Ilaris®) technology appraisal was terminated because no evidence submission was received from the manufacturer. As such the treatment cannot be recommended.
The Idiopathic pulmonary fibrosis - pirfenidone (Esbriet®) technology appraisal is recommended for patients with a predicted FVC between 50% and 80% and provided the treatment is made available with the discount agreed in the patient access scheme. Treatment should be stopped if the predicted FVC decline by more than 10% in 12 months.
The Rheumatoid arthritis - abatacept (2nd line) (Orencia®) technology appraisal recommends this treatment in combination with methotrexate as an option for treating rheumatoid arthritis in adults whose disease has responded inadequately to two conventional DMARDs. This recommendation is based upon it being used in accordance with the recommendations for other biological DMARDs as defined in TA130 and provided the treatment is made available with the discount agreed in the patient access scheme.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Medicines and Healthcare products Regulatory Agency has published guidance on patient specific directions (PSDs) in response to a number of enquiries about the use of PSDs in healthcare settings.
The guidance answers some frequently asked questions and includes a definition of a PSD. It also clarifies what information is needed on a PSD, how long they remain valid and the responsibilities and accountabilities of the prescriber who writes the PSD.
Action: Clinicians who make use of PSDs should be aware of this guidance and ensure that use of PSDs is in accordance with this guidance.
The 65th Edition of the British National Formulary has been published and it is currently being distributed in the NHS.
New or revised content in this version includes updated advice in the following areas:
- Updated guidance on pain management in palliative care
- Updated advice on the management of hereditary angioedema
- Revised guidance on the treatment of endocarditis
- Updated advice on the risk of malignancy with long-term use of calcitonin
- Several new drugs or indications have been added
The web version has already been updated but requires registration or an Athens account for continued access. The printed version is available for purchase.
Action: All clinicians should start using BNF 65 as soon as the print version arrives. The web version can be used to access the latest information if necessary.
The manufacturer of the OneTouch® Verio® IQ and OneTouch® Verio® Pro blood glucose testing meters have written to healthcare professionals advising that these meters either fail to provide a warning or provide an incorrect result when blood glucose levels are very high. As a result users of both meters are being advised to access a replacement meter.
In the case of the IQ meter, when glucose levels are 56.8mmol/L or above the meter will turn off instead of displaying a message warning the user that their glucose level is extremely high. In the case of the Pro meter, when glucose levels are 56.8mmol/L or above the meter will display an inaccurate reading that is the difference between the actual level and 56.8mmol/L. For example, if the real level is 59.1mmol/L the display would read 2.3mmol/L (59.1-56.8 = 2.3).
Patients can be advised to call 0800 279 9118 to access a replacement meter. Both affected meters use the OneTouch Verio testing strip so it might be prudent to identify patients who are prescribed these strips and advise them accordingly.
Action: Clinicians should be aware of this issue and advise affected patients of the need to obtain a replacement meter.