Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

A worthwhile read

You may have noticed that there have been few posts made in the last two weeks. The reason for this is that I have been on holiday and away from work. I placed an order with Amazon before I left hoping the order would arrive before I left; unfortunately it wasn't delivered in time but was waiting for me on my return.

My order included a copy of The Whistleblower: Confessions of a Healthcare Hitman. The author, Peter Rost, is a former vice president for Pfizer who was the first company executive to speak out in favour of re-importation of drugs in America.

The book provides an, albeit one sided, expose on practices adopted within the pharmaceutical industry to ensure and protect healthy profits. Often these practices place short-term gain ahead of long-term improvements and ethical conduct.

Action: Amazon currently lists the book at a little over £7 and it really is an eye-opener and a worthwhile read.

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MeReC Extra 24

The National Prescribing Centre (NPC) has published MeReC Extra 24, it details the results of the ACTIVE W Study, future changes in controlled drug management and reminders about CFC free beclometasone and the important health benefits associated with smoking cessation.

Patients with atrial fibrillation are currently recommended to receive aspirin therapy if they are at low risk of stroke and therapy with warfarin at high risk of stroke. The ACTIVE W Study examined the efficacy of the combination of aspirin and clopidogrel versus warfarin in preventing stroke in moderate to high risk patients.

The primary outcome of stroke, systemic embolus, myocardial infarction or vascular death occurred less frequently in the warfarin group with a relative risk reduction of 44% (ARR 2.1%). The risk of stroke was also lower in the warfarin group with a relative risk reduction of 72% (ARR 1.25%). Additionally, the risk of bleeding was 21% lower in the warfarin group (ARR 2.8%).

The NPC conclude that this study "supports the use of warfarin in patients with AF who are at high risk of stroke".

The remaining sections provide reminders about the MHRA advice about prescribing of CFC free beclometasone inhalers, planned changes to the inspection and monitoring of controlled drugs and the role healthcare professionals can play in promoting smoking cessation.

Action: Clinicians involved in the treatment of AF will find the review of the ACTIVE W Study interesting. Other sections provide useful links to further information.

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BNF 52

The 52nd Edition of the British National Formulary is currently being printed and distributed.

Priority is given to the print version before the web version is updated.

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 52 as soon as the print version arrives.

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