☀️     🌓

Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

No more free pens

The Association of the British Pharmaceutical Industry (ABPI) has voted in favour of several changes to the Code of Practice to "increase transparency and trust".

The changes will be incorporated into the Code of Practice on the 1st January 2011 but enforcement of the newly introduced requirement will start of the 1st May 2011. The main changes are:

  • the industry will no longer provide branded promotional items to healthcare professionals
  • inexpensive items to be passed on and used by patients as part of a formal patient support programme are allowed
  • companies will also have to declare payments to healthcare professionals each year

More details of the changes are available from the Prescription Medicine Code of Practice Authority (PMCPA). An updated version of the Code of Practice will be available to download shortly with print copies available by the end of the year.

Action: Clinicians should be aware of the changes to the ABPI Code of Practice and the phased introduction of the new requirements. These most recent updates are the end of the line for drug name branded pens and sticky pads!

Share 'No more free pens' by emailShare 'No more free pens' on FacebookShare 'No more free pens' on TwitterShare 'No more free pens' on MastodonShare 'No more free pens' on LinkedInShare 'No more free pens' on reddit

Metformin and reduced cancer risk

Diabetes Care has published the results of a study that aimed to assess the effect of metformin on cancer incidence in a consecutive series of insulin-treated patients.

The study identified 1,340 consecutive type 2 diabetic outpatients (mean age 63, 56% female). Participants had no history of cancer and all were started on insulin therapy between 1998 and 2007 in Florence, Italy. Incident cancer diagnoses were identified using hospital admission data or the Mortality Register (for cancer deaths).

112 patients were identified with incident cancer (29 gastrointestinal, 16 lung, 14 pancreatic, 53 others) over a media follow up of 73.9 months (approximately 6 years). These cases were matched to controls for age, gender and BMI at insulin initiation from a cohort of 370 patients. In those patients who were prescribed metformin that was a significantly reduced risk of cancer (odds ratio 0.46, 95% CI 0.25-0.85, p=0.014).

The authors conclude that, "the reduction of cancer risk could be a further, relevant reason for maintaining metformin in insulin-treated patients ".

The authors note that there are limitations in the data and therefore the analysis. Prescription bias could not be ruled out and some patients may have been misdiagnosed as diabetic. Also, the greater incidence of cancer in those patients that did not receive metformin may be due to co-morbidities.

Action: Clinicians should be aware of this small study. The results of this study may be useful when discussing the risks and benefits of metformin treatment.

Share 'Metformin and reduced cancer risk' by emailShare 'Metformin and reduced cancer risk' on FacebookShare 'Metformin and reduced cancer risk' on TwitterShare 'Metformin and reduced cancer risk' on MastodonShare 'Metformin and reduced cancer risk' on LinkedInShare 'Metformin and reduced cancer risk' on reddit

CKS Update - November 2010

Clinical Knowledge Summaries (CKS) has been updated in November 2010 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.

Share 'CKS Update - November 2010' by emailShare 'CKS Update - November 2010' on FacebookShare 'CKS Update - November 2010' on TwitterShare 'CKS Update - November 2010' on MastodonShare 'CKS Update - November 2010' on LinkedInShare 'CKS Update - November 2010' on reddit

BNF 60

The 60th Edition of the British National Formulary was published in September and is currently being distributed within the NHS.

New or revised content in this version includes updated advice regarding:

  • Use of beta-blockers in patients with asthma or chronic obstructive pulmonary disease
  • Prophylaxis of venous thromboembolism
  • Antiplatelet drugs in patients with a coronary stent
  • Chronic obstructive pulmonary disease
  • Neuropathic pain
  • Influenza vaccination
  • Meningococcal A, C, W135, and Y conjugate vaccine

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

Action: All clinicians should start using BNF 60 as soon as the print version arrives. The web version can be used to access the latest information if necessary.

Share 'BNF 60' by emailShare 'BNF 60' on FacebookShare 'BNF 60' on TwitterShare 'BNF 60' on MastodonShare 'BNF 60' on LinkedInShare 'BNF 60' on reddit

NICE Guidance - October 2010

The National Institute of Health and Clinical Excellence has published new guidance for the month of October 2010. This month there is one clinical guideline and one technology appraisal that impact upon primary care.

The nocturnal enuresis clinical guideline (QRG) provides evidence-based advice on the assessment, care and treatment of children and young people up to the age of 19 with bedwetting.

The technology appraisal (QRG) reviews the place for liraglutide (Victoza®) in the treatment of type 2 diabetes mellitus. It is recommended as an alternative to exenatide (Byetta®) in the following circumstances:

  • At a maximum dose of 1.2mg daily (1.8mg daily is not recommended)
  • In triple therapy combination with metformin and a sulphonylurea or a glitazone
  • In dual therapy combination with metformin or a sulphonylurea when other oral treatments (including metformin, sulphonylureas, glitazones and gliptins) are not tolerated or contraindicated
  • Control of blood glucose remains or becomes inadequate (HbA1c above 7.5% or other higher level agreed with the individual)
  • BMI > 35kg/m2 and associated weight based medical problems or BMI < 35kg/m2 where weight loss would benefit co-morbidities, or insulin therapy would have significant occupational implications
  • Treatment should only be continued if successful in reducing HbA1c by 1% at 6 months and body weight by 3% in the same time period when use in triple therapy

Action: Clinicians should be aware of these recommendations and implement any necessary changes to practice.

Share 'NICE Guidance - October 2010' by emailShare 'NICE Guidance - October 2010' on FacebookShare 'NICE Guidance - October 2010' on TwitterShare 'NICE Guidance - October 2010' on MastodonShare 'NICE Guidance - October 2010' on LinkedInShare 'NICE Guidance - October 2010' on reddit

« Older Posts Newer Posts »

Prescribing Advice for GPs is powered by ClassicPress.
Connect to our RSS or Atom Feeds.