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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - December 2020

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of December 2020. This month there are eight clinical guidelines, two COVID-19 Rapid Guidelines and one technology appraisal that impact upon primary care.

The seven clinical guidelines of relevance to primary care this month have all been updated.

The Osteoarthritis: care and management guideline, Low back pain and sciatica in over 16s: assessment and management guideline and the Peripheral arterial disease: diagnosis and management guideline have both been updated in line with guidance on the use of opioids for non-cancer pain in response to a Public Health England evidence review on dependence on, and withdrawal from, prescribed medicines.

The Pancreatitis guideline and the Eating disorders: recognition and treatment guideline have both been updated in line with MHRA advice highlighting the importance of rotating insulin injection sites within the same body region.

The Type 1 diabetes in adults: diagnosis and management guideline and the Type 2 diabetes in adults: management guideline have both seen minor changes to the recommendations on diabetic retinopathy to align them with the NHS diabetic eye screening programme.

The Diabetes in pregnancy: management from preconception to the postnatal period guideline has seen changed recommendations on intermittently scanned CGM (isCGM, also commonly referred to as flash) and continuous glucose monitoring during pregnancy for women with type 1 diabetes.

The COVID-19 rapid guideline: managing the long-term effects of COVID-19 guideline has been published. It covers identifying, assessing and managing the long-term effects of COVID-19, often described as 'long COVID'. It makes recommendations about care in all healthcare settings for adults, children and young people who have new or ongoing symptoms 4 weeks or more after the start of acute COVID-19. It also includes advice on organising services for long COVID.

The COVID-19 rapid guideline: vitamin D guideline has been published. It covers vitamin D use in the context of COVID‑19. It is for adults, young people and children in hospitals and community settings. Vitamin D is important for bone and muscle health. It may also have a role in the body's immune response to respiratory viruses.

The Liraglutide for managing overweight and obesity technology appraisal has been published. Liraglutide is recommended as an option for managing overweight and obesity alongside a reduced-calorie diet and increased physical activity in adults but it is restricted to prescribing in secondary care by a specialist multidisciplinary tier 3 weight management service with a commercial agreement in place.

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

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