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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - April 2021

The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of April 2021. This month are four guidelines and one technology appraisal that impact upon primary care.

The Chronic pain (primary and secondary) in over 16s guideline has been published. It covers assessing all chronic pain (chronic primary pain, chronic secondary pain, or both) and managing chronic primary pain in people aged 16 years and over. Chronic primary pain is pain with no clear underlying cause, or pain (or its impact) that is out of proportion to any observable injury or disease.

The Neonatal infection: antibiotics for prevention and treatment guideline has been published. It covers preventing bacterial infection in healthy babies of up to and including 28 days corrected gestational age, treating pregnant women whose unborn baby is at risk of infection, and caring for babies of up to and including 28 days corrected gestational age with a suspected or confirmed bacterial infection. It aims to reduce delays in recognising and treating infection and prevent unnecessary use of antibiotics.

The Postnatal care guideline has been published. It covers the routine postnatal care that women and their babies should receive in the first 8 weeks after the birth. It includes the organisation and delivery of postnatal care, identifying and managing common and serious health problems in women and their babies, how to help parents form strong relationships with their babies, and baby feeding. The recommendations on emotional attachment and baby feeding also cover the antenatal period.

The Atrial fibrillation: diagnosis and management guideline has been published. It covers diagnosing and managing atrial fibrillation in adults. It includes guidance on providing the best care and treatment for people with atrial fibrillation, including assessing and managing risks of stroke and bleeding.

The Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia or mixed dyslipidaemia technology appraisal has been published. This treatment recommended as an option for treating primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia as an adjunct to diet in adults. It is recommended only if:

  • statins are contraindicated or not tolerated,
  • ezetimibe alone does not control low-density lipoprotein cholesterol well enough, and
  • the company provides bempedoic acid and bempedoic acid with ezetimibe according to the commercial arrangement

It is noted that bempedoic acid with ezetimibe can be used as separate tablets or a fixed-dose combination.

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

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