The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of August 2022. This month there are two guidelines that impact upon primary care.
The Type 1 diabetes in adults: diagnosis and management guideline has been updated. It covers care and treatment for adults (aged 18 and over) with type 1 diabetes. The update amended recommendations on blood pressure targets to make them consistent with other guidance.
The Tobacco: preventing uptake, promoting quitting and treating dependence guideline has been updated. It covers support to stop smoking for everyone aged 12 and over, and help to reduce people's harm from smoking if they are not ready to stop. The update includes recommending an in-person group seminar as a stop-smoking intervention and also highlights that varenicline is currently unavailable in the UK.
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 (MHRA) has published Drug Safety Update for August 2022 (PDF).
This issue advises clinicians that the home use of nebulisers in paediatric asthma should be initiated and managed only by specialists. The MHRA is aware of a number of fatal cases in children in England, which occurred between 2008 and 2022, in which clinically unsupervised use of a nebuliser was a potential contributory factor in the child's death from asthma.
This issue contains the latest COVID-19 vaccine and medicine information including confirmation of the authorisation of the first bivalent vaccine.
Lastly in this issue is a summary of letters to healthcare professionals in July. These generally related to supply issues and recalls as well as the reclassification of estradiol 10 microgram vaginal tablets (Gina®) as a pharmacy medicine.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Scottish Medicines Consortium (SMC) has issued its monthly advice on newly licensed medicines.
Beclometasone, formoterol, glycopyrronium inhaler (Trimbow®) has been accepted for use as a maintenance treatment of asthma, in adults not adequately controlled with a maintenance combination of a long-acting beta2-agonist and high dose of inhaled corticosteroid, and who experienced one or more asthma exacerbations in the previous year.
Somatrogon (Ngenla®) has been accepted for use in the treatment of children and adolescents from 3 years of age with growth disturbance due to insufficient secretion of growth hormone. It is noted that this is an additional treatment choice in the therapeutic class of recombinant human growth hormones.
Potassium citrate and potassium hydrogen carbonate granules (Sibnayal®) has been accepted for use in the treatment of distal renal tubular acidosis (dRTA) in adults, adolescents and children aged one year and older. It is noted that this advice applies only in the context of an approved NHSScotland Patient Access Scheme (PAS) and the evidence used for this decision is based on three days of treatment. As such it would be expected that this item would be prescribed in secondary care.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
During July 2022 Clinical Knowledge Summaries were published or updated in the following areas.
The Coronavirus - COVID-19 topic is new. All of the other topics have been reviewed and updated with minor structural and layout changes. A red flag section has been added to the Dyspepsia - pregnancy-associated topic and prescribing recommendations for acid-suppressing drugs have been updated in line with recent NICE guidelines. The Fibroids topic has been updated with an additional information section added to the Management section, which outlines specialist assessment and management options.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
