Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

CKS Updates - March 2017

During March 2017 Clinical Knowledge Summaries were updated for the following topics:

The following topics were all reviewed:

The topics have undergone minor restructures. The most significant change is that all people presenting with suspected TIA within the last week should be referred urgently (to be seen within 24 hours) to a stroke physician without risk stratification.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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Dabigatran capsule colour change

The manufacturer of dabigatran (Pradaxa®) has written to healthcare professionals to advise that the colour of the capsule is being changed in a move that is likely to improve patient safety.

Dabigatran is available in three strengths, 75mg, 110mg and 150mg. Previously the capsule shell was the same colour for all three strengths with the size and imprint text being different. The new colour will see the 75mg capsule coloured white, the 110mg will be light blue and the 150mg will be two-tone white and light blue. The size and text imprint will remain the same. The changes have also removed sunset yellow as a colouring agent.

Patient support materials are available from company representatives or direct from the company by emailing of calling 01344 742 579.

Action: Clinicians should be aware of this change. Patients who are concerned that their medication has changed in appearance can be reassured and advised to continue to take dabigatran as prescribed.

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NICE Guidance - March 2017

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of March 2017. This month there are two guidelines that impact upon primary care.

The Stroke and transient ischaemic attack in over 16s clinical guideline has been updated to give a definition of aspirin intolerance, rather than a link to a definition. The guideline covers interventions in the acute stage of a stroke or transient ischaemic attack (TIA). It offers the best clinical advice on the diagnosis and acute management of stroke and TIA in the 48 hours after onset of symptoms, although some interventions of up to 2 weeks are covered as well.

The Familial breast cancer clinical guideline has been updated after a review of the evidence for chemoprevention for women with no personal history of breast cancer. The guideline covers care for people with a family history of breast, ovarian or another related (prostate or pancreatic) cancer. It aims to improve the long-term health of these families by describing strategies to reduce the risk of and promote early detection of breast cancer (including genetic testing and mammography). It also includes advice on treatments (tamoxifen, raloxifene) and surgery (mastectomy).

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

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Prescription Charges for 2017

The Department of Health announced in March that the price for an NHS prescription in England will increase by 20p to £8.60 with effect from the 1st April 2017.

The prices for 3 and 12 month pre-payment certificates are frozen and have remained the same at £29.10 and £104 respectively. For anyone requiring more than 3 items in 3 months or more than 12 in a year these certificates can provide significant savings.

Other NHS charges such as for dental work, wigs and fabric supports are also being increased in line with inflation.

Action: Clinicians should be aware of the current prescription charge and also the value for money represented by pre-payment certificates.

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CKS Updates - February 2017

During February 2017 Clinical Knowledge Summaries were updated for the following topics:

The following topics were all reviewed:

The topics have undergone minor restructures. More significant changes include recommendations for urgent referral for suspected cancer in the Breathlessness topic and amending several recommendations about repeating swabs for staphylococcal carriage, reducing period of treatment for recurrent boils and antiseptic choice in line with advice from Public Health England.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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