Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

NICE Guidance - February 2018

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of February 2018. This month there are three guidelines and three technology appraisals that impact upon primary care.

The Pancreatic cancer in adults guideline has been published. It covers diagnosing and managing pancreatic cancer in adults aged 18 and over. It aims to improve care by ensuring quicker and more accurate diagnosis, and by specifying the most effective treatments for people depending on how advanced their cancer is.

The Heavy menstrual bleeding clinical guideline has been updated to include signposting to the temporary safety measures as part of an ongoing review of ulipristal acetate (Esmya®) for uterine fibroids.

The Peripheral arterial disease clinical guideline has been updated with two new recommendations in diagnosing peripheral arterial disease in people with diabetes.

The Raloxifene for the primary prevention of osteoporotic fragility fractures in postmenopausal women technology appraisal has been updated to reflect the current recommendations. Guidance on strontium ranelate and etidronate have been removed because these drugs are no longer marketed in the UK. Some recommendations have also been replaced by newer guidance.

The Raloxifene and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women technology appraisal has been updated to reflect the current recommendations as detailed above. Some recommendations have also been replaced by newer guidance.

The Bisphosphonates for treating osteoporosis technology appraisal has also been updated in line with the amendments to the two technology appraisals listed above.

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

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CKS Updates - January 2018

During January 2018 Clinical Knowledge Summaries were updated in the following areas.

The following topics were all reviewed:

The majority of topics have undergone reviews and minor restructures.

The most significant changes are in the Burns and scalds topic that now has a new Assessment section and prescribing details have been replaced with a link to the Cellulitis topic. In the Tennis Elbow topic there is a new differential diagnosis section and the Vestibular neuronitis topic now contains more detailed prescribing information.

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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NICE Guidance - January 2018

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of January 2018. This month there is one guideline that impacts upon primary care.

The Age-related macular degeneration clinical guideline covers diagnosing and managing age-related macular degeneration (AMD) in adults. It aims to improve the speed at which people are diagnosed and treated to prevent loss of sight.

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

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NICE Guidance - December 2017

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of December 2017. This month there is one guideline, one diagnostic guideline and one technology appraisal that impact upon primary care.

The Autism spectrum disorder in under 19s clinical guideline has been updated to include ADHD as a factor associated with an increased prevalence of autism and changed references from DCM-4 to DCM-5. The guideline covers recognising and diagnosing autism spectrum disorder in children and young people from birth up to 19 years and it also covers referral.

The Atrial fibrillation and heart valve disease: self-monitoring diagnostic guideline has been updated removing the recommendations for the InRatio2 PT/INR monitor as this device is no longer available.

The Naltrexone–bupropion for managing overweight and obesity technology appraisal has been published. Naltrexone–bupropion (Mysimba®) is not recommended within its marketing authorisation for managing overweight and obesity in adults alongside a reduced-calorie diet and increased physical activity.

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

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Antiviral Medicines Authorised for Influenza Season 2017/18

The Department of Health has written to healthcare professionals via the Central Alerting System (PDF) to advise that antiviral medicines may now be prescribed at NHS expense due to rising levels in reporting of influenza-like illness.

Surveillance data indicates an increase in influenza cases in the community, GPs and other prescribers working in primary care may now prescribe antiviral medicines for the prophylaxis and treatment of influenza. Doses and treatment schedules are contains in existing Public Health England guidance.

Clinicians are reminded to endorse the prescription with 'SLS' to ensure that it can be dispensed in community pharmacies without undue delay.

Action: Clinicians should be aware of this letter and familiarise themselves with the current prescribing guidance.

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