Audit demonstrates impact of non-medical prescribing
July 18, 2011 by admin
The introduction of non-medical prescribing schemes reduced the number of GP and consultant appointments and hospital admissions, according to a Pulse report of an audit carried out by NHS North West.
BTS/SIGN update asthma guideline
July 18, 2011 by admin
The British asthma management guideline published by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) has been revised and can be downloaded here. Changes include a new section on asthma in adolescents and revisions to monitoring asthma and pharmacological management.
Medicines and transferring care between settings: new guidance
July 18, 2011 by admin
Information about people’s medicines often does not move with them when they transfer between different care settings, says the Royal Pharmaceutical Society, which has just published guidance (see here) to help healthcare professionals and organisations address this problem. Older people and those with long-term conditions are particularly vulnerable to problems arising with their medicines as they move between care settings.
The Department of Health, which requested the guidance, says that having safe systems for managing information and supply of medicines across care settings is likely to reduce avoidable medicines-related hospital admissions, including unnecessary readmissions, as well as reducing harm to patients. The professionals’ guidance cites a 2010 audit involving more than 8600 patients in 50 acute trusts: most patients had at least one incorrect or omitted dose when medicines were checked post-admission. It also describes the case of a patient whose weekly regular oral dose of cytotoxic medicine was wrongly prescribed as daily on transfer home: the patient died.
The guidance for professionals describes four core principles and includes the recommended core content for medicines records when patients transfer between settings.
Many organisations were involved in the development of the guidance and back its publication, including the Academy of Medical Royal Colleges, the Care Quality Commission, and the Royal College of Nursing.
Time to make prescribing safety a primary care priority?
July 15, 2011 by admin
There are ‘considerable’ opportunities to improve primary care prescribing safety and it is time that prescribing safety becomes a priority in primary care, according to the authors of this study. They analysed data from 315 Scottish general practices and found that nearly 14% of patients who were defined as being vulnerable to adverse drug events had received one or more high-risk prescriptions in the last year.
Vulnerability was assessed on the basis of age, pre-existing condition such as heart failure or chronic kidney disease, or existing prescription of a drug with potential for interaction such as warfarin or diuretics. Indicators for high-risk prescribing were defined on the basis of safety alerts, national clinical guidelines, the BNF and prescribing advice. What this means is that although few of these prescriptions were absolutely contraindicated and may have been appropriate, explicit guidance mostly underpinned by a solid evidence base existed that they carried significant risk of harm and should be avoided in most situations. Of those patients prescribed 11 or more drugs in the long term, more than a quarter received a high risk prescription, and increasing age also increased the risk, up to the age of about 80. There was wide variation in high-risk prescribing between practices, with none of the variables examined accounting for this.
The authors suggest that drug reviews could be targeted at those receiving high risk prescriptions defined using these indicators, so that their appropriateness can be the subject of clinical judgement. Despite the significant harm caused by prescribing, these results suggest that prescribing improvement activity does not focus enough on safety.
Guthrie B et al. High risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross sectional population database analysis in Scottish general practice. BMJ 2011; 342:d3514.
http://dx.doi.org/10.1136/bmj.d3514.
NICE approves rheumatoid arthritis drug golimumab
July 15, 2011 by admin
NICE has recommended the drug golimumab, in combination with methotrexate, for adults with rheumatoid arthritis whose condition has not responded enough to other disease-modifying anti-rheumatic drugs. A quick guide can be found here and the longer version here.
ANP announces line-up for autumn conference
July 15, 2011 by admin
The Association for Nurse Prescribing (ANP) has announced the preliminary programme for its 13th annual conference and CPD event, to be held in London on 19 October 2011, at the Wellcome Collection Conference Centre on the Euston Road.
ANP Patron Baroness Julia Cumberlege CBE will chair the day, which will include workshops on mental health, sexual health, cancer and breakthrough pain, diabetes, and prescribing and medicines management in aesthetic medicine. There is a discount for ANP members and non-members will also receive a year’s free ANP membership. These events are always lively and interesting, with plenty of opportunity for discussion, so do come and join in!
For more information and booking, contact Jo Stuttle or see here.
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