5th Floor, Becketts House, 2-14
Ilford Hill, Ilford. IG1 2QX
Phone: 0208 822 3074/3076
Fax:
0208 926 5423
Issue 22
Jan 2015
LAST ROUND OF PRESCRIBING FORUMS
INSIDE THIS ISSUE:
Prescribing
forums— save the
date
1
Diclofenac—no
longer available
OTC
1
Shared decision
making –blood
glucose meters
2
Pregabalin and
Gabapentin—
abuse potential
2
The last round of prescribing forums for this financial year will be commencing shortly.
Flyers with details of the agenda and times will be sent to practices in
due course but please save the dates below. At least one clinical member of staff from each practice is required to attend although all are welcome.
Note that practices who have missed a previous forum will need to ensure a representative is in attendance in order to qualify for the full prescribing scheme points. If you have any queries, please contact Denise
Baker at [email protected]
Clinical Commissioning Group (CCG)
Barking and
Dagenham
Havering
Redbridge
Date
Venue
Wednesday, 11th February
2015
Urswick Education
Centre
Thursday, 12th March
2015
Urswick Education
Centre
Thursday, 26th February
2015
Havering Indoor Bowls
Club
Wednesday, 4th March
2015
Havering Indoor Bowls
Club
Wednesday, 25th February
2015
Prince Regent Hotel
Thursday, 19th March
2015
Prince Regent Hotel
DICLOFENAC—NO LONGER AVAILABLE OTC
The MHRA has issued a Drug Alert (EL_(15)A_01_Final1.pdf ) directing
the recall of all oral over the counter preparations of Diclofenac with the
legal status of Pharmacy only. This action is in line with previous alerts
from the MHRA advising healthcare professionals of new warnings and
Back issues of ‘The
contra-indications associated with the use of Diclofenac as detailed in the
Prescription Pad’ are Drug Safety Update, June 2013. From the 15th of January 2015, pharmaarchived at:
cists are no longer able to supply oral Diclofenac without a prescription.
http://www.redbridgeccg. Topical preparations will however remain available over the counter.
nhs.uk/AboutAction for prescribers
us/Medicinesmanage1. Be aware that Diclofenac can only be supplied to clinically appropriate
ment/prescribingpatients on the basis of an FP10 prescription.
newsletters.htm
1
Pa g e 2
SHARED DECICION M AKING—BLOOD
GLUCOSE METERS
NICE guidance CG 138, Patient experience in adult NHS services contains a list of quality statements which include:
1. Patients are supported by healthcare professionals to understand relevant treatment options, including benefits, risks and potential consequences.
2. Patients are actively involved in shared decision making and supported
by healthcare professionals to make fully informed choices about investigations, treatment and care that reflect what is important to them.
3. Patients are made aware that they have the right to choose, accept or
decline treatment and these decisions are respected and supported.
Practices are reminded that in reviewing and making changes to patients
treatments or medical devices; it is important to offer the patients choice,
support them to make informed decisions and respect the patients decisions about their care.
For example, in carrying out reviews of patients blood glucose meters in
line with the locally approved BHR CCG Blood Glucose meters recommendations for GP practices document; patients should be given the opportunity to choose a meter (from the portfolio) that best meets their
needs. There has been feedback from some patients that this is not happening which would indicate a deviation from recommended good practice.
Action for practices
1. Healthcare professionals should actively support patients to make informed decisions about their care by offering clinically appropriate choice.
PREGABALIN AND GABAPENTIN—ABUSE POTENTIAL
Public Health England has issued advice (link) to all prescribers on the risk
of misuse of Pregabalin and Gabapentin.
Pregabalin is licensed for the treatment of epilepsy, generalised anxiety
disorder and neuropathic pain (link to SPC). Gabapentin is licensed for the
treatment of epilepsy and neuropathic pain (link to SPC). Both have a similar mechanism of action and have a propensity for misuse. Misuse has
been noted for some years and may be growing. At the moment, Pregabalin seems to be the more sought after product.
Actions for prescribers
1. Prescribers should be aware of the potential benefits of these drugs as
well as the potential for dependence, misuse or diversion
2. When used for pain the drugs do not work for everyone but a proportion of patients benefit sufficiently to notice an improvement in quality of
life
3. Practitioners should prescribe Pregabalin and Gabapentin appropriately
to minimise the risks of misuse and dependence, and should be able to
identify and manage problems of misuse if they arise. Practices are encouraged to look out for excessive requests for prescriptions, claims of lost
prescriptions etc. and manage in line with the practice policy
Patients should
be actively
involved in
making choices
about their care
in line with
national
guidance and
good practice
References
Please note that references to articles are
embedded in hyperlinks
within the text. Look out
for underlined text. Click
on the link to see full
articles or references.
For further information regarding this
newsletter, contact:
Lola Apakama. Prescribing Advisor, Lola.apakama@
onel.nhs.uk or 0208
822 3074
2
Please note: This information is intended to support prescribing, not dictate it.