Cardiovascular – MO opportunities

At the end of July 2023 NHSE published guidance titled “National medicines optimisation opportunities 2023/24”. This guidance describes the 16 national medicines optimisation opportunities for the NHS in 2023/24, and signposts to resources to help with their implementation. It recommends Integrated Care Boards (ICBs) choose at least five medicines optimisation opportunities to focus and deliver on alongside their local medicines optimisation priorities. Progress against chosen opportunities will be reviewed using available data.

This report has data at SICBL, ICB and Commissioning Region level and focuses on the cardiovascular MO opportunities:

  • Identifying patients with atrial fibrillation and using best value direct-acting oral anticoagulants
  • Identifying patients with hypertension and starting antihypertensives where appropriate
  • Optimising lipid management for cardiovascular disease prevention

NHS England Aims:

  • To increase the diagnosis of AF and anti-coagulate with the best value DOAC where clinically appropriate.
  • Identify patients with hypertension and start antihypertensives when appropriate.
  • Increase the proportion of patients with CVD prescribed a statin and 2nd line therapies where required, to optimise lipid management. Reduction in CVD deaths, and hospital admissions for MI and stroke.

The report is provided to NHS colleagues only, please do not share outside the NHS.

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Frequency

Quarterly

Data period

January 2021 to December 2023

Cardiovascular System

Overview

This report looks at prescribing trends in primary care for the Cardiovascular System at SICBL and ICB level with particular focus on anticoagulants, antiplatelets and lipid-regulating. Prescribing data is weighted with QOF registers, and also uses HES data to measure prescribing to outcomes. The report also calculates the potential opportunity cost for cardiovascular drugs based on the NHS England Right Care indicators.

If you have any queries about the content of the report please contact us at nuth.nyrdtc.rxsupp@nhs.net

Frequency

Quarterly

Data Period

January 2021 to December 2023

Comparison of DOACs for Atrial Fibrillation

Comparison tables are produced for prescribers and medicines management teams. They are designed to assist in prescribing and decision-making within a specific therapeutic area.

Several direct oral anticoagulants (DOACs) are licensed for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF). This comparison table allows prescribers and other healthcare professionals to easily compare the characteristics of these medicines.

This publication was updated in January 2024 to reflect the latest NHSE operational note on choice of DOAC, and recently published guidance from SPS around drug interactions with DOACs

Formulary assessment – metolazone (Xaqua)

Formulary assessment tools are templates to support local decision making. They list NICE guidance, MHRA safety advice, and other relevant high quality advice and guidelines relevant to making decisions for local formularies.

The templates are pre-populated with useful information to reduce duplication of effort, with space for the addition of local information as appropriate. The purpose of the document is to support consistent decision making by formulary groups and APCs.

This information is produced for use by NHS healthcare professionals and RDTC stakeholders.

Formulary assessment – indapamide 1.5mg modified release

Formulary assessment tools are templates to support local decision making. They list NICE guidance, MHRA safety advice, and other relevant high quality advice and guidelines relevant to making decisions for local formularies.

The templates are pre-populated with useful information to reduce duplication of effort, with space for the addition of local information as appropriate. The purpose of the document is to support consistent decision making by formulary groups and APCs.

This information is produced for use by NHS healthcare professionals and RDTC stakeholders.

Atrial Fibrillation [NICE NG196]: Financial and commissioning impact

In April 2021, NICE published a new guideline NG196 – Atrial fibrillation: diagnosis and management which updates and replaces NICE CG180 (2014). There are a number of new recommendations, which are likely to have both a significant financial impact and potentially affect the way anticoagulation monitoring is managed. This bulletin aims to raise awareness of the commissioning and financial impact of this new guideline.

There are five versions of this publication; please select the appropriate version for your region below.

Cardiovascular outcomes associated with SGLT2 inhibitors (update 2)

Overview

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services. The series aims to maximise health gains through the optimum use of medicines, by influencing and changing prescribing behaviour.

The sodium-glucose co-transporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, empagliflozin and ertugliflozin are licensed for the improvement of glycaemic control in adults with type 2 diabetes, a population at increased risk of cardiovascular events. Recent clinical trials and cohort studies have assessed whether the SGLT2 inhibitors reduce this risk.

Download the full review below to read more.

Cardiovascular outcomes associated with GLP1 receptor agonists (updated)

Overview

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services. The series aims to maximise health gains through the optimum use of medicines, by influencing and changing prescribing behaviour.

The glucagon-like peptide 1 receptor agonists (GLP1RAs) dulaglutide, exenatide, liraglutide, lixisenatide, and semaglutide are licensed for the improvement of glycaemic control in adults with type 2 diabetes, a population which is also at increased risk of cardiovascular events. Good quality evidence assessed the effect of these drugs on cardiovascular outcomes.

Download the full review below to read more.