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 fully reviewed and updated in August 2023.
Monthly Formulary Amendments – April 2023
Monthly Formulary Amendments Documents list any NICE Technology Appraisals, NICE Guidelines, RMOC Guidance, MHRA Drug Safety Updates, and National Patient Safety Alerts published in the previous calendar month which may have an impact on local formularies and guidelines. This document is for APCs, and formulary committees to ensure formularies remain up to date, and in line with latest NICE guidance and safety information.
This edition covers guidance and alerts published in April 2023.
It includes a suggested formulary position for APCs/formulary committees, together with a summary of any financial/commissioning implications. The purpose of the document is to support consistent decision making by APCs.
This information is produced for use by NHS healthcare professionals and RDTC stakeholders.
Formulary assessment – Otinova ear spray for otitis externa
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.
What are the statutory obligations of an ICS for the implementation of NICE guidance
The National Institute for Health and Clinical Excellence (NICE) produce a range of guidance types, some of which commissioners have a statutory obligation to implement. This document sets out the forms of guidance published by NICE and outlines the types for which there is a statutory responsibility for commissioners as well as the timescales within which this action should be taken.
Prescribing Update Newsletter – April 2023
Prescribing support newsletters aim to inform readers of work done by the unit and work in progress, to help tailor local work plans and highlight any ‘topical’ issues in prescribing or medicines management.
If you have any suggestions for future topics for the newsletter, then please contact nuth.nyrdtc.rxsupp@nhs.net
This month’s edition focuses on Semaglutide for managing overweight and obesity, Familial Hypercholesterolaemia Gene Testing Workshops, a new NHSE short course on working with people and communities, recent publications from the RDTC, and an update on the RDTC prescribing support team attendance at the GNPRC Conference in July 2023. It also includes another in the series of “Meet the Team” where you can get to know the people behind the work we do. There is also information on some key medicines availability, new and updated NICE guidance, and UK product launches.
Monthly Horizon Scanning Report – April 2023
Monthly horizon scanning reports are designed to inform the NHS about new products, significant changes to product licenses, significant new guidance, and decisions that have been made by recognised bodies.
This information is produced for use by NHS healthcare professionals.
Monthly Horizon Scanning Report – April 2022
Monthly horizon scanning reports are designed to inform the NHS about new products, significant changes to product licenses, significant new guidance, and decisions that have been made by recognised bodies.
This information is produced for use by NHS healthcare professionals.
Monthly Horizon Scanning Report – April 2021
Monthly horizon scanning reports are designed to inform the NHS about new products, significant changes to product licenses, significant new guidance, and decisions that have been made by recognised bodies.
This information is produced for use by NHS healthcare professionals.
Safer Medication Use – Opioids and gabapentinoids
Overview
Safer Medication Use is a bulletin series jointly produced by the Regional Drug and Therapeutics Centre and the Yellow Card Centre Northern and Yorkshire, which aims to promote safer prescribing. It discusses specific drug related safety problems, provides guidance to ensure safe, appropriate prescribing and raises awareness of adverse drug reaction detection and reporting.
The use of combination opioids and gabapentinoids is associated with an increased risk of adverse events. Gabapentinoid overdose is much more likely to be fatal when combined with opioids and there is a greater risk of gabapentinoid dependence in patients with a history of opioid use disorder.
There are limited circumstances when patients should be prescribed both an opioid and a gabapentinoid, and prescribers must carefully balance potential benefits against the risk of adverse effects from combination therapy. In such situations the opioid dose should be reduced before starting a gabapentinoid and the patient reviewed regularly. Treatment should be stopped if it is not effective or not tolerated but withdrawal of established opioids and / or gabapentinoid therapy should be done slowly to prevent discontinuation symptoms.
Postoperative patients who are prescribed long term gabapentinoids should be closely monitored for respiratory depression.