April 2023 Newsletter

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.

Transfer of prescribing from private provider to NHS GP – RDTC of prescribing from private provider to NHS GP – RDTC

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services.

This publication aims to provide guidance on what NHS prescribers need to be aware of when they are asked by a private healthcare provider, and/or patient, to take on the regular prescribing of a medication for a patient, including medicines supplied under formal shared care agreements. Based on suggested best practice it discusses the principles which underpin the transfer of patients from private to NHS provision and highlights Shared Care specific, and ethical considerations.

Medicines in Practice: Considerations for Sustainable Inhaler Prescribing

Medicines in Practice is a series of evidence–based publications specifically designed to support stakeholder medicines optimisation services.

Inhalers account for approximately 3% of all NHS carbon emissions. Reducing the carbon impact from inhaler prescribing has been identified as a significant area of focus for delivering a net zero NHS. This document aims to outline strategies that can be considered to promote optimal respiratory care, while minimising the environmental impact from inhalers and consequences of suboptimal disease management.

A briefing for ICSs regarding NICE TA875: Semaglutide for managing obesity

In March 2023 NICE published TA875: Technology Appraisal guidance for semaglutide (Wegovy®) for managing overweight and obesity. The guidance recommends semaglutide as an option for weight management when prescribed by a specialist service alongside a reduced-calorie diet and increased physical activity in adults if they meet the criteria specified. This briefing aims to provide advice to prescribers on how the treatment can be accessed and which patient groups are eligible to receive Wegovy®. The document explains some of the limitations of the treatment and the evidence base, as described by NICE and may help to manage patient expectations.

Formulary Assessment Tool: Tacalcitol (Curatoderm) Lotion and Ointment

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.

The Formulary Assessment tool for tacalcitol (Curatoderm) can be found here.

Prescribing for Population Health: Problematic Polypharmacy: Prescribing Cascades Evidence Evaluation

Prescribing for Population Health (PPH) is an ongoing series that aims to support ICSs to improve the health of the populations they serve.

Problematic polypharmacy is a significant concern with overprescribing and occurs where the prescribing of multiple medicines is either inappropriate or where the intended benefit of the medication is not realised.

The publication aims to raise awareness of potential prescribing cascades and to highlight resources, tools, and strategies to help identify, prevent, and resolve inappropriate cascades.

February 2023 Newsletter

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 RDTC resources to help you make the most of your budget, updates to the cost comparison charts, the voluntary recall of certain FreeStyle Libre 2 sensors, and an E-learning programme on internet safety, suicide, and self-harm. It highlights recent publications from the RDTC including a series of publications as part of the Polypharmacy and Overprescribing theme reviewing opioid prescribing, and a Prescribing Bulletin looking at the budget impact of Metformin immediate release 1g tablets. 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 issues and serious shortage protocols

Prescribing for Population Health – Polypharmacy and Overprescribing: Opioids

In recent years, there has been increasing concern regarding the overprescribing of opioids and associated harms. The RDTC has produced a series of publications as part of the Polypharmacy and Overprescribing theme reviewing opioid prescribing:

Each publication includes considerations and interventions for medicines optimisation teams and health systems. To avoid duplication across this series of overprescribing and polypharmacy opioid publications, the suggested actions have only been listed in the most relevant theme but may apply across all. We recommend reading all parts of the series sequentially to ensure the breadth of potential actions are known. The publications can be accessed using the links below:

PPH 3. Polypharmacy & Overprescribing: Opioid patient populations:

This publication aims to support greater understanding of the patient populations prescribed opioids and the inter-relationships and dependencies between prescribing and the available metrics.

PPH 4. Polypharmacy & Overprescribing: Opioid patient demographics:

This publication aims to support greater understanding of the demographics of the patient populations prescribed opioids.

PPH 5. Opioid population health management:

This publication aims to support greater understanding of the population health management of patients prescribed opioids, specifically in terms of deprivation level and the impact on sustainability and climate change.

Prescribing Bulletin: Budget impact of metformin 1g immediate release tablet prescribing

The purpose of this bulletin is to highlight the rapid increase in price of metformin 1g tablets over the last year, and to raise awareness of the difference in price of metformin 1g immediate release (IR) tablets compared with 500mg IR tablets. It considers the potential budget impact to primary care of prescribing metformin 1g IR tablets across the ICSs in the North East & Yorkshire region and Greater Manchester.

Formulary assessment tool: Morphine sulfate (Actimorph) orodispersible tablets

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.

The Formulary assessment tool for morphine sulfate orodispersible tablets (Actimorph) can be found here.