Medicines in Practice: Optimising the use of morphine 10mg/5mL oral solution in primary care (Update)

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.

Opioids are effective for acute pain and pain at the end of life, but there is little evidence of their effectiveness for long term pain. This document supports primary care teams to review patients receiving regular large quantities of morphine 10mg/5mL oral solution and includes advice on how these patients could be managed.

This update includes:

  • opioid equivalence information to align with the updated Opioids Aware information
  • information on safety issues identified with morphine oral solution 10mg/5mL.
  • details regarding the NHSBSA Epact2 opioid dashboard which can be used to identify patients for review.

August 2022 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 introduces Strategic Insights, our new publication type, and has the first in a series of “Meet the Team”, where you can get to know the people behind the work we do. We also cover the new national shared care protocols published by NHSE, changes to the childhood vaccination schedule, and outline some resources that are available to support DOAC switches. There is also information on the changes to the Medicines Information Service, and some key medicines availability issues.

Comparison table: DOACs for Atrial Fibrillation

This a new RDTC publication to aid clinical decision making when choosing the most appropriate DOAC for an individual patient with atrial fibrillation.

It has been prepared in response to the NHSE England National Procurement and Commissioning Recommendations published in January 2022.

This publication was updated in August 2022 to update guidance on use of DOACs in patients with AF with prosthetic heart valves. Further information was also added about use in extremes of bodyweight.

Formulary assessment tool: melatonin (Adaflex) for ADHD

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 for melatonin (Adaflex) for ADHD can be found here.

Medicines in Practice: Budesonide orodispersible tablets for maintenance of remission in eosinophilic oesophagitis

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.

Budesonide orodispersible tablets (Jorveza) are indicated for induction and maintenance of remission in adults with eosinophilic oesophagitis. A NICE technology appraisal recommended budesonide ODT for induction of remission but did not address maintenance. This review assesses the evidence for use in maintenance treatment.

New publication type: Strategic Insights

The RDTC has published a new Strategic Insights report on Electronic Repeat Dispensing: understanding the prescribing population & initial barriers to uptake.

Strategic Insight reports are designed to support strategic objectives and planning by Integrated Care System (ICS) leaders. Through the analysis of data and communication with key stakeholders across the ICS, interventions to be undertaken by the ICS are proposed to Integrated Care Boards or associated committees.

This report highlights the benefits of electronic repeat dispensing (eRD) and examines its use at ICS level in the North of England, in order to support systems in identifying where prescribing processes may be further streamlined.

Additional funding from NHS England regional teams has enabled this publication to be made available to non-stakeholders across the North East and Yorkshire, and North West. Further titles in this series will follow, see our work plan for more details.

If you have any queries or comments about this publication, please do not hesitate to contact us at nuth.nyrdtc.rxsupp@nhs.net.

Strategic Insight: Electronic repeat dispensing: Understanding the prescribing population & initial barriers to uptake

Strategic Insight reports are designed to support strategic objectives and planning by Integrated Care System (ICS) leaders.

This report highlights the benefits of electronic repeat dispensing (eRD) and examines its use at ICS level in the North of England, in order to support systems in identifying where prescribing processes may be further streamlined.

Prescribing support workplan – June

The Prescribing Support workplan has been updated and is now available on the workplan page. The workplan is updated monthly and includes topics in active development.

May 2022 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 covers how the RDTC can support stakeholder organisations, our recent publications, and the prescribing support workplan. It also has features on post exposure prophylaxis for chickenpox and shingles, the national flu immunisation programme 2022-23, inadvertent oral administration of potassium permanganate, the CVD eLearning programme, WHO changes to the treatment of drug-resistant tuberculosis, and sources of information on menopause and HRT availability.

Formulary assessment tool: tirbanibulin (Klisyri)

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 tirbanibulin (Klisyri) can be found here.