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Medicines Management Matters

Medicines Management Team

Number: 9 | February 2021

In This Issue:

BLMK CCG Homely Remedies Toolkit – Dec 2020 update

Management of Hay Fever

BLMK Care Homes Newsletter – New edition

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BLMK CCG Homely Remedies Toolkit – Dec 2020 update

The Homely Remedies toolkit for care homes has been reviewed and approved for use by the Prescribing Committee meeting. This will replace the previous Bedfordshire CCG Homely Remedies Toolkit and Flowcharts. The new toolkit is available to view and download via the Care Home page on the BLMK Medicines Management website: https://medicines.blmkccg.nhs.uk/categories/care-homes/. This toolkit can be used as a template for care homes to use and adapt, and as long as the CCG approved list of products are stocked the care homes are not required to write to each residents GP for the homely remedies to be ‘approved’ or ‘signed off’ for use.

 

Main changes to note:

  • The toolkit is now for use across BLMK Care homes (previously BCCG care homes only)
  • Flowcharts to support decision making for minor ailments have been incorporated in the toolkit (previously separate document)
  • Loperamide capsules have been removed in line with the Regional Medicines Optimisation Committee (RMOC) template policy, however oral rehydration sachets still remain in place for management of diarrhoea
  • Homely Dressings for use in Nursing homes page has been removed, but is now a separate guidance document entitled ‘First Dressings Scheme for use within Nursing Homes’. This is a list of stock dressings (in line with the Bedfordshire & Luton CCGs JPC Wound formulary) that nursing homes should keep to be used as a ‘first dressing’. These are purchased and stocked by the home in the same way as homely remedies and the same policies and procedures apply to use and record keeping. This guidance can also be found on the Care Home page on the BLMK Medicines Management website (link above).

The Homely Remedies Toolkit and First Dressing Scheme for use in Nursing homes guidance will be disseminated to the relevant stakeholders (e.g. care homes, local councils, community pharmacists etc.)

Please note: for those care homes who have previously not had homely remedies in place, it may be prudent to postpone implementation of any new initiatives to a less busy time and when it is more convenient for the care home.

Management of Hay Fever

As we approach the spring requests for medication to alleviate the symptoms of hay fever will start being received at surgeries.  Hay fever is a self-limiting condition and patients should be encouraged to follow self-care advice and utilise OTC products as a first line treatment for mild to moderate symptoms.1

There are many on-line resources available to patients who are experiencing symptoms.

The NICE CKS on allergic rhinitis is also accessible and lists a range of advice to give to patients.  Available here

Ardens has an information leaflets on a range of self-care topics that can be sent by SMS or email to patients.

For severe allergic rhinitis it may be necessary to prescribe items that cannot routinely be purchased over the counter.  However, many steroid nasal sprays, oral antihistamines and eye drops are now legally available for purchase from supermarkets, pharmacies, on-line retailers and other retailers.  The costs vary depending on the retailer.

Examples of products that can be purchased are:

Oral preparations:

Cetirizine, loratadine, chlorphenamine, acrivastine, diphenhydramine, cyproheptadine, fexofenadine 120mg (recently reclassified – Allevia – not available at time of writing)

Nasal sprays:

Beclomethasone, budesonide, triamcinolone, xylometazoline, fluticasone, mometasone.  N.B. most nasal sprays are licensed for sale to patients 18 years and over.

Eye drops:

Sodium cromoglicate, lodoxmide, xylometazoliine/antazoline

Patients can seek advice as to which is the most appropriate product for them from their community pharmacist.

Consider when adding items to patients repeat lists that this should be for a limited number of issues as some people who suffer with hay fever do not suffer all year round unlike patients with severe allergic rhinitis e.g. nasal polyps, allergies to house dust mite or pets.

References

  1. Conditions for which over the counter items should not routinely be prescribed in primary care. https://www.england.nhs.uk/wp-content/uploads/2018/03/otc-public-faqs.pdf

 

  1. NICE CKS Allergic Rhinitis: Management Scenario https://cks.nice.org.uk/topics/allergic-rhinitis/management/management/

BLMK Care Homes Newsletter – New edition

The 1st edition of the Bedfordshire, Luton and Milton Keynes (BLMK) CCG quarterly care homes newsletter produced by the BLMK Medicines Optimisation Care Home Team (previously Bedfordshire only) is available to view and download via the Care Home page on the BLMK Medicines Management website: BLMK Medicines Optimisation Care Home Team Newsletter – BLMKCCG Medicines Management

Useful Links

Bedfordshire and Luton Joint Formulary
Care Home Medicines Management information can be found here
Joint Prescribing Committee newsletters can be accessed here
Care Home newsletters can be accessed here

Monthly prescribing practice reports are now available on TeamNet. Log in to see the most up to date data.

For further advice on any of the drugs/issues highlighted in this newsletter, please contact your Medicines Management Team: Tel 01525 624375. E-mail BEDCCG.bedsmeds@nhs.net

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