Medicines Management Matters
Medicines Management Team
Number: 6 | September 2020
In This Issue:
Freestyle Libre Diabetes Clinic Reviews
End of Life Medication – reminder
Updated Dry Eye Products
The BLMK Medicines Optimisation teams have developed a new website for Primary Care resources: The site replaces:
- GPRef, which will be closing in November 2020
- MicroGuide for JPC Guidelines will no longer be updated
The MicroGuide site for the Wound Care Formulary for Bedfordshire and Luton (https://viewer.microguide.global/mo/100000007) remains unaffected.
Feedback on the new website should be directed to the Medicines Optimisation team: Click here
Update – RADAR alerts now live!
Most practices are familiar with and use the prescribing support tool Optum ScriptSwitch. We have activated a new feature as part of the software: RADAR alerts for ScriptSwitch. This allows ScriptSwitch to link in with the patient record and provides Eclipse RADAR alerts. These are the same red/amber safety alerts that are delivered through EclipseLive.
These patient specific alerts pop up on the clinical screen when the patient record is open. These show as a small pop-up, and prescribers can choose to view the full details of the alert or close the pop-up to review at a later time. These alerts help to improve patient safety but do not replace the alerts practices view via the Eclipse website and only practices regularly getting Eclipse downloads will get the additional alerts. Initially only red alerts will appear with Amber alerts being added in soon.
If you have new terminals or laptops requiring ScriptSwitch installation please get in touch with Optum on 02476 214700 or email@example.com.
FREESTYLE LIBRE DIABETES CLINIC REVIEWS
Patients receiving the Freestyle Libre sensors should be reviewed by the diabetes team at the trusts 6 months after initiation and then every 6-12 months as clinically appropriate.
Due to the Covid-19 pandemic the diabetes nurses are behind with their reviews, and it has been agreed that reviews will be prioritised and completed within a 9 month timeframe.
Please continue to prescribe the Freestyle Libre sensors until patients are reviewed.
END OF LIFE MEDICATION - REMINDER
Managing patients at the end of life is a key component of general practice. As a result of the COVID-19 pandemic, new challenges around end of life care have arisen, including facilitating symptom management.
Anticipatory prescribing is common in primary care to facilitate quick access to symptom-relieving medications in the community for dying patients. Common symptoms at the end of life include pain, nausea and vomiting, breathlessness, agitation, and excess respiratory secretions. The management of these symptoms has not changed significantly since the advent of COVID-19, however it is suggested that prescribing should take account of potential waste, medicines shortages and lack of administration equipment by prescribing smaller quantities or by prescribing a different medicine, formulation, or route of administration when appropriate. For example, the prescribing of oral medications instead of injectable medications if appropriate.
The BLMK Medicines Optimisation COVID19 Primary Care Bulletin: End of Life Care Medicines Prescribing Guidance summarises the information regarding non-injectable end of life medications from the NICE COVID -19 rapid guideline: managing symptoms (including at the end of life) in the community to assist GPs in the prescribing of end of life medication in patients with COVID-19.
BLMK CCG commissions the End of Life Medicines Service from selected community pharmacies across the area. This service aims to ensure that patients receiving palliative care in the community have access to specialised drugs when these are required in an emergency, through member pharmacies holding minimum quantities of a prescriptive list of medicines, which now includes four non-injectable medications (lorazepam tablets, haloperidol tablets, hyoscine patches and morphine sulphate liquid). In addition, the East of England have launched a palliative care medicines website which supports access to community pharmacies that stock EOL medications in accordance with location.
COVID-19 Medicines Management related information can be found here.
UPDATED DRY EYE PRODUCTS
A full list of formulary products can be obtained from the Medicines Optimisation team and will be circulated to all Practice Managers, Prescribing leads and Practice pharmacists.
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.