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Found 1,111 results
  1. News Article
    Researchers have warned there is a lack of evidence around prescribing antidepressants for chronic pain. Guidance from the National Institute for Health and Care Excellence (Nice) in 2021 recommends that an antidepressant (amitriptyline, citalopram, duloxetine, fluoxetine, paroxetine or sertraline) can be considered for people aged 18 and over with pain lasting longer than three months which cannot be accounted for by another diagnosis. The guidance said the drugs may help with quality of life, pain, sleep and psychological distress, even if the patient is not suffering depression. A separate guideline on neuropathic (nerve) pain recommends offering a choice of treatments, including amitriptyline and duloxetine, alongside a discussion on possible benefits and side-effects. However, researchers writing in the BMJ have warned that recommending antidepressants for pain is not always backed by evidence. Professor Martin Underwood from the University of Warwick, said: “There is a role for antidepressants in helping people living with chronic pain, however, this is more limited than previously thought. “Antidepressants may have unpleasant side effects that patients may wish to avoid. “We need to work harder to help people manage their pain and live better, without relying on the prescription pad.” Read full story Source: The Independent, 1 February 2023
  2. News Article
    Ambulance crews in the North East frequently responded to emergencies without access to life-saving drugs, a damning inspection report has found. The study of North East Ambulance Service NHS Trust (NEAS) concluded patients were potentially put at risk by the poor management of medicines. The Care Quality Commission (CQC) found a deterioration of services and rated NEAS's urgent care as "inadequate". In response, NEAS said it had faced a year of "unprecedented pressures". The damaging assessment follows the launch of a full independent NHS review into numerous "tragic failings" involving patients. Announcing the review, the then health secretary Sajid Javid said he was "deeply concerned" about claims NEAS had covered up mistakes. Whistleblowers have told Newsnight multiple deaths were not investigated properly because information was not always provided to coroners and families. Read full story Source: BBC News, 1 February 2023
  3. News Article
    A woman who died shortly after giving birth to her daughter did not receive the correct medication, a coroner has ruled. Jess Hodgkinson, 26, from Chesterfield, died from a pulmonary embolism in 2021. Assistant coroner Matthew Kewley said there was a "failure" to ensure Ms Hodgkinson received blood thinners right up until the birth. Chesterfield Coroner's Court heard Ms Hodgkinson had a high risk pregnancy due to severe hypertension. On 21 April 2021, a consultant in Chesterfield prescribed a prophylactic dose of tinzaparin due to an increased risk of clotting, the inquest heard. During the inquest, the consultant said the intention was for Ms Hodgkinson to continue to receive a daily dose of anticoagulant medication up until birth. Ms Hodgkinson was transferred to a hospital in Sheffield the next day, but there was a "failure to communicate" the medication plan, Mr Kewley said. After being discharged, clinicians in Chesterfield "failed to identify" Ms Hodgkinson was no longer receiving the medication, the coroner said in his ruling. On 13 May, Ms Hodgkinson attended Chesterfield Royal Hospital and a decision was made to carry out an emergency Caesarean section. The procedure was successful and Ms Hodgkinson's baby was born. But after delivery, Ms Hodgkinson went into cardiac arrest and later died. In his concluding remarks, Mr Kewley said: "There was a failure to ensure that Jess received anticoagulant medication that a clinician had intended should be taken until birth. This failure made a more than minimal, negligible or trivial contribution to Jess' death". Read full story Source: BBC News, 31 January 2023
  4. News Article
    Erik, a 26-year-old Seattle grocery clerk, who also has attention-deficit hyperactivity disorder (ADHD), has been unable to get his medications filled for months now – and he’s worried he’ll lose the first full-time job he’s ever had. For people like Erik, ADHD medication is a prerequisite for basic functioning – and over the last year it’s become dramatically harder for patients like them to access care. Last October, the Food and Drug Administration (FDA) announced a shortage of Adderall, one of the most common stimulant medications for ADHD. In recent months, patients have reported problems filling nearly every type of ADHD medication. What’s stranger is that no one seems to know why. Is it some kind of supply chain issue? A pandemic-era surge in demand? A government crackdown? Official explanations have offered little clarity. The FDA’s announcement mentioned “intermittent manufacturing delays” at Teva, the producer of the branded version of Adderall, but few other details. The American Society of Health Pharmacists reports shortages of multiple ADHD drugs but says manufacturers have given no explanation. The situation has left patients in turmoil. Read full story Source: The Guardian, 30 January 2023
  5. News Article
    A highly toxic chemical compound sold illegally in diet pills is to be reclassified as a poison, a government minister has said. Pills containing DNP, or 2,4-dinitrophenol, were responsible for the deaths of 32 young vulnerable adults, said campaigner Doug Shipsey. His daughter Bethany, from Worcester, died in 2017 after taking tablets containing the chemical. The deaths were down to a "collective failure of the UK government", he said. DNP is highly toxic and not intended for human consumption. An industrial chemical, it is sold illegally in diet pills as a fat-burning substance. Experts say buying drugs online is risky as medicines may be fake, out of date or extremely harmful. Mr Shipsey said he had targeted the minister following the death of another young man who had taken the drug sold as a slimming aid. Prior to this, following the inquests of dozens of young people who had suddenly and unexpectedly died from DNP toxicity, the government had "ignored numerous coroners reports" to prevent future deaths, he said. "So, at last after 32 deaths and almost six years of campaigning, the Home Office (HO) finally accept responsibility to control DNP under the Poisons ACT 1972," he added. Read full story Source: BBC News, 28 January 2023
  6. News Article
    The government’s target for England to become smoke-free by 2030 – which integrated care systems are expected to pursue – is being undermined by the unavailability of two smoking cessation medicines. The objective, set by government in 2019, is being taken forward by many ICSs, as they seek to prevent premature illness and death, and narrow health inequalities, with smoking rates normally higher in more deprived populations. However HSJ analysis of drug shortages revealed that the two cessation medicines are both currently unavailable for an extended period. Champix (varenicline) has been unavailable since October 2021, a situation exacerbated by the absence of Zyban (bupropion), since December 2022. Both drugs were withdrawn because of concerns about the presence of nitrosamines, which may increase risk of cancer if people are exposed to them above acceptable levels, and will be subject to further tests and regulatory checks if they are to return. Matthew Evison, a lung cancer and tobacco dependency specialist at Manchester University Foundation Trust, said Champix was clinicians’ “most powerful weapon” against smoking. He said the treatment gap would make the target harder because “smoking prevalence declines will be slower without varenicline”. Read full story Source: HSJ, 30 January 2023
  7. News Article
    Medicine supply issues have soared in the past year, with the number of unavailable medicines nearly doubling from 52 in January 2022 to 97 this month, figures seen by HSJ reveal. Analysis of NHS supply alerts shared with HSJ shows a persistent monthly rise over the past year in the number of unavailable drugs. It also reveals that 12 “serious shortage protocols” – a more serious level of alert which allow pharmacists to dispense alternatives more easily – have been issued this month, compared to three in January last year. This is based on an analysis by the British Generics Manufacturers Association of NHS Specialist Pharmacy Service (SPS) medicines supply tool data. SPS data, seen by HSJ, shows several “high impact” shortages, which means they have the potential to change clinical practice or have safety implications. Read full story (paywalled) Source: HSJ, 26 January 2023
  8. News Article
    The World Health Organization (WHO) has called for “immediate and concerted action” to protect children from contaminated medicines after a spate of child deaths linked to cough syrups last year. In 2022, more than 300 children - mainly aged under 5 - in the Gambia, Indonesia and Uzbekistan died of acute kidney injury, in deaths that were associated with contaminated medicines, the WHO said in a statement on Monday. The medicines, over-the-counter cough syrups, had high levels of diethylene glycol and ethylene glycol. “These contaminants are toxic chemicals used as industrial solvents and antifreeze agents that can be fatal even taken in small amounts, and should never be found in medicines,” the WHO said. As well as the countries above, the WHO told Reuters on Monday that the Philippines, Timor Leste, Senegal and Cambodia may be affected because they may have the medicines on sale. It called for action across its 194 member states to prevent more deaths. “Since these are not isolated incidents, WHO calls on various key stakeholders engaged in the medical supply chain to take immediate and coordinated action,” WHO said. Read full story Source: The Guardian, 24 January 2023
  9. News Article
    Older women are at higher risk than older men of experiencing adverse reactions to drugs prescribed by their family doctor, and older patients taking more than 10 medicines are at higher risk than those taking fewer, according to a study. Overall, one in four older people experience adverse drug reactions (ADRs) to pills prescribed by their GP, the research published in the British Journal of General Practice suggests. It has prompted calls for GPs to consider deprescribing ineffective medications and prioritise patients taking lots of drugs for a regular review of their prescriptions. The medicines most commonly associated with ADRs included those used to treat high blood pressure and other cardiac conditions, strong painkillers such as tramadol, and antibiotics such as amoxicillin, according to the study. The study monitored 592 patients aged 70 and older across 15 general practices in the Republic of Ireland over a six-year period. One in four experienced at least one ADR. Patients prescribed 10 or more medicines had a threefold increased risk of experiencing a reaction, researchers said. Women were at least 50% more likely to have ADRs than men, the study found. “ADRs can be difficult to identify in medically complex older adults as they often present as non-specific symptoms,” the researchers wrote in the British Journal of General Practice. “GPs are well placed to detect the occurrence of ADRs from drugs prescribed in primary care as well as in other care settings. Deprescribing of ineffective medications and those no longer clinically indicated is one approach to reducing the risk of ADRs in older patients.” Read full story Source: The Guardian, 24 January 2023
  10. News Article
    An NHS trust has introduced pharmacy changes to help patients who are medically fit to leave hospital sooner. Gloucestershire Hospitals NHS Foundation Trust is focusing on getting TTOs (drugs To Take Out) to the pharmacy by 13:00 GMT each day. It says this reduces the length of stay for patients by several hours and can release up to 20 beds a day. "That's 20 people not waiting in the emergency department," said medical director, Professor Mark Pietroni. The plan has been called 'Early Meds to Release Beds' by the trust. Patients whose TTOs are with the pharmacy by 13:00 GMT are usually discharged about four hours later. Read full story Source: BBC News, 20 January 2023
  11. News Article
    During the pandemic, nearly half a million people in the UK missed out on starting medication to help prevent heart attacks and strokes, a new study suggests. The British Heart Foundation (BHF) team looked at prescribing data for the first 18 months after Covid hit. Some 491,000 people (27,000 a month) appear to have missed out on blood pressure pills, and 316,000 did not get treatment to lower their cholesterol. The team says more needs to be done to make sure that anyone who needs treatment gets it. During the pandemic, normal NHS services were severely disrupted. For example, there was a reduction in diagnosis, monitoring and treatment of high blood pressure, and other heart and circulation disease risk factors. Although the NHS took action, including providing more than 220,000 blood pressure monitors for people to use at home, data shows two million fewer people in England were recorded as having controlled hypertension in 2021 compared to the previous year. Lead investigator Prof Reecha Sofat, who is based at the University of Liverpool, said the findings, published in the journal Nature Medicine, highlight the impact Covid has had on other important health conditions: "Despite the incredible work done by NHS staff, our data show that we're still not identifying people with cardiovascular risk factors at the same rate as we were before the pandemic. " Read full story Source: BBC News, 20 January 2023
  12. News Article
    High risks relating to the ordering, prescribing, storing and administration of medicines have been found by the Mental Health Commission in a series of inspections of mental health centres in Dublin. The commission emphasised the need to have appropriate practices including the recording of the minimum dose interval information; where medication has been stopped, the stop date to be recorded; and the need to always have the prescriber’s signature recorded. The inspector of mental health services Dr Susan Finnerty said it was positive to see centres maintaining high compliance rating, but spoke of concerns around the administration of medication. “We know that medication is an important tool in treatment of mental illness. In order to reduce the risk of medication errors, we need to be sure that medication prescription and administration records are completed correctly,” Dr Finnerty said. Read full story Source: Independent Ireland, 18 January 2023
  13. News Article
    GPs whose patients want to stop taking antidepressants should reduce the dose of their medication in stages to lower the risk and severity of withdrawal symptoms, the medicines watchdog has said. About one in six (16%) adult Britons experience moderate to severe depression, according to the Office for National Statistics. In England alone, 21.4m antidepressant drugs were prescribed between July and September 2022, according to the NHS Business Services Authority. A new draft quality standard for the care of adults with depression from the National Institute for Health and Care Excellence (NICE) – the first update in 11 years – includes specific guidance to help adults come off antidepressant medication permanently. NICE’s independent advisory committee, which includes experts in treating adults with depression, recommends the staged withdrawal of antidepressants in patients who want to stop taking the drugs. A staggered reduction of medicine, known as tapering, helps to reduce withdrawal effects and long-term dependence on the medication, according to Nice. The committee said primary care and mental health professionals should follow the NICE guideline recommendations on stopping antidepressant medication, including agreeing with their patient whether it is right for them to stop taking the medication and, if so, the speed and duration of withdrawal from it. Read full story Source: The Guardian, 17 January 2023
  14. News Article
    About 15 million more people in England could be prescribed daily cholesterol-lowering statin pills to cut their risk of heart attacks and stroke, new advice for the NHS says. Given the very cheap price of the tablets and the possible health gains, they should be considered more often, the draft guidance says. There can be side effects though and there is debate about how widely this long-term treatment should be given and what associated risks are acceptable. The National Institute for Health and Care Excellence (NICE), which advises the NHS, says people should be thoroughly assessed before statins are prescribed, warning the pills are not a quick fix or substitute for a healthy diet and exercise. The previous advice was for anyone with a one in 10 chance of having a cardiovascular event, such as a heart attack or stroke, within the next 10 years - based on factors such as age, blood pressure and cholesterol levels - to be offered a statin. But NICE now says including adults with a one in 20 chance could save 2% of them from having a heart attack or stroke during that period. Spokesman Paul Chrisp said patients should discuss the benefits and risks with their doctor, adding: "The evidence is clear, in our view, that for people with a risk of 10% or less over 10 years, statins are an appropriate choice." Read full story Source: BBC News, 12 January 2023
  15. News Article
    The FDA is greenlighting the drug Leqembi after it appeared to slow cognitive decline in some early stage Alzheimer’s patients in spite of some potential risks. In this video, Kristen Dahlgren has more details about findings from the clinical trial. Watch full story Source: NBC News, 7 January 2023
  16. News Article
    The US Food and Drug Administration (FDA) has granted accelerated approval for the Alzheimer’s disease drug lecanemab, one of the first experimental dementia drugs to appear to slow the progression of cognitive decline. Lecanemab will be marketed as Leqembi, the FDA statement said. It has shown “potential” as an Alzheimer’s disease treatment by appearing to slow progression, according to Phase 3 trial results, but it has raised safety concerns due to its association with certain serious adverse events, including brain swelling and bleeding. In July, the FDA accepted Eisai’s Biologics License Application for lecanemab under the accelerated approval pathway and granted the drug priority review, according to the company. The accelerated approval programme allows for earlier approval of medications that treat serious conditions and “fill an unmet medical need” while the drugs continue to be studied in larger and longer trials. If those trials confirm that the drug provides a clinical benefit, the FDA could grant traditional approval. But if the confirmatory trial does not show benefit, the FDA has the regulatory procedures that could lead to taking the drug off the market. Read full story Source: CNN Health, 7 January 2023
  17. News Article
    NHS trusts in England have increased recruitment from low-income “red list” countries to make up for the post-Brexit loss of EU staff, despite a code of practice to safeguard health services in those developing countries. A report by the Nuffield Trust thinktank also identified shortages in vital specialist areas since Brexit, including dentistry, cardiothoracic surgery and anaesthesiology. It found that Brexit is still causing issues with the supply of medicines in Northern Ireland despite a change in the arrangements put in place by the EU last April. The report says that since 2021, the Northern Ireland protocol obliging EU trade rules to be followed in the region has led to a different set of medicines being available compared with the rest of the UK. Of the 597 products specifically approved by the Medicines and Healthcare products Regulatory Agency since Brexit, “only eight were also approved for Northern Ireland under the same name and company”. It also found that since 2021, 52 products had been granted marketing authorisation for Northern Ireland but not in Great Britain under the EU approvals system, including a painkiller from the Slovenian company Sandoz Farmacevtska Druzba designed to stop people dying from opiate overdoses. The Democratic Unionist Party (DUP) described the report as “deeply alarming”. Read full story Source: The Guardian, 7 January 2023
  18. News Article
    A shortage of cough and cold medicines in the UK is a result of ministers’ “lack of planning”, according to pharmacy leaders. Rishi Sunak’s Conservatives were accused of “being in denial” as supply chain problems worsen, with pharmacists reporting shortages of once-common cold and flu medicines. The Association of Independent Multiple Pharmacies said throat lozenges, cough mixtures and some painkillers are among the affected medicines, after issues with the supply of antibiotics and HRT last year. “Pharmacists are struggling to obtain the very basic, most common cold and flu medicine,” chief executive Leyla Hannbeck told the PA news agency. “This isn’t just the branded medicines, it is also simple things like throat lozenges, cough mixtures or painkillers – particularly the ones that are soluble. “The demand has been high because this season we’ve seen higher cases of colds and flu and people are obviously trying very hard to look after themselves and making sure that they use the relevant products to manage the symptoms. “And that has led to a shortage of these products in terms of us not being able to obtain them.” Read full story Source: The Guardian, 4 January 2023
  19. News Article
    Families of people with dementia have said there is a national crisis in care safety as it emerged that more than half of residential homes reported on by inspectors this year were rated “inadequate” or requiring improvement – up from less than a third pre-pandemic. Serious and often shocking failings uncovered in previously “good” homes in recent months include people left in bed “for months”, pain medicine not being administered, violence between residents and malnutrition – including one person who didn’t eat for a month. In homes in England where standards have slumped from “good” to “inadequate”, residents’ dressings went unchanged for 20 days, there were “revolting” filthy carpets, “unexplained and unwitnessed wounds” and equipment was ”encrusted with dirt”, inspectors’ reports showed. Nearly one in 10 care homes in England that offer dementia support reported on by Care Quality Commission inspectors in 2022 were given the very worst rating – more than three times the ratio in 2019, according to Guardian analysis. Read full story Source: 29 December 2022
  20. News Article
    German public research funder Deutsche Forschungsgemeinschaft (DFG) is conducting an audit of the clinical trials it has supported in the past. The audit was announced in response to a request from TranspariMED asking DFG for a list of all its trials completed between 2009 and 2017, to which DFG replied that it currently has no such comprehensive dataset. DFG stated that it is "currently preparing an evaluation of its clinical trials programme. In the framework of this evaluation the data you requested will be collected and analysed, as the outcomes of trials supported by DFG is of high interest including for DFG itself." TranspariMED, an organisation which aims to end evidence distortion in medicine, sees this development as a good opportunity for DFG to check whether and when clinical trials were registered and their results made public. Previous research has shown that nearly a third of German academic trials never make their results public. This not only wastes public money, but also harms patients because it leaves gaps in the evidence base on the efficacy and safety of drugs, medical devices, and non-drug treatments. Due to gaps in German law, there is still no legal obligation to make the results of many German clinical trials public. Read full story Source: TranspariMed, 20 December 2022
  21. News Article
    The number of suspected scarlet fever cases since September has risen to nearly 30,000 after the UK Health Security Agency added almost 10,000 potential new infections in the last week. More than 27,000 people could have had infections since 12 September, according to the UKHSA, who revealed on Tuesday that there were more cases than first thought because of the “significant rise” in infections. The figures come from medical practitioners referring suspected cases to the local authority or health protection team. A total of 16 children aged under 18 have died from invasive group A streptococcus (iGAS), otherwise known as strep A. Parents are advised to contact 111 or a GP surgery if a child has symptoms. They can also include nausea and vomiting. New serious shortage protocols were issued to pharmacists last week in an attempt to help those experiencing supply issues with penicillin. Chemists had widely reported problems getting hold of liquid penicillin and amoxycillin due to the increase in demand. The antibiotics are often prescribed for children who have scarlet fever or strep A. People in the industry have also reported rising prices. Pharmacists are now able to prescribe an alternative antibiotic or formulation of penicillin, such as tablets. Read full story Source: The Guardian, 20 December 2022
  22. News Article
    Private menopause clinics are prescribing HRT at "twice the recommended dose", an investigation has revealed. The investigation by The Pharmaceutical Journal has revealed that patients attending private menopause clinics are subject to “unorthodox prescribing” by providers. Many are receiving oestrogen at up to double the recommended dose placing them at higher risk of cancer and vaginal bleeding. Nuttan Tanna, a pharmacist consultant in women’s health at London North West University Healthcare NHS Trust, said she had seen referrals for “bleeding investigations” and then found the patient was on "very large doses [of oestrogen] prescribed previously by private providers”. Brendon Jiang, a senior clinical pharmacist for North Oxfordshire Rural Alliance Primary Care Network, said that his team were increasingly getting letters from private clinics requesting for patients to be prescribed doses of oestrogen that are off-label or exceed licensed recommendations. He also raised concerns that patients were not taking enough progesterone alongside increased doses of oestrogen. Taking increased doses of oestrogen alone can increase the risk of womb cancer but progesterone protects against that risk and therefore the two hormones should be taken together. Read full story (paywalled) Source: The Telegraph, 19 December 2022 Further reading on the hub: Surgical menopause: a toolkit for healthcare professionals (British Menopause Society) Menopause Support - Getting the most out of your doctor’s appointment World Menopause Day 2022: Raising awareness of surgical menopause All-Party Parliamentary Group on Menopause: Inquiry to assess the impacts of menopause and the case for policy reform - conclusions
  23. News Article
    Three more children have died from strep A, it has emerged, and pharmacists in the UK have been told they can supply alternative antibiotics to those originally prescribed, in a bid to ease shortages of certain forms of penicillin. The UK Health Security Agency (UKHSA) data shows at least 19 children have now died across the UK, while there are 7,750 cases of scarlet fever so far this season. This is more than treble the 2,538 at the same point in the year during the last comparably high season in 2017 to 2018. The Department of Health and Social Care (DHSC) has issued serious shortage protocols (SSPs) for three penicillin medicines amid increased demand for the antibiotics. Pharmacists and GPs in the UK have faced serious difficulties in securing supplies of penicillin and amoxycillin, antibiotics used to treat infections including strep A. As a result, parents have reported having to visit a string of pharmacies to obtain medicines prescribed for their sick children, while the price of some antibiotics has risen sharply – a situation pharmacists say has left them facing losses. The health minister Will Quince said: “The increased demand for the antibiotics prescribed to treat strep A has meant some pharmacists have been unable to supply the medicine shown on the prescription. “These serious shortage protocols will allow pharmacists to supply an alternative form of penicillin, which will make things easier for them, patients, and GPs. “We are taking decisive action to address these temporary issues and improve access to these medicines by continuing to work with manufacturers and wholesalers to speed up deliveries, bring forward stock they have to help ensure it gets to where it’s needed, and boost supply to meet demand as quickly as possible.” Read full story Source: The Guardian, 15 December 2022
  24. News Article
    Pharmacists say supplies of key antibiotics to treat strep A have "gone from bad to worse" in the past week. The Association of Independent Multiple Pharmacies (AIMP) said the situation was "unacceptable" and it was time for the government to get a plan in place. Four antibiotics, which treat different conditions, have been added to a list of products that the UK cannot export. The UK government says it is working urgently with manufacturers and wholesalers to speed up deliveries. However, Leyla Hannbeck, chief executive of the AIMP, which represents 4,000 pharmacies in the UK, said the supply of antibiotics to treat bacterial infections including strep A and scarlet fever was "very poor". She said the problem had been highlighted a week ago, but it was now getting worse, making it very difficult to get hold of any antibiotics. "People are having to go from one pharmacy to another - it's chaos," she said. "Supplies are not coming through to us and it feels like no-one cares." Read full story Source: BBC News, 14 December 2022
  25. News Article
    Medicine shortages are an “increasing problem” for Australia and antibiotics are among the commonly prescribed drugs currently in short supply, the peak body for general practitioners says. The drugs regulator, the Therapeutic Goods Administration (TGA), said the three most commonly prescribed antibiotics – amoxicillin, cefalexin and metronidazole – are scarce. They are used to treat a range of bacterial infections, including pneumonia and other chest infections, skin infections and urinary tract infections. To see patients through the shortage, the TGA has authorised pharmacists to provide alternative antibiotics without approval from the prescribing doctor. “Importantly, many of these medicines have alternatives available,” the TGA said. “Your pharmacist may be able to give you a different brand, or your doctor can prescribe a different strength or medicine with similar spectrum of activity.” A TGA spokesperson said “most of the antibiotic shortages are caused by manufacturing issues or an unexpected increase in demand”. Dr Nicole Higgins, the president of the Royal Australian College of General Practitioners, said the shortage of certain medicines was “becoming an increasing problem in Australia”. Read full story Source: The Guardian, 12 December 2022
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