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Found 322 results
  1. News Article
    Children will no longer routinely be prescribed puberty blockers at gender identity clinics, NHS England has confirmed. The decision comes after a review found there was "not enough evidence" they are safe or effective. Puberty blockers, which pause the physical changes of puberty, will now only be available as part of research. It comes weeks before an independent review into gender identity services in England is due to be published. An interim report from the review, published in 2022 by Dr Hilary Cass, had earlier found there were "gaps in evidence" around the drugs and called for a transformation in the model of care for children with gender-related distress. Health Minister Maria Caulfield said: "We have always been clear that children's safety and wellbeing is paramount, so we welcome this landmark decision by the NHS. "Ending the routine prescription of puberty blockers will help ensure that care is based on evidence, expert clinical opinion and is in the best interests of the child." Read full story Source: BBC News, 13 March 2024
  2. Content Article
    In this interview, we talk to Darren Powell, Clinical Lead for NHS England and Community Pharmacist, about medication supply issues. Darren shares his experiences of how medication shortages and tariffs are affecting patients and staff and offers insights into the complexity of the situation.  He tells us his thoughts on potential causes and barriers, as well as suggesting three actions for wider system safety. 
  3. Content Article
    This article in the Pharmaceutical Journal outlines best practice principles and practical advice for structuring antimicrobial reviews and effective stewardship practices. It aims to equip pharmacists to: Understand the role of essential antimicrobial stewardship tools and frameworks to improve antibiotic prescribing; Structure an antimicrobial review effectively, covering all relevant details; Personalise the antimicrobial review to ensure patient-centred care and effective antimicrobial stewardship practices; Develop skills for effective antimicrobial review and stewardship practices to mitigate antimicrobial resistance threat.
  4. Content Article
    This study aimed to determine whether the use of video telemedicine for paediatric consultations to referring hospital emergency departments (EDs) results in less frequent medication errors than the current standard of care—telephone consultations. The authors found no statistically significant differences in physician-related medication errors between children assigned to receive telephone consultations vs video telemedicine consultations.
  5. Content Article
    This consensus statement co-ordinated by the British In Vitro Diagnostics Association (BIVDA) outlines the role of point of care testing in reducing the amount of antibiotics prescribed in primary care. It highlights the issue of antimicrobial resistance (AMR) and outlines evidence for the effectiveness of the rapid point-of-care C-Reactive Protein (POC CRP) test to assist clinical decision making as to whether an individual presenting with symptoms of respiratory tract infection needs an antibiotic. It makes a series of recommendations for the Department of Health and Social Care (DHSC) and NHS England around the use of POC CRP testing in primary care.
  6. Content Article
    Salbutamol is a selective beta2-agonist providing short-acting (4-6 hour) bronchodilation with a fast onset (within 5 minutes) in reversible airways obstruction. The nebuliser liquids are licensed for use in the management of chronic bronchospasm unresponsive to conventional therapy, and in the treatment of acute severe asthma. A Medicines Supply Notification (MSN) issued on 14 February 2024, detailed a shortage of salbutamol 2.5mg/2.5ml and 5mg/2.5ml nebuliser liquid. The resolution date is to be confirmed. The supply issues have been caused by a combination of manufacturing issues resulting in increased demand on other suppliers. Terbutaline, salbutamol with ipratropium, and ipratropium nebuliser liquids remain available, however, they cannot support an increase in demand. Ventolin® (salbutamol) 5mg/ml nebuliser liquid (20ml) is out of stock until mid-April 2024 and cannot support an increased demand after this date.
  7. News Article
    "Taking medication meant my brain was quiet for the first time; it was amazing, I cried because I was so happy," Jass Thethi, whose life was transformed after an ADHD diagnosis just over a year ago, told a BBC North West investigation. But the 34-year-old's joy was short-lived because, like more than 150,000 others who live with the condition and are reliant on medication, Jass has been affected by a UK-wide medicine shortage that started in September. Jass, who lives in Levenshulme, Greater Manchester, said: "When the medication shortage started I had to go back to white knuckling everyday life… I had to take the decision to change things and I had to quit the job I was doing." The charity ADHD UK said it had recorded a "significant decline" in the availability of medicines, with only 11% having their normal prescription in January, a drop from 52% in September. The Department of Health and Social Care (DHSC) said increased global demand and manufacturing issues were behind the shortages. Dr Morgan Toerien, associate specialist in mental health at Beyond Clinics in Warrington, said Jass's experience was not unique and many patients' lives had been "completely destabilised". Read full story Source: BBC News, 27 February 2024 Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our Community post. We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue.
  8. News Article
    Codeine linctus, an oral solution or syrup licensed to treat dry cough in adults, is to be reclassified to a prescription-only medicine due to the risk of abuse, dependency and overdose, the Medicines and Healthcare products Regulatory Agency (MHRA) has announced. Codeine linctus is an opioid medicine which has previously been available to buy in pharmacies under the supervision of a pharmacist but will now only be available on prescription following an assessment by a healthcare professional. Since 2019, there have been increasing reports in the media of codeine linctus being misused as an ingredient in a recreational drink, commonly referred to as ‘Purple Drank’. The decision to reclassify the medicine has been made following a consultation with independent experts, healthcare professionals and patients. 992 responses were received. The consultation was launched by the MHRA after Yellow Card reports indicated instances of the medicine being abused, rather than for its intended use as a cough suppressant. Dr Alison Cave, MHRA Chief Safety Officer, said: "Patient safety is our top priority. Codeine linctus is an effective medicine for long term dry cough, but as it is an opioid, its misuse and abuse can have major health consequences." Alternative non-prescription cough medicines are available for short-term coughs to sooth an irritated throat, including honey and lemon mixtures and cough suppressants. Patients are urged to speak to a pharmacist for advice and not to buy codeine linctus from an unregistered website as it could be dangerous. Read full story Source: MHRA, 20 February 2024
  9. News Article
    A woman said she has been unable to get her ADHD medication for months. Hannah Huxford, 49, from Grimsby is one of thousands of patients unable to get hold of medicine to manage their symptoms due to a national shortage. Mrs Huxford, who was diagnosed with the condition two years ago, described the situation as a "huge worry". The Department of Health and Social Care (DHSC) said it had taken action to improve the supply of medicines but added that "some challenges remain". Mrs Huxford said the medicine made a "huge difference" and got her life back on track. "It enables me to function and concentrate so I can be more proactive, I can be more productive," she explained. She said she had been unable to get her usual supply since October 2023 and has to ration what she can get hold of. "Christmas time it was just getting beyond a joke. I was going back to the pharmacy, probably two or three times in a month, just to collect the little IOUs and it was getting to the point where that, in itself, was becoming a stress," she said. "All of a sudden, if this medication is taken away from me, I'm frightened that I will go back to not being able to cope." James Davies, from the Royal Pharmaceutical Society, said the supply shortage has been caused by manufacturing problems and an increase in demand. "There are more people who are being diagnosed with ADHD, more people seeking to access ADHD treatments. That's not just related to the UK, this is a global problem," he said. Mr Davies said some ADHD medication has come back into stock but added "it's quite a fluid situation at the moment". Read full story Source: BBC News, 19 February 2024 Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our community thread on the topic: You'll need to register with the hub first, its free and easy to do. We would also like to hear from pharmacists working in community or hospital settings, and others who have insights to share on this issue. What barriers and challenges have you seen around medication availability? Is there anything that can be done to improve wider systems or processes?
  10. Content Article
    Medication errors in ambulatory care settings present unique patient safety challenges. This systematic review explored the prevalence of medication errors in outpatient and ambulatory care settings. Findings indicate that prescribing errors (e.g., dosing errors) are the most common type of medication error and are often attributed to latent factors, such as knowledge gaps.
  11. News Article
    Concerns have been raised that patients may not be receiving “vital” safety information after HSJ discovered a high-risk medication was frequently not being dispensed as originally packaged. In 2018, the Medicines and Healthcare Products Regulatory Agency asked pharmacies to dispense valproate-containing medications in their original pack where possible, to ensure packages include safety warnings. It also asked manufacturers to produce smaller pack sizes and add pictorial warnings, while pharmacists were additionally asked to add stickered warnings to the outer box of any valproate-containing medication not dispensed in its original packaging. Yet, data obtained via freedom of information requests to the NHS Business Services Authority revealed that while the proportion and number of valproate-containing items dispensed as split packs – as opposed to whole packs – had decreased over the last five years, split packs still accounted for more than half of items dispensed in 2022-23. Emma Murphy, of campaign group In-Fact, said the figures on split pack dispensing were “quite horrifying” and showed “the system is not working”. She added: “Attitudes have got to change – prescribers, GPs etc need to be proactive and warn women of the risks because this isn’t just a side effect, this is harming real babies. As a mum of five affected children, the consequences of valproate in pregnancy on that baby is devastating.” Alison Fuller, of Epilepsy Action, said the high proportion of split packs being dispensed made it “clear why the change in guidance introduced in October 2023 was necessary”, adding: “The manufacturer’s original full pack always contains all the relevant information, which is why it’s the best option for patient awareness.” Read full story (paywalled) Source: HSJ,
  12. News Article
    Treatments for seven conditions such as sore throats and earaches are now available directly from pharmacists, without the need to visit a doctor. The Pharmacy First scheme will allow most chemists in England to issue prescriptions to patients without appointments or referrals. NHS England says it will free up around 10 million GP appointments a year. Pharmacy groups welcome the move but there is concern about funding and recent chemist closures. Pharmacists can carry out confidential consultations and advise whether any treatment, including antibiotics, are needed for the list of seven minor ailments. Patients needing more specialist or follow-up care will be referred onwards. Read full story Source: BBC News, 31 January 2024
  13. News Article
    New digital prescriptions mean NHS App users in England can now collect medication from a pharmacy without having to visit a GP or health centre. The usual paper slip given by doctors has been replaced by an in-app barcode, which can be scanned at any pharmacy. Users can already request repeat prescriptions on the app - and every digital order fulfilled will save the GP three minutes, NHS Digital says. It comes after a trial last year, involving more than a million users. Patients can use the app to check what medicines they have been prescribed, and when. Anyone who has a nominated pharmacy can continue to collect medication without a paper prescription or barcode, as the details are sent to their pharmacy electronically. Read full story Source: BBC News, 30 January 2024
  14. Event
    If you work in primary care or primary care research, this one-hour NIHR Evidence webinar is for you. This webinar will cover NIHR research that could help reduce antibiotic prescribing in primary care. Speakers will present actionable evidence on antibiotic stewardship, and safe and effective prescribing. Presentations will be followed by a Q&A session, giving you a unique opportunity to quiz the researchers on how this research could be implemented at your organisation and reflect on potential barriers and facilitators. The webinar will cover: making decisions about who is in most need of antibiotics if antibiotics are needed for children with chest infections how digital tools can help reduce antibiotic prescribing. Register
  15. News Article
    Hundreds of rheumatology patients have stopped receiving drugs they did not need or had their diagnosis changed after a damning review of the service found the standard of care was “well below” what would be considered acceptable. Jersey’s Health and Community services department has said it will be contacting some of the affected patients “over the coming weeks” and would also be seeking legal advice on “an appropriate approach to compensation”. The independent review by the Royal College of Physicians also noted there was “no evidence” of standard operating procedures for most aspects of routine rheumatological care and, in some cases, “no evidence of clinical examinations”. It also found that there had been incorrect diagnosis and wrongly prescribed drugs, describing the standard of care as “well below what the review team would consider acceptable” for a contemporary rheumatological service. The review was commissioned by HCS medical director Patrick Armstrong, following concerns raised by a junior doctor in January 2022. Read full story Source: Jersey Evening Post, 22 January 2024
  16. Content Article
    New safety and educational materials have been introduced for men and women and healthcare professionals to reduce the harms from valproate, including the significant risk of serious harm to the baby if taken during pregnancy and the risk of impaired fertility in males. These safety and educational materials support the new regulatory measures announced in the National Patient Safety Alert. Healthcare professionals should review the new measures and materials and integrate them into their clinical practice when referring patients and when prescribing or dispensing valproate.
  17. News Article
    A national shortage of epilepsy medication is putting patients' safety at risk, consultants have said. Medical professionals are becoming genuinely concerned as ever more frequent supply issues continue to bite tens of thousands of sufferers. According to the Epilepsy Society charity, over 600,000 people in the UK have the condition, or about one in every 100 people. Among them is Charlotte Kelly, a mother of two living in London who has had epilepsy for over 20 years. She must take two tablets a day to manage her condition but issues with supply have forced her to start rationing her medication. Speaking to Sky News, Ms Kelly told us of the fear surrounding the restricted access to the medicate she needs to survive. "I'm scared. If I'm truly honest, I'm scared knowing that I might not get any medication for a few weeks, or a couple of months, I just don't know when. "It's scary to know that I have to worry about getting hold of medication. I do believe that something needs to happen very quickly because even if it's pre-ordered there's no guarantee you're going to get it. Speaking to Sky News, Professor Ley Sander, director of medical services at the Epilepsy Society, says the supply concern is not just on the minds of patients but those in the industry too. "It might be that we need a strategic reserve for storage of drugs, we might have to bring drugs over from other parts of the world to avoid this from recurring. "We're not at that point yet, but this is an urgent issue." Read full story Source: Sky News, 21 January 2024
  18. Content Article
    Medication shortages can occur for many reasons, including manufacturing and quality problems, delays and discontinuations. This Food and Drug Administration (FDA) database provides information on drugs with a supply issue. Information is provided to the FDA by manufacturers.
  19. Content Article
    Reckitt has taken the precautionary step of recalling Nutramigen LGG stage 1 and stage 2 Hypoallergenic Formula powders because of the possible presence of Cronobacter sakazakii. Both products are foods used for special medical purposes for infants. The products are mainly prescribed but are also available without a prescription. Symptoms caused by Cronobacter sakazakii usually include fever and diarrhoea, and in severe cases may lead to sepsis or meningitis which include symptoms in infants including poor feeding, irritability, temperature changes, jaundice (yellow skin and whites of the eyes) and abnormal breaths and movements. Read Reckitt's recall notice
  20. News Article
    Patients' lives are being put at risk because it is too easy to buy prescription-only medicines from online pharmacies, a leading pharmacist says. A BBC investigation found 20 online pharmacies selling restricted drugs without checks - such as GP approval. In total, over 1,600 various prescription-only pills were bought during the investigation entering false information without challenge. Regulator the General Pharmaceutical Council says extra checks are needed when selling some drugs online. The BBC's findings highlight the "wild west" of buying medicines on the web, says Thorrun Govind, a pharmacist, health lawyer and former chair of the Royal Pharmaceutical Society. "The current guidance basically tells pharmacies to be robust, but do that in your own way, and we know that under this current system, patients have died," she says. The parents of a woman who died in 2020, after accidentally overdosing on medicines she bought online, are among those calling for stricter rules. Katie Corrigan, from St Erth in Cornwall, had developed an addiction to painkillers after experiencing neck pain. "Katie needed help, she didn't need more medication," says her mum, Christine Taylor. Her GP had stopped supplying the drug after realising she had been allowed to request new prescriptions prematurely and been prescribed too much. Instead, Katie, 38, was able to buy a painkiller and a drug used to treat anxiety from multiple online pharmacies without notifying her GP. The coroner at Katie's inquest confirmed her GP had not been contacted by any of the pharmacies to check the drug was safe for her. In his final report, he said the safety controls were inadequate. Read full story Source: BBC News, 5 January 2024
  21. Content Article
    Antimicrobial agents, such as antibiotics, are essential to treat some human and animal infectious diseases. Antimicrobial resistance (AMR) occurs when microorganisms change so that they are no longer affected by antimicrobial drugs used to treat them. There are different types of antimicrobials, which work against different types of microorganisms, such as antibacterials or antibiotics against bacteria, antivirals against viruses, and antifungals against fungi. Antimicrobials are often used incorrectly. The development of resistance is accelerated by the inappropriate use of these drugs, for example, using antibiotics (which help to treat bacteria) for viral infections like flu, or as a growth promoter in agriculture. Because of growing resistance, the world is running out of effective antibiotics to treat infectious diseases. Unless appropriate action is taken, decades of progress in health and medicine risk being undone. In May 2015, the World Health Assembly (WHA) endorsed a global action plan on AMR and urged all WHO Member States to develop national action plans (NAPs). The Seventy-third session of the WHO Regional Committee for Europe launched the new European roadmap on AMR (2023–2030) to help accelerate the implementation of national strategies on AMR. The new brief from WHO Regional Office for Europe highlights the important connections between AMR infection prevention and control.
  22. Content Article
    The US Food and Drug Administration (FDA) list of drug names with recommended tall man (mixed case) letters was initiated in 2001 with the agency’s Name Differentiation Project. Tall man lettering (TML) is a technique that uses uppercase lettering to help differentiate look-alike drug names. Starting on the left side of a drug name, TML highlights the differences between similar drug names by capitalizing dissimilar letters (e.g., vinBLAStine versus vinCRIStine and CISplatin versus CARBOplatin). TML can be used along with colour or bolding to draw attention to the dissimilarities between look-alike drug names, and alert healthcare providers that the drug name can be confused with another drug name. The Institute for Safe Medication Practices (ISMP) 'Look-alike drug names with recommended tall man (mixed case) letters' contains drug name pairs or larger groupings with recommended, bolded uppercase letters to help draw attention to the dissimilarities in look-alike drug names. The list includes mostly generic-generic drug names, although a few brand-brand or brand-generic names are included.  See also our Medication error traps gallery
  23. Content Article
    The opioid epidemic has been declared a public health emergency in the US, with major news outlets calling operating rooms “unintended gateways.” In response to this emergency, a team from Thomas Jefferson University sought to decrease their organisation's contribution to the potential diversion pool—the opioids surgeons prescribe to patients which go unused. This article in the journal Patient Safety looks at the research and improvement work undertaken by the team, who concluded that surgical departments can develop opioid reduction toolkits aimed at reducing the potential diversion pool of opioids in communities.
  24. Content Article
    On 11 January 2021 an investigation into the death of Susan Ann Gladstone was started. The investigation concluded at the end of the inquest on 20 November 2023. The conclusion of the inquest was Susan died as a result of a generally unknown interaction between warfarin and tramadol which caused exceptional thinning of her blood: 1a Intraparenchymal and subarachnoid haemorrhage.
  25. News Article
    NHS England has been told it must take action to raise awareness about the potentially fatal interaction between tramadol and warfarin, following the death of a patient. Graham Danbury, assistant coroner for Hertfordshire, issued a prevention of future deaths report on 1 December 2023, after Susan Gladstone, from Hertfordshire, died on 8 January 2021 from a bleed in the brain. An inquest, which ended on 20 November 2023, concluded that Gladstone “died as a result of a generally unknown interaction between warfarin and tramadol, which caused exceptional thinning of her blood”. Gladstone was prescribed tramadol twice for lower back pain: on 20 December 2020 and 4 January 2021. According to the report, she had been taking the anticoagulation medication warfarin for “a number of years”. The report continues: “There was nothing to warn the prescribing doctor of any possible interaction. I found on the balance of probabilities that an interaction between tramadol and warfarin had caused this dangerous, and in the event, fatal INR to develop. “In my opinion, actions should be taken to prevent future deaths and I believe you, NHS England, have the power to take such action.” Read full story Source: Pharmaceutical Journal, 13 December 2023
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