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  1. Content Article
    I am Luke. I’ve been suffering with PSSD for more than 10 years. My life has been drastically altered. I am now an active member of the PSSD UK patient group and PSSD Network, through which I help raise awareness and support fellow sufferers in the hope that our situations can improve and a cure can be found. Post-SSRI sexual dysfunction Post-SSRI sexual dysfunction (PSSD) is a disorder in which individuals, who have been administered selective serotonin reuptake inhibitors (SSRIs) or other serotonin reuptake-inhibiting (SRI) drugs, experience persistent changes in sexual function and/or genital numbness for an extended period after ceasing to take the drug. Although it is most commonly caused by SSRIs (a widely prescribed group of antidepressants), cases have also been reported following the use of serotonin-norepinephrine reuptake inhibitors (SNRIs), SRI tricyclic antidepressants, SRI antihistamines, tetracycline antibiotics such as doxycycline, and analgesics such as tramadol.[1] Antidepressants have been known for some time to impact sexual function (while being taken) and this risk is included, to some extent, in the medication information. However, the risk of long-term impact to sexual function, after a person ceases to take the medication, has lacked widespread recognition for many years despite being highlighted by patients and researchers around the world.[2,3,4] Awareness remains poor despite some formal recognition In 2019, the European Medicines Agency formally recognised that sexual dysfunction can persist beyond discontinuation of SSRI and SNRI antidepressants[5]. The Pharmacovigilance Risk Assessment Committee stated: “Sexual dysfunction, which is known to occur with treatment with SSRIs and SNRIs and usually resolves after treatment has stopped, can be long-lasting in some patients, even after treatment withdrawal.”[6] Despite this, awareness is still very poor and formal recognition still does not exist in most countries. Although some urologists and sexual medicine specialists seem familiar with the condition, many general practitioners have not heard of PSSD. Psychiatrists often dispute the legitimacy of the illness or claim that it is exceedingly rare, but don’t have any data to prove the prevalence. For a long time, PSSD has been dismissed by many doctors as being a psycho-somatic illness – for example, the result of untreated depression. It is still typical for patients to be disbelieved like this, despite the clear distinction between the diagnostic criteria for clinical depression and the diagnostic criteria that has been developed by researchers for PSSD.[7] The latter outlines two ‘necessary’ criteria for PSSD to be diagnosed. (1) Prior treatment with a serotonin reuptake inhibitor. (2) An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops. ‘Additional’ criteria includes: Enduring reduction or loss of sexual desire. Enduring erectile dysfunction (males). Enduring inability to orgasm or decreased sensation of pleasure during orgasm. The problem is present for ≥3 months after stopping treatment. Also listed are both sexual and non-sexual symptoms of PSSD as per below: genital pain reduced nipple sensitivity decreased or loss of nocturnal erections (males) reduced ejaculatory force (males) flaccid glans during erection (males) decreased vaginal lubrication (females) emotional numbing depersonalisation other sensory problems involving skin, smell, taste or vision. The lack of awareness amongst the medical community also means that there is no available treatment or support for PSSD sufferers, who will often turn to the internet for help. Many sufferers, desperate to improve things, end up trialling a variety of drugs and supplements, some of which seem to make symptoms permanently worse. Medication labelling and communicating risk Only Canada and the EU countries (plus post-Brexit Britain) require any warning of persistent sexual side effects on the drug labels. In the rest of the world, there are still no warnings about persistent sexual side effects of SRI antidepressants. Non-English speakers have additional challenges finding information about PSSD, even online. With so many doctors still unaware of the illness, the risks are frequently not being communicated to patients, meaning they can’t possibly give informed consent when taking antidepressants as prescribed. A community abandoned (Image: PSSD Network photo campaign) PSSD sufferers in our communities are absolutely desperate. They feel lied to, mistreated and abandoned. We know from those with lived experience that PSSD often includes complete loss of libido and ability to function sexually, complete emotional dysfunction (anhedonia) and cognitive dysfunction. This frequently results in the breakup of existing romantic relationships and extreme difficulty in forming new ones. PSSD sufferers can find it hard to bond and connect emotionally with others due to emotional dysfunction, and struggle to find any kind of enjoyment in activities that were previously enjoyable. It can cause alienation from friends and family. Some are unable to continue working due to severe cognitive impairments. They often describe it as like being chemically castrated and lobotomised, bearing no resemblance to the experience of suffering clinical depression. Despite PSSD being a result of a prescribed medication, sufferers frequently report being gaslit by doctors, who have typically claimed that their complaints are really symptoms of underlying depression. However, patients prescribed SRI antidepressants for conditions as diverse as irritable bowel syndrome, nerve pain and premenstrual dysphoric disorder have also developed PSSD. These harmful attitudes, and the lack of any known treatment or available support, makes PSSD sufferers feel like there is no hope. Some have ended up taking their lives as a result of PSSD, despite never having been suicidal at any point in their lives previously. Improvements needed Thankfully, further research[8] and an increase in media coverage in the UK,[9] including a recent Panorama documentary, are helping draw attention to this issue and change attitudes. There needs to be further action taken if we are to see long-lasting improvements in the care and treatment of patients with PSSD. I would like to see: Widespread acknowledgement of the condition. Doctors provided with up-to-date information and training (informed by lived experience) on the dangers of antidepressants and how to support patients. Warnings on instructions for the medications updated and prescribing clinicians alerted to ensure patients are adequately informed. An awareness and media campaign launched targeting patients, prescribers and the public. Funding secured for research that helps us gain an understanding of the underlying pathophysiology, identification of a diagnostic biomarker and, eventually, a cure for PSSD. Doctors listening to patients so they can understand how PSSD is a life-changing condition and be able to refer to support services. PSSD is a modern-day tragedy which devastates the lives of sufferers and their families. There are people with this condition who still don’t know that there is a name for it and more of them come out of the woodwork with each new media mention. It is vital that the medical community begins listening and supporting sufferers, and researching a cure before more lives are lost. How you can help I’d encourage you to visit the PSSD Network website to help you understand PSSD and our campaigning work. Clinicians can offer their support by watching this powerful podcast made by PSSD sufferers, discussing the issue with their healthcare organisation and by joining the list of doctors and specialists acknowledging the condition. Researchers can get involved by contacting PSSD network or RxISK. Patients can speak out about PSSD using the initiatives under the ‘take action’ section of the PSSD Network website. Anyone can donate to research via the RxISK website or PSSD Network. References Healy D, Bahrick A, Bak M et al. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med. 2022;33(1):65-76. Healy D. Post-SSRI sexual dysfunction & other enduring sexual dysfunctions. Cambridge University Press, 2019. Access online 18/09/2023. Healy D, Le Noury J and Mangin D. Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases. Int J Risk Saf Med. 29 (2018) 125–134. PSSD UK. Our stories. Accessed online 18/09/2023. Pharmacovigilance Risk Assessment Committee (PRAC). New product information wording – Extracts from PRAC recommendations on signals. European Medicines Agency. 2019. Lane C. Post-SSRI Sexual Dysfunction Recognized as Medical Condition. Psychology Today. 2019. Accessed online 18/09/2023. Healy D, Bahrick A, Bak M et al. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med. 2022;33(1):65-76. Ben-Sheetrit J, Hermon Y, Birkenfeld S at el. Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants. Ann Gen Psychiatry 22, 15 (2023). 9. RxISK. Media Articles: PSSD & Related Conditions. Accessed online 18/09/2023. Do you have an experience or insights to share? Have you ever experienced adverse and/or long-lasting side effects of a medication you were prescribed that you didn't feel you adequately warned about beforehand? Perhaps you are a prescribing clinician who can share some of the challenges and complexities involved in medication safety? What did you think of the points raised and calls to action in Luke's article? Please comment below (sign up first for free) or get in touch with us at content@pslhub.org to tell us more.
  2. News Article
    Patients with Parkinson’s disease are being put at risk when they have spells in hospital due to a lack of timely medication, according to a new report. Some 58% of people with Parkinson’s disease who were admitted to hospital in England last year said that they did not receive their medication on time during their stay. Parkinson’s UK said that medication for people with the condition is “time critical” and a delay of 30 minutes can mean the difference between functioning well and being unable to move, walk, talk or swallow. The charity also conducted freedom of information requests on English hospitals and found that one in four (26%) NHS trusts do not have policies that allow people with Parkinson’s to take their own medication in hospitals. Only half (52%) require staff responsible for prescribing and administering medication to have training on time critical medication, the charity found. Parkinson’s UK has called for a number of measures to be put in place to make sure patients in hospital can get access to medications when needed including: ensuring there are medication self-administration policies for patients where it is safe to do so; more training for staff and better use of e-prescribing to keep on track of medication timings. Read full story Source: The Independent, 19 September 2023
  3. Content Article
    Download the report Parkinson's UK have also issued a joint statement with other charities whose patients are impacted by needing time-critical medication with the support from professional bodies. Further reading on the hub: Medication delays: A huge risk for inpatients with Parkinson’s Keeping patients with Parkinson’s safe in hospital: 4 key actions for staff
  4. News Article
    A new regional centre which promotes the reporting of suspected safety concerns associated with healthcare products has been launched in Northern Ireland. The Yellow Card centre for Northern Ireland will bring together a dedicated team to increase awareness, educate, and promote reporting of suspected adverse events to the Medicines and Healthcare products Regulatory Agency (MHRA) Yellow Card scheme. The Yellow Card scheme provides a mechanism for patients, care givers and healthcare staff to report suspected safety concerns associated with healthcare products. Speaking at the launch of the new service, Northern Ireland Chief Pharmaceutical Officer Professor Cathy Harrison said: “Collecting and monitoring information on possible adverse effects of medications and healthcare products is vital to ensuring patient safety. "It is fitting that the launch of the Yellow Card centre for Northern Ireland coincides with World Patient Safety Day on 17 September, with this year’s theme of "Engaging patients for patient safety". "The Yellow Card scheme puts the patient voice at its heart. By voluntarily reporting issues, patients, families and care givers can play a crucial role in their own care, and the safety of healthcare as a whole. I welcome the launch of the new regional centre and would encourage anyone who has suspected safety concerns to report them.” Read full story Source: Department of Health (Northern Ireland), 13 September 2023
  5. News Article
    A high-profile government climbdown which legalised a type of cannabis medicine on the NHS five years ago misled patients, campaigners say. It was thought the law change would mean the unlicensed drug, which treats a range of conditions, could be freely prescribed by specialist doctors. But fewer than five NHS patients have been given the medicine, leaving others to either pay privately or miss out. The government says safety needs to be proven before a wider rollout. Legalisation of whole-cannabis medicine was hailed as a breakthrough for patients - giving either NHS or private specialist doctors the option to prescribe it if they believed their patients would benefit. But patients are being turned away, say campaigners, because doctors often do not know about the medicine, which is not on NHS trusts' approved lists. Some specialists who do know about it say there is insufficient evidence of the drug's safety and benefits to support prescribing. Senior paediatric consultant Dr David McCormick, from King's College Hospital in London, says it was "disingenuous" of the government to suggest in 2018 that NHS prescribing was ready to take place. "Parents were clamouring at our door, or phoning all the time, as they believed we were able to prescribe and that was not the case. "The message went out, 'doctors can now prescribe cannabis products' and that put us in a difficult position, because in truth we need to apply for that to be approved by NHS England." Read full story Source: BBC News, 13 September 2023
  6. Content Article
    Advice for healthcare professionals: Systemic (by mouth, injection, or inhalation) fluoroquinolones can cause long-lasting (up to months or years), disabling, and potentially irreversible side effects, sometimes affecting multiple systems, organ classes, and senses Despite new restrictions and precautions introduced in 2019, a new study has shown no evidence of a change in fluoroquinolone prescribing patterns in the UK, and the MHRA has continued to receive Yellow Card reports of these side effects. Advise patients to stop treatment at the first signs of a serious adverse reaction, such as tendinitis or tendon rupture, muscle pain, muscle weakness, joint pain, joint swelling, peripheral neuropathy, and central nervous system effects, and to contact their doctor immediately for further advice. Do not prescribe fluoroquinolones: for non-severe or self-limiting infections, or non-bacterial conditions, for example non-bacterial (chronic) prostatitis. for mild to moderate infections (such as in acute exacerbation of chronic bronchitis and chronic obstructive pulmonary disease).unless other antibiotics that are commonly recommended for these infections are consider inappropriate (see below) Do not prescribe ciprofloxacin or levofloxacin for uncomplicated cystitis unless other antibiotics that are commonly recommended are considered inappropriate (see below). Avoid fluoroquinolone use in patients who have previously had serious adverse reactions with a quinolone antibiotic (for example, nalidixic acid) or a fluoroquinolone antibiotic Prescribe fluoroquinolones with special caution for people older than 60 years and for those with renal impairment or solid-organ transplants, because they are at a higher risk of tendon injury Avoid use of a corticosteroid with a fluoroquinolone since coadministration could exacerbate fluoroquinolone-induced tendinitis and tendon rupture Report suspected adverse drug reactions to fluoroquinolone antibiotics on the Yellow Card website or via the Yellow Card app (download it from the Apple App Store, or Google Play Store Advice for healthcare professionals to give to patients and caregivers: Fluoroquinolone antibiotics are a group of antibiotics that include ciprofloxacin, delafloxacin, levofloxacin, moxifloxacin, and ofloxacin – sometimes these medicines may also have a brand name so patients should check the details of all antibiotics prescribed to them. Fluoroquinolone antibiotics have been reported to cause serious side effects involving tendons, muscles, joints, nerves, or mental health – in some patients, these side effects have caused long-lasting or permanent disability. Stop taking your fluoroquinolone antibiotic and contact your doctor immediately if you have any of the following signs of a side effect: tendon pain or swelling – if this happens, rest the painful area until you can see your doctor pain in your joints or swelling in your shoulders, arms, or legs abnormal pain or sensations (such as persistent pins and needles, tingling, tickling, numbness, or burning), weakness in your body, especially in the legs or arms, or difficulty walking severe tiredness, depressed mood, anxiety, or problems with your memory or severe problems sleeping changes in your vision, taste, smell, or hearing tell your doctor if you have had any of the above effects during or shortly after taking a fluoroquinolone – this means you should avoid them in the future.
  7. Event
    World Patient Safety Day, observed annually on 17 September, aims to raise global awareness about patient safety and calls for solidarity and united action by all countries and international partners to reduce harm to patients. Patient and family engagement is one of the main strategies to eliminate avoidable harm in healthcare and ‘Engaging Patients for Patient Safety’ is the defining theme for World Patient Safety Day 2023. Access to safe, quality, and affordable medicines and their correct administration and use is critical for patient treatment and satisfaction. However, harm from medication treatment, including that resulting from a medicine shortage, in hospitals is common. 80 million people in Europe report experiencing a serious medication error during hospitalisation. With the outcomes of enhanced pharmacovigilance practices on medication safety practices in hospitals unclear and widespread deployment and adoption of digitalisation that can contribute to medication safety lagging, error reporting remains one of the most effective strategies to improve patient safety from medication harm. The 72nd World Health Assembly affirms that informed patients and carers could support the elimination of avoidable harm during care delivery. However, in many cases, patients nor their families are unaware of what systems are available to report the error. Therefore, awareness, access and use of patient-centred, user-friendly, reporting systems, will strengthen the evidence base that medication errors are not an unfortunate occupational hazard in healthcare delivery. This webinar will raise awareness of the importance of all stakeholders engaging with patients to improve medication safety in hospitals. It will discuss the importance of ensuring that patients are informed about medication safety and know how to report an unintended medication error when it occurs. Register
  8. News Article
    Sharri Shaw walked out of the CVS on Vermont Avenue in South Los Angeles in 2019 believing she had a prescription for the pain reliever acetaminophen. Instead the bottle held a medicine to treat high blood pressure, a problem she did not have. Shaw began taking the pills, not learning of the mistake until six days later when a CVS employee arrived at her home, according to a lawsuit she filed last year. The employee told her not to take the tablets, the lawsuit said, before leaving the correct prescription at her door. The mistake, she said, left her stunned. Shaw’s experience is far from an isolated event. California pharmacies make an estimated 5 million errors every year, according to the state’s Board of Pharmacy. Officials at the regulatory board say they can only estimate the number of errors because pharmacies are not required to report them. Most of the mistakes that California officials have discovered, according to citations issued by the board and reviewed by The Times, occurred at chain pharmacies such as CVS and Walgreens, where a pharmacist may fill hundreds of prescriptions during a shift, while juggling other tasks such as giving vaccinations, calling doctors’ offices to confirm prescriptions and working the drive-through. Christopher Adkins, a pharmacist who worked at CVS, and then at Vons pharmacies until March, said that management policies at the big chains have resulted in understaffed stores and overworked staff. “At this point it’s completely unsafe,” he said. Read full story Source: Los Angeles Times, 5 September 2023
  9. News Article
    Rhiannon Kennedy-Chapman’s early twenties could hardly be described as the best years of her life. Covered in grazes, open sores and dry skin, she was at a loss as to why her body was continuously failing her, despite her efforts to follow medical advice and take her steroid medication. Having used both steroid cream and oral tablets since suffering from eczema as a child, she had little concern about the medication when she was once again prescribed it for small patches of eczema. “It worked for a bit and then it would stop working. The GP would give me a higher dose and the pattern went on for many months. I went through four different strengths – it would work for a short period of time and when I stopped using it, it would come back even fiercer. Little did she know that she was suffering from topical steroid withdrawal (TSW), a rare skin condition caused by the repeated use and cessation of steroid creams. A 2021 report by the Medicines and Healthcare Products Regulatory Agency (MHRA) gave guidance on the risks of TSW and it is now included as patient information for all prescribed topical steroids. Patients can now also report their suspected reactions to topical steroids via the MHRA’s “yellow card scheme” and eczema charities have called for further research into the causes and long-term effects of TSW. Andrew Proctor, chief executive of the National Eczema Society, said it was calling on the UK medicines regulator, the MHRA, to introduce clearer strength and potency labelling of topical steroids to support their safe and effective use. “This change needs to happen and is supported by patients and healthcare professional bodies,” he said. Read full story Source: The Independent, 5 September 2023
  10. News Article
    Staffing shortages are likely to restrict the use of a beneficial painkiller in birthing suites, even once its use has been recommended by national guidance. Research by HSJ suggests that just over half of trusts are already offering remifentanil to women in labour, although some are having to restrict its use due to lack of staffing. Responses to freedom of information requests from 108 trusts revealed 55 offered remifentanil during labour in 2022-23. Recent draft National Institute for Health and Care Excellence guidance on intrapartum care, published in April, suggested healthcare professionals “consider intravenous remifentanil patient-controlled analgesia” in obstetric units. This is partly because it reduces the likelihood of forceps or ventouse being required compared to intramuscular pethidine (an opioid commonly used in labour). However, the drug is not yet mentioned in official NICE guidelines and the opioid’s use in labour is currently off-label (its more common licenced use is alongside anaesthesia in surgery). A Royal College of Anaesthetists spokesperson said the use of drugs off-label “is extremely common in obstetrics given that drug trials do not often include pregnant women”. Read full story (paywalled) Source: HSJ, 1 September 2023
  11. News Article
    Hundreds of people across England with drug and alcohol dependencies who have been prescribed Valium long-term, will have their cases reviewed following an Ombudsman investigation. The Local Government and Social Care Ombudsman has found that Change Grow Live (CGL), on behalf of Cambridgeshire County Council, has been prescribing benzodiazepines to people long-term, against national guidance. The company also provides drug and alcohol services for 50 other councils. Benzodiazepines – including diazepam (Valium) - are a class of medicines that can relieve nervousness, tension and other symptoms of anxiety and should usually only be prescribed short-term. CGL’s policy explains people use them for anxiety, insomnia, to enhance opiate effects, to deal with mental health issues, improve confidence and to reduce psychotic symptoms like hearing voices. However, if they are prescribed for too long, they can have significant negative effects including dependence, withdrawal symptoms and drug-seeking behaviour. People on these medicines should have their prescriptions reviewed regularly, and those reviews should consider the benefits and risks of continuing with the current dose, reducing or stopping it, with a management plan put in place after each review. However, the Ombudsman’s investigation found CGL were either not reviewing people’s prescriptions regularly enough or not keeping proper records of those reviews. Nigel Ellis, Local Government and Social Care Ombudsman Chief Executive, said: “Clinicians need to weigh up the benefits and risks for patients who are taking these medicines long-term and should have a clear rationale for continuing to prescribe. “I am pleased that patients in these vulnerable groups will now have their cases reviewed more regularly and comprehensively following my investigation. “Both CGL and the council have co-operated fully with our investigation, and I welcome their ready acceptance of our recommendations.” Read full story Source: Local Government and Social Care Ombudsman, 23 August 2023
  12. News Article
    In September last year, Ebrima Sajnia watched helplessly as his young son slowly died in front of his eyes. Mr Sajnia says three-year-old Lamin was set to start attending nursery school in a few weeks when he got a fever. A doctor at a local clinic prescribed medicines, including a cough syrup. Over the next few days, Lamin's condition deteriorated as he struggled to eat and even urinate. He was admitted to a hospital, where doctors detected kidney issues. Within seven days, Lamin was dead. He was among around 70 children - younger than five - who died in The Gambia of acute kidney injuries between July and October last year after consuming one of four cough syrups made by an Indian company called Maiden Pharmaceuticals. In October, the World Health Organization (WHO) linked the deaths to the syrups, saying it had found "unacceptable" levels of toxins in the medicines. A Gambian parliamentary panel also concluded after investigations that the deaths were the result of the children ingesting the syrups. Both Maiden Pharmaceuticals and the Indian government have denied this - India said in December that the syrups complied with quality standards when tested domestically. It's an assessment that Amadou Camara, chairperson of the Gambian panel that investigated the deaths, strongly disagrees with. "We have evidence. We tested these drugs. [They] contained unacceptable amounts of ethylene glycol and diethylene glycol, and these were directly imported from India, manufactured by Maiden," he says. Ethylene glycol and diethylene glycol are toxic to humans and could be fatal if consumed". Read full story Source: BBC News, 21 August 2023
  13. Content Article
    Understanding medication safety challenges Medication safety challenges in addiction treatment programs can arise from a variety of factors. Complex treatment regimens, potential drug interactions and the risk of medication misuse are just a few of the hurdles that healthcare providers and patients may encounter. Balancing the benefits of medications with the potential risks demands a comprehensive approach that takes into account the unique needs of each patient. The role of comprehensive assessment Addressing medication safety challenges begins with a comprehensive assessment of each patient's medical history, addiction severity and any co-occurring conditions. By gaining a holistic understanding of the patient's health, healthcare providers can tailor treatment regimens to minimise potential risks. This individualised approach helps identify suitable medications and dosages while considering the potential for adverse reactions or interactions. Enhancing communication amongst care providers Effective communication among the multidisciplinary team is essential for ensuring medication safety in addiction treatment programs. Regular case conferences and shared electronic health records can facilitate seamless information exchange. This collaborative approach enables healthcare providers to monitor medication adherence, track progress, and promptly address any emerging concerns. Educating patients about medications Empowering patients with knowledge about their medications is vital to ensuring their safety. Addiction treatment programs should include comprehensive patient education on the purpose, potential side effects and proper administration of prescribed medications. When patients are actively involved in their treatment journey, they become partners in promoting their own safety and wellbeing. Fostering open and transparent communication between healthcare providers and patients cultivates a sense of trust and collaboration. This partnership allows patients to freely express their concerns, ask questions and provide valuable feedback, leading to more personalised and effective medication management. As patients develop a deeper understanding of how medications fit into their overall recovery plan, they gain the confidence to contribute to informed decisions about their treatment actively, ultimately enhancing the safety and success of their rehabilitation process. Utilising technological solutions In our technologically advanced landscape, digital tools can be pivotal in addressing medication safety challenges. Mobile apps and online platforms can provide patients with reminders for medication doses, track their progress and facilitate direct communication with healthcare providers. These solutions enhance patient engagement, reduce the risk of medication errors and promote adherence to treatment plans. Minimizing polypharmacy risks Polypharmacy, the use of multiple medications simultaneously, can magnify medication safety challenges. Healthcare providers should strive to minimise the number of prescribed medications whenever possible, opting for simpler treatment regimens that reduce the risk of adverse interactions. This streamlined approach not only enhances patient safety but also improves treatment adherence. Regular medication reviews Ongoing assessment and adjustment of medication regimens are essential to address emerging safety challenges. Regular medication reviews allow healthcare providers to evaluate the effectiveness of the current treatment plan, identify any new safety concerns and make necessary modifications. This proactive approach ensures that patients receive the most appropriate and safe medications throughout their recovery. Incorporating behavioural therapies Beyond pharmacological interventions, behavioural therapies can significantly contribute to medication safety in addiction treatment programs. By addressing underlying triggers and promoting healthy coping mechanisms, behavioural therapies can reduce the reliance on medications and mitigate potential safety risks. A holistic approach that combines medication management with psychological support can lead to more comprehensive and sustainable outcomes. Empowering patients in self-monitoring Encouraging patients to actively self-monitor their medication-related experiences can provide valuable insights into their wellbeing. Routine self-assessment of side effects, cravings and mood fluctuations empowers patients to promptly communicate their observations to healthcare providers. This proactive engagement enhances medication safety by enabling timely adjustments to treatment plans. Conclusion As addiction treatment programs continue to evolve, medication safety remains a critical consideration. By embracing comprehensive assessment, effective communication, patient education, technological solutions and a holistic approach, healthcare providers can successfully navigate these challenges while prioritising patient wellbeing. Addressing medication safety challenges within addiction treatment programs requires a concerted effort from all stakeholders, united by a common goal: to provide the best possible care for individuals on their journey to recovery.
  14. News Article
    Almost 180,000 patients have been prescribed strong painkillers every month for two years, a rise of over a third compared to levels recorded just before the pandemic, data obtained by HSJ shows. The figures collected by the NHS Business Services Authority showed 179,353 patients had been prescribed an opioid analgesic every month between April 2021 and March 2023, a 36% increase compared with 131,876 receiving the same prescription between April 2017 and March 2019. Guidelines issued by the National Institute for Health and Care Excellence in 2021 advised clinicians not to prescribe opioids to manage chronic pain. A statement published alongside an earlier draft of these guidelines explained: “While there was little or no evidence that they made any difference to people’s quality of life, pain or psychological distress, there was evidence that they can cause harm, including possible addiction.” In 2020, the Medicines and Healthcare Products Regulatory Agency asked healthcare professionals to discuss the risks of dependency and addiction with any patient taking or planning to take an opioid-containing medicine and made sure such warnings were reinforced in the patient information leaflet. The regulator at the time defined long-term use as longer than three months. Read full story (paywalled) Source: HSJ, 18 August 2023
  15. News Article
    Roughly three in 10 adults have been addicted to opioids or have a family member who has been, and less than half of those with a substance use disorder have received treatment, according to a new survey conducted by KFF, a health policy research group. The survey, which polled more than 1,300 adults in July, underscores the broad and often harmful influence of opioid addiction across the nation, which recorded around 110,000 fatal drug overdoses last year alone. And the findings suggest that some proven medications for helping curb drug cravings, such as buprenorphine and methadone, are still not getting to those who need them. Only 25 percent of participants in the poll who said they or someone in their family had an opioid addiction reported receiving medication for themselves or family members. Mollyann Brodie, the executive director of KFF’s polling program, said that the numbers might be an undercount, as some survey participants might have been hesitant to share histories of opioid addiction. Addiction cuts across class, race and geography, the KFF researchers found. Rural and white Americans were the likeliest to report personal or family opioid addiction, but significant percentages of Black, Hispanic, urban and suburban families did, as well. White families were more likely than Black or Hispanic families to say that they had received treatment. Overdose fatality rates among Black Americans have climbed substantially in recent years, the Centers for Disease Control and Prevention found in a study last year. Dr. David Fiellin, an addiction physician at the Yale School of Medicine, said the survey showed the need for a stronger federal response to substance use disorders, akin to the one for AIDS. He said, “There’s often a misunderstanding of what treatment actually looks like and what it is—people often look to a quick fix,” he said, referring to a detox strategy. “Effective treatment tends to be much more long term and requires addressing the denial that can be part of the condition.” Read full story (paywalled) Source: New York Times, 15 August 2023
  16. News Article
    Measures for avoiding medication errors with the injectable agents used routinely in anaesthesia care have been recommended in new guidelines from the Association of Anaesthetists. The guidelines, published in Anaesthesia, the journal of the Association of Anaesthetists, were drawn up "in response to requests for guidance from members in view of continuing incidents of medication errors and patient harm." The working party of UK anaesthesia experts that drew up the guidance emphasised the potential safety benefits of using prefilled and labelled syringes, as well as aids such as colour-coded medication trays. It highlighted that these were not yet in widespread use within the NHS. The group noted that unlike many healthcare workers, anaesthetists usually undertook medication preparation (transfer from labelled ampoules into unlabelled syringes) in a solo capacity, and that there could be an average of 10 medication administrations per anaesthetic procedure. Labelling errors have been reported in around 1–1.25% of peri-operative administrations, and medication substitutions in 0.2% of administrations during anaesthesia. The working party, chaired by Dr Mike Kinsella, honorary consultant in the Department of Anaesthesia at University Hospitals Bristol and Weston, said it aimed "to provide pragmatic safety steps" for use within operating theatres, as well as goals for the development of "a collaborative approach to reducing errors" as a basis for "instilling good practice." "It is important to acknowledge that every practitioner is open to error," the authors said, noting that the risk could increase over time during a case, especially if an anaesthetist's performance was diminished by fatigue. Read full story Source: Medscape, 10 August 2023
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