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Showing results for tags 'Prescribing'.
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News ArticleThe emergence of antimicrobial resistance (AMR), including drug-resistant bacteria, or “superbugs”, pose far greater risks to human health than Covid-19, threatening to put modern medicine “back into the dark ages”, an Australian scientist has warned, ahead of a three-year study into drug-resistant bacteria in Fiji. “If you thought Covid was bad, you don’t want anti-microbial resistance,” Dr Paul De Barro, biosecurity research director at Australia’s national science agency, the CSIRO, told The Guardian. “I don’t think I’m exaggerating to say it’s the biggest human health threat, bar none. Covid is not anywhere near the potential impact of AMR. We would go back into the dark ages of health.” WHO warns overuse of antibiotics for COVID-19 will cause more deaths While AMR is an emerging public health threat across the globe, in the Pacific, where the risk of the problem is acute, drug-resistant bacteria could stretch the region’s fragile health systems beyond breaking point. An article in the BMJ Global Health journal reported there was little official health data – and low levels of public knowledge - around antimicrobial resistance in the Pacific, and that high rates of infectious disease and antibiotic prescription were driving up risks. “A challenge for Pacific island countries and territories is trying to curtail antimicrobial excess, without jeopardising antimicrobial access for those who need them,” the paper argued. Read full story Source: The Guardian, 10 September 2020
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News ArticleFollowing four deaths and more than 300 incidents with steroid replacement therapy involving patients with adrenal insufficiency in the past two years, patients at risk of adrenal crisis will be issued with a steroid emergency card. All adults with primary adrenal insufficiency (AI) will be issued an NHS steroid emergency card to support early recognition and treatment of adrenal crisis, a National Patient Safety Alert has said. The cards will be issued by prescribers — including community pharmacists — from 18 August 2020. AI is an endocrine disorder, such as Addison’s disease, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an additional illness or surgery, can also lead to an adrenal crisis. The alert has requested that “all organisations that initiate steroid prescriptions should review their processes/policies and their digital systems/software and prompts to ensure that prescribers issue a steroid emergency card to all eligible patients” by 13 May 2021. Read full story Source: The Pharmaceutical Journal, 17 August 2020
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Coroner warns about poor drug reviews after patient dies from tramadol overdose
Patient Safety Learning posted a news article in News
A senior coroner has demanded action by Simon Stevens, chief executive of NHS England, to ensure that GPs monitor repeat prescriptions properly, after an 84 year old man with dementia died from an overdose of tramadol. Peter Cole, who was found collapsed at his home in Welwyn in Hertfordshire by a neighbour, had amassed a large quantity of unused prescription drugs at his house. He had numerous drugs on repeat prescription, said Geoffrey Sullivan, chief coroner for Hertfordshire. Read full story (paywalled) Source: BMJ, 5 August 2020 -
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Antibiotic Resistance & Patient Safety Portal
Claire Cox posted an article in International patient safety
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Medicines safety: NHS online learning index
Claire Cox posted an article in Medication including labelling
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Report finds ‘profound failings’ in Scottish NHS IT systems
Patient Safety Learning posted a news article in News
A Scottish Government committee has found that the “profound failings” of IT systems are the biggest problem facing a medicine-prescribing service that does not sufficiently focus on patients. A report from the members of Scottish Parliament on the Health and Sport Committee describes a medicines system “burdened by market forces, public sector administrative bureaucracy and under resourcing, inconsistent leadership and a lack of comprehensive, strategic thinking and imagination, allied to an almost complete absence of useable data”. The committee particularly criticised the failure of the NHS to introduce appropriate IT systems. “We are extremely disappointed that once again all roads lead to the dismal failure of the NHS in Scotland to implement comprehensive IT systems which maximise the use of patient data to provide a better service,” the report says. Committee members are calling for an overhaul of the system to allow for collection and analysis of data that would ensure the best possible outcomes for patients and cost savings for the NHS. MSPs found a “lack of care” to understand patients’ experience of taking medicines and a lack of follow up to ensure that medicines were effective or even being used. Prescribers were “instinctively reaching for the prescription pad” and not taking the time to discuss medicines with patients, nor were the principals of realistic medicine, in which patients and clinicians share decision making about their care, being followed. Read full story Source: Public Technology.net, 1 July 2020 -
Content ArticleThe Faculty of Pain Medicine of the Royal College of Anaesthetists is concerned with the professional standards of Pain Medicine specialists, so this document focuses on the Pain Medicine specialist’s contribution to Paediatric Pain Medicine (PPM). This document describes two levels of involvement in the practice of PPM: • The first level outlines the core knowledge, skills and attitudes for all anaesthetists specialising in Pain Medicine who may need to be involved with this area e.g. making timely and appropriate referrals for paediatric pain management and emergency management of a child with pain. Whilst it is recognised that not all Pain Medicine specialists will be directly involved in providing a paediatric pain service, all need to have an understanding of this area. • The second level outlines the advanced knowledge, skills and attitudes required of Pain Medicine specialists who work in teams providing a paediatric pain service. These competencies reflect those of the paediatric pain module which is an option at Advanced level of Pain Medicine training of the Royal College of Anaesthetists’ CCT in Anaesthetics curriculum, which sets out competencies for trainees who elect to take a deeper interest in this area of Pain Medicine practice
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Content ArticleThis resource, developed by UK healthcare professionals and policymakers, provides the information to support a safe and effective prescribing decision. Key Messages 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain. 2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation). 3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is no increased benefit: tapering or stopping high dose opioids needs careful planning and collaboration. 4. If a patient has pain that remains severe despite opioid treatment it means they are not working and should be stopped, even if no other treatment is available. 5. Chronic pain is very complex and if patients have refractory and disabling symptoms, particularly if they are on high opioid doses, a very detailed assessment of the many emotional influences on their pain experience is essential.
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Content ArticleThis web page offers numerous resource pages which include: drug monitoring medicines management during this crisis summary of drugs for COVID-19.
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MHRA guidance on Coronavirus (COVID-19)
PatientSafetyLearning Team posted an article in Guidance
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Human medicines: highlights of 2019
Claire Cox posted an article in Medication including labelling
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Content ArticleThis study, published by Antimicrobial Resistance & Infection Control, shows that in hospital outpatient clinics, prophylaxis accounted for a quarter of the antimicrobial prescriptions and had in general a good guideline-adherence rate, with the exception of unnecessarily prescribed post-surgical/intervention prophylaxis, whereas a substantial part of the therapeutic prescriptions were inappropriate. Amoxicillin-clavulanic acid was the most inappropriately prescribed antimicrobial agent, regarding non-adherence to the guideline and also regarding the lack of considering renal function for dosage adjustment. Altogether, it is believed that antimicrobials prescribed at the hospital outpatient clinics warrant ASP attention. The variation of the guideline adherence rate between the investigated hospitals, as well as the differences with prior studies addressing antibiotic use in ambulatory settings in general, emphasise that (hospital) outpatient antimicrobial use should be audited locally.
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Content ArticleIssuing of controlled drugs within the operating department and key holding Ordering and transferring of drugs Unused controlled drugs Security requirements Disposal of controlled drugs.
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News ArticleThe toxicity of a commonly prescribed beta blocker needs better recognition across the NHS to prevent deaths from overdose, a new report warns today. The Healthcare and Safety Investigation Branch (HSIB) report focuses on propranolol, a cardiac drug that is now predominately used to treat migraine and anxiety symptoms. It is highly toxic when taken in large quantities and patients deteriorate quickly, making it difficult to treat. The investigation highlighted that these risks aren’t known widely enough by medical staff across the health service, whether issuing prescriptions to at risk patients, responding to overdose calls or carrying out emergency treatment. Dr Stephen Drage, ICU consultant and HSIB’s Director of Investigations, said: “Propranolol is a powerful and safe drug, benefitting patients across the country. However, what our investigation has highlighted is just how potent it can be in overdose. This safety risk spans every area of healthcare – from the GPs that initially prescribe the drug, to ambulance staff who respond to those urgent calls and the clinicians that administer emergency treatment." The report also emphasises that there is a link between anxiety, depression and migraine, and that more research is needed to understand the interactions between antidepressants and propranolol in overdose. Read full story Source: HSIB, 6 February 2020
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Content ArticleSafety recommendations The safety recommendations are focused on: Updating clinical guidance (NICE) and the UK’s pharmaceutical reference source (the British National Formulary) on use of propranolol and highlighting the toxicity in overdose. National organisations supporting their staff membership to understand the risks when prescribing propranolol to certain patients. Improving the clinical oversight in ambulance control rooms and the treatment/transfer guidance for ambulance staff for propranolol/beta blocker overdose. As well as the safety recommendations, the report makes several safety observations and highlights some safety actions that have already been undertaken by NHS England and NHS Improvement, and the Medicines and Healthcare products Regulatory Agency. The report also emphasises that there is a link between anxiety, depression and migraine, and that more research is needed to understand the interactions between antidepressants and propranolol in overdose.
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Content ArticleOptiMed-ID is an innovation unique within the UK, which uses robotic technology and logistics software to produce and deliver individual doses of medication within an acute hospital setting. It enables complete control of medicine prescribing, supply and administration, reducing medication errors and cutting waste. Already deployed and delivering significant cost savings in 20 hospitals in Italy, the independent evaluation work – completed December 2015 – has confirmed that the use of “optimisation of medicines with individual dosing” (OptiMed-ID) in an NHS acute hospital setting can deliver drugs cost savings in excess of 25%. Deployed throughout four wards at UHL, this is the first time that an automated individual medicines dosing solution has been brought into operational use in the UK. The evaluation report has informed UHL’s decision to extend the pilot whilst business case and procurement activities for the rollout of the innovation throughout the whole trust are completed. The trust-wide deployment at Leicester is expected to deliver savings to the NHS of around £4m per annum, as well as improving medicines adherence and reducing the risk of medicine errors.
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Australia: ‘Medicine safety is a priority for us all.’
Patient Safety Learning posted a news article in News
Stakeholders from across various sectors in Australia attended a medicine safety forum convened in Canberra on Monday. Held by the Consumers Health Forum of Australia (CHF), Pharmaceutical Society of Australia (PSA), the Society of Hospital Pharmacists of Australia (SHPA), NPS MedicineWise and academic partners Monash University and University of Sydney, the forum challenged participants to ‘think differently’ on the safe use of medicines in Australia. This included brainstorming on what success in improving medicine safety would look like in 10 years. “Medicine safety is a priority for us all and we each have a role to play,” PSA National President Associate Professor Chris Freeman said. “It was inspiring to see the sector work together today to proactively identify those measures we can cooperatively pursue to make a real difference and protect patients.” Read full story Source: AJP.com.au -
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Online prescribing 'must get safer'
Patient Safety Learning posted a news article in News
More deaths could occur unless action is taken to keep people safe when obtaining medications from online health providers, says a UK coroner. Nigel Parsley has written to Health Secretary Matt Hancock highlighting the case of a woman who died after obtaining opiate painkillers online. Debbie Headspeath, 41, got the medication, dispensed by UK pharmacies, after website consultations. Her own GP was unaware of what she had requested from doctors on the internet. The Suffolk coroner has now written to the Department of Health asking for urgent action to be taken. The General Pharmaceutical Council – the independent regulator for pharmacies – said it was responding to the coroner's report and would continue to take necessary action to make sure medicines are always supplied safely online. Read full story Source: BBC News, 9 December 2019 -
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Patient Stories: Paul's Story (10 March 2013)
Claire Cox posted an article in Patient stories
