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/ Title of Meeting: / Area Prescribing Committee Meeting
Time: / 1:00pm
Date: / Wednesday, 16 January 2008
Venue: / Ravenfield Room, RDGH
Reference: / PS/dd
Chairman: / Phil Scorah
Present: / Dr P Scorah / (Chair)
Dr J Radford / Director of Public Health, Rotherham PCT
Mike Ireland / RPCT
Andrew Houston / Pharmacist, DASH
Dr C Harrison / RGHT
Christina Dezelak / RGHT
Surinder Ahuja / RGHT
Ian Cawthorne / RGHT
Sue Wright / Prescribing Advisor, Nine Trees
Chris Horsfield / Prescribing Advisor, Nine Trees
Donna Dennison / Secretary, RPCT
Agenda Items & Action Points / Action By
08/001 / Apologies:
Robin Carlisle, Stuart Lakin, Dr P Martin
08/002 / Minutes from the last meeting held on the 21 November 2007.
Sue Wright gave apologies for the previous meeting.
07/33 – Bisphosphate & Calcium + Vit D Post Fracture - Osteoporosis – spelling error.
07/37 – Asthma Guidelines – This will need discussing at the Drugs and Therapeutics Committee.
07/45 – Mycophenolate Shared Care Protocol - This needs traffic lighting as RED for renal and AMBER for Rheumatology.
All other minutes were agreed to be a true and accurate record.
08/003 / Matters Arising:
07/07 – Controlled Drugs – SW is to visit the Slimming Clinic in Rotherham to review their usage of Controlled Drugs.
07/15 – PBC Engagement with APC – we will need to reconsider the makeup of the committee if a representative from the PBC steering group is not forthcoming
07/37 – Asthma Guidelines – this is to be discussed at the Drugs and Therapeutics Committee in two weeks time.
07/52 – Letters from Primary Care re: Secondary Care – Discharge letters to GPs need to clarify the length of time that Clopidogrel needs to be continued following discharge.
07/45 – Paediatric Prescribing Issues – A Paediatric leaflet is given on every discharge.
07/52 – C Difficile – Appropriate advice will be in the antibiotic formulary, which is due to be published very soon.
08/004 / Declarations of Interest
Nothing to discuss
08/005 / LHRH Agonists in the Treatment of Prostate Cancer
The Urology consultants in Rotherham will be discharging new patients on Decapeptyl, however many existing patients are on Goserelin (Zoladex/Postrap) and the Area Prescribing Committee suggest that existing patients may feel more confident if left on their existing medication. A tiny group of patients will be discharged on Goserelin for clinical reasons and we will support the Urologists in recommending that GPs continue Triptorelin in new patients.
08/006 / Controlled Drugs
Nothing to discuss
08/007 / Paediatric Prescribing Issues:
There has been a GP complaint that they do not have a copy of the Paediatric BNF.
CH will take this up. / CH
08/008 / Traffic Light System
Lanthanum
Lanthanum is not a dangerous drug and will probably be traffic lighted as RED/AMBER. SW to talk to SL and bring back to the next meeting.
Complaint re: Piracetam
The traffic lighting of drugs ought to be consistent across South Yorkshire – to try and alleviate these problems SW & SL are taking to the South Yorkshire Prescribing Leads for discussion. / SW
DD
SW/SL
08/009 / SY Prescribing Leads Meeting
SW attended the South Yorkshire Prescribing Leads meeting and fed back to the APC the following information: Levocitrizine has been traffic lighted as BROWN – strongly not recommended,Palperidone has been traffic lighted as AMBER – this is not a dangerous drug once it has been initiated, Lenalidomide has been traffic lighted as RED and Abatacept has been traffic lighted as RED.
As we only have the minutes from the September meeting SW is to forward the minutes for the October, November and December meetings for information at the Rotherham APC. / SW
08/010 / Monitored Dosage Systems
To be brought back next time. / DD
08/011 / Asthma Guidelines
This is to be taken back to the PCT Prescribing Committee for ratification. / DD
08/012 / Shared Care Protocols for Intramusclar Gold Therapy
Azathioprine Therapy
Leflunomide Therapy
Sulfasalazine Therapy
Methotrexate Therapy
All the Shared Care Protocols above are reviews for the APC. The Committee felt that the Protocols could be reviewed every two years instead of yearly unless new evidence comes to light – next review now due October 2009.
SW raised the point that certain GPs are not using the document as they do not feel that they have a shared care they are merely prescribing the drugs – not monitoring.
SW is to formulate a form of words stating which protocol applies to which group of GPs.
A letter is needed from the Hospital to the GPs re the monitoring and prescribing of shared care medications.
IC is to amend the protocols as per the discussion and bring back next time for ratification.
Letter from Dr Polkinghorn
Further to receiving the letter from Dr Polkinghorn IC is to clarify the blood tests for Azathioprine whether they need to happen on a monthly or three monthly basis. SW is to write back to Dr Polkinghorn after she has spoken to the FACT team. / SW
IC?
IC
IC
SW
08/013 / Horizon Scanning:
Nothing to discuss.
08/014 / NICE Guidance:
NICE Guidance for Omalizumab
This drug is traffic lighted as BLUE – each case has to be approved by the Priority Panel.
NPSA –there is good information sharing between the GP and the hospital.
08/015 / Information Only:
Sheffield APC Minutes October 2007
APC Newsletter
Sheffield Traffic Light System
08/016 /
Any Other Business:
PS raised that if the Paediatric team have any prescribing issues if they have 4 or 5 big issues then half of one of the future meetings could be dedicated to that but we would need 4 months notice.
Discharge System
IC notified the committee that as the discharge system will be obsolete in March 2008 a new system will be implemented which should print out 2 lists for the GPs – 1 listing the medications the patient was taking on admission and 1 stating the medications prescribed for discharge with the changes highlighted in red. / CH/DM
08/017 / Agenda Deadline:
Wednesday, 12 March 2008 by CoB
Date & Time of next Meeting:
Wednesday, 19 March 2008 – 1.00pm in the Bramley Room at Oakwood Hall

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