Gateshead Prescribing and Medicines Management Committee

Annual Report 2010/11

Introduction

The Gateshead Prescribing and Medicines Management Committee is now in its sixth year.

In the past year the GMMC has continued to work to establish itself in the new medicines management structures of NHS South of Tyne & Wear. It continues to ensure the medicines management agenda remains a high priority for all stakeholder organisations. During the year the GMMC has revised its Terms of Reference to reflect the requirements of the NHS Constitution and changes in healthcare management structures locally.

Achievements 2010/11

  • Local Decision Making Around Medicines

Together with all stakeholders across Gateshead, South Tyneside and Sunderland the group has worked to develop a policy and standardise processes for the handling of all requests for drugs to be added to local formularies South of Tyne. These have been developed in response to the requirement s of the NHS Constitution and National Prescribing Centre advice. The group also had input into the North East SHA workstream on reviewing Local Decision Making around Medicines across the region.

  • Shared Care Guidelines

The GMMC has worked with the NHS South of Tyne & Wear Medicines Management Committee to harmonise existing shared care arrangements and guidelines across Gateshead, South Tyneside and Sunderland.

The GMMC this year has worked across the primary/secondary care interface providing input into the development and implementation of shared care protocols in the following areas:

Degarelix

DMARDs for rheumatology

Ketamine in palliative care

  • Development of New Guidelines

The GMMC has worked with stakeholders in Gateshead and across NHS South of Tyne & Wear to develop/launch guidelines in the following areas in the past year:

Appropriate use of ketone testing strips – advice for GPs
Chronic Pain – incorporating the use of pregabalin for neuropathic pain & recent NICE guidance
Osteoporosis
Malnutrition and Sip Feed Guidelines for Primary Care
Choice of anti-TNFs for rheumatology
Recommended use of Rifaximin
Vitamin D Supplementation in Adults
Gluten Free Food Guidance
Patient Controlled Analgesia in Secondary Care
Antibiotic Management of Cellulitis in the Community
Use of Unlicensed Medicines – Patient Information Leaflet
Use of Off-Label Medicines – Patient Information Leaflet
  • Review of Existing Guidelines

The group has worked with stakeholders to review the following guidelines:

SOTW Wound Care Formulary

Constipation in adults

Constipation in children

SOTW Antiplatelet Guidance

SOTW Lipid Lowering Drug Strategy

Ivabradine Guideline

Workplan 2010/11
  • Shared Care Protocols

The group is continuing to work across the primary/secondary care interface to develop shared care protocol where there is a need for them identified.

  • Development of New Guidelines

The GMMC is working with stakeholders in Gateshead to develop guidelinesin the following areas:

Dabigatran for Atrial Fibrillation
Raynauds
  • Cost Improvements and Cost-effective Use of Medicines

The GMMC will continue to work with stakeholders in Gateshead to introduce measures to manage the increasing drug spend in both primary and secondary care. These are aimed at ensuring the cost-effective use of medicines for the wider healthcare economy which will release money to fund new additions to the formulary, and new medicines as they come to market.

New drugs added to Gateshead Formulary in 2009/10

Of the twenty-four applications received for addition to the formulary in 2010/11fifteenwere accepted.

DRUG
/ INDICATION
Colecalciferol
20 000 unit caps
(Dekristol®) / Vitamin D supplementation in adults as no other licensed preparations currently available in the UK
** Unlicensed **
Rifaximin / For the treatment of persistant hepatic encephalopathy
Cetirizine / Antihistamine
Rivastigmine patches / Alzheimer’s disease in those unable to swallow oral preparations
Denosumab / 3rd line treatment of postmenopausal osteoporosis
Febuxostat / Treatment resistant gout
Fluticasone nasal spray (Avamys®) / 2nd line topical nasal spray for use in allergic rhinitis
Tocilizumab / Rheumatoid arthritis after failure/intolerance of 1st line anti-TNFs
Rituximab / Rheumatoid arthritis after failure/intolerance of 1st line anti-TNFs
Fesoterodine / Urinary infrequency
Dronedarone / Alternative to amiodarone in treatment of atrial fibrillation
Prucalopride / Chronic constipation in women when at least two other laxative regimens have failed
Nebulised Sodium Chloride 7%
(Nebusal®) / Approved as red drug (hospital only) as a mucolytic in those patients with CF or non CF Bronchiectasis. Not approved for use in COPD patients.
Fomepizole / Treatment of ethylene glycol poisoning
Hyperbaric prilocaine 2% / Intrathecal anaesthesia in day case surgery

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April 2011

Gateshead Medicines Management Committee