We mentioned this in a previous newsletter but another query has come in from our hospices which has led to a more thorough review. Proton Pump Inhibitors (PPIs) are used to treat gastroesophageal reflux disease and work by blocking the transport of acid into the stomach to decrease the acidity. They are used widely in…
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We have had some interesting queries over the past few months which have required some time to answer in full. We also had some feedback from previous queries which we respond to below. All our visiting pharmacists are there to respond to your queries and if they can’t answer the question on the spot, we…
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Who issues medication safety alerts? The Medicines Healthcare Products and Regulatory Agency (MHRA) is responsible for issuing medication and medical device safety alerts. How are these communicated? This autumn, the way the MHRA communicates safety alerts is changing. All medication safety and critical alerts that need to be actioned by healthcare organisations will be issued…
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Advance planning for flu vaccination clinics has become an important part of patient care. The flu vaccination delivered in the following year provides vulnerable patients with protection against the strands of flu that are going to be the most prevalent over the next year. This is even more important this year, as hospitals deal with…
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The MHRA has repeated its concerns about overuse of opioids based on a set of recommendations from its Opioid Expert Working Group of the Commission on Human Medicines. The first step taken was to put safety warnings on packs of medicines containing opioids. They now want to ensure people are supplied with consistent information on…
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It is generally accepted that the management of symptoms in palliative care must involve appropriate polypharmacy. We are comfortable with using more than one medicine to help with one symptom provided the mechanisms of action are different and complementary – for example morphine plus gabapentin for pain with neuropathic characteristics. At the same time, we…
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The two opioids available for delivery via a transdermal patch in the UK are fentanyl and buprenorphine. Fentanyl products are licensed for severe and chronic pain that requires long-term opioids or that does not respond to non-opioids. Buprenorphine is available in two sets of products – the stronger patches have a similar license to fentanyl while the lower strengths are indicated for non-malignant pain when an opioid is necessary (they are used for cancer pain in some cases, where patients only require low opioid doses)…
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One of the audits collected on our Ashtons Live View system is the number of prescription items for each patient. This information enables us to provide you with comparative data and percentages for our clinical interventions. It is not unusual to count more than twenty items for one patient on a hospice drug chart, although many of these items will be on the PRN pages. We pay great attention to detail with the patient’s response to their medicines, but what are the prompts for reducing the number of items?
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From 31 March 2020 NHS and partner organisations are required to use modern communication methods instead of faxes, such as secure email, in order to comply with their information governance requirements and in a bid to improve patient safety and cyber security. How do we swap to using secure email?
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Looking back on my emails, I see that my first COVID-related message came in on 3rd March. At first, it was impossible to judge the impact the virus was going to have on our healthcare system and hospices. The shocking lack of their inclusion in the two essential components – PPE and testing – soon became apparent. Many of our senior hospice colleagues have described how they had to ‘fight’ for what was needed –on top of caring for very sick patients who may or may not have the virus and staff having to isolate for the statutory period…
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