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P&MM articles

Targeted MURs for patients on NSAIDs

December 2011

Four drug classes — antiplatelets, diuretics, non steroidal anti-inflammatory drugs and anticoagulants — account for about half of these admissions and this is reflected in the high-risk drug targeted medicines use review service in England. Carina Livingstone shares early results from the south east, which support targeting medicines use reviews at patients on NSAIDs to improve gastrointestinal safety, and tips for performing these MURs

Keep patients with heart failure out of hospital: ensure they get target doses

June 2011

Although the quality and outcomes framework requires heart failure patients to be prescribed an angiotensin-converting enzyme inhibitor and a beta-blocker, there is little reporting of whether they are titrated to doses with proven benefits, says practice pharmacist Karen Mander Sanghera. She presents a snapshot of prescribing in Dudley and plans to increase benefits from drug therapy

Notes on prescribing and medicines management in children with epilepsy

June 2011

Although epilepsy can start at any age it often begins in childhood. Emma Kirk discusses the medicines management issues surrounding antiepileptic drug therapy in children

How to limit antipsychotic use in dementia

May 2011

It is estimated that only a fifth of people with dementia and who are prescribed an antipsychotic actually benefit. And considering the mortality risks, it is time for action by pharmacists, say Vanessa Redmond and Jonathan Cavan. They describe a new service reviewing antipsychotic prescribing for nursing home residents 

VTE: a journey to meet that 90pc goal

April 2011

According to the latest Department of Health figures, 68 per cent of adults admitted for acute care in the NHS in England were risk assessed for venous thromboembolism. Trusts failing to reach the 90 per cent target in April 2011 will find themselves penalised financially. Oweikumo Eradiri, lead medication safety pharmacist at Colchester Hospital University NHS Foundation Trust, gives insight into how his trust has been working to prevent VTE deaths

Generic or branded mycophenolate — what strategy should the NHS adopt?

December 2010

The availability of generic mycophenolate mofetil for use after organ transplant offers the potential of considerable cost savings to a cash-strapped NHS but a transplant failure means money down the drain. Prescribing decisions, therefore, need careful consideration. Sinead Tynan and Paul Jerram present conclusions from a discussion with stakeholders from England and Wales

Rosiglitazone — managing the change to a suitable alternative product

October 2010

Now that rosiglitazone has had its product licence suspended clinicians will need to consider switching patients to alternative agents. Mark Peasley, clinical pharmacist at Aintree University Hospitals NHS Foundation Trust, provides some guidance 

Emerging concerns with PPI therapy

September 2010

Proton pump inhibitors have transformed the management of upper gastrointestinal acid-related disorders but potential consequences of potent acid suppression are now emerging. With this year marking the 21st anniversary of the launch of these medicines in the UK and pantoprazole recently joining omeprazole as an over-the-counter option, Angus Thompson highlights some of the concerns

Mesalazine: is changing to the cheapest really cost-effective?

August 2010

With over a dozen mesalazine products available for ulcerative colitis, choosing between them can be difficult. Anja St.Clair Jones discusses some of the factors that prescribers should consider. Choice should not be based on cost alone, she says, but should take into account current management strategies and adherence

Plugging a prescribing hole with formulation and compounding skills

August 2010

What can you do when an effective medicine is discontinued and alternatives are just not the same? Ray Bunn, a community and palliative care pharmacist, describes how his pharmacy went back to basics to maintain the supply of a preparation for mouth ulceration in palliative care patients and avoid his local hospice having to pay the high cost of the product as a commercially procured unlicensed special

Better MURs for patients with chronic pain

June 2010

Susan Youssef, senior lecturer at De Montfort University and community pharmacist with Dean & Smedley Ltd, describes some of the problems encountered during medicines use reviews with people with chronic pain and ways of improving care for these patients

Primary care pharmacist initiating insulin

April 2010

Daljinder Singh Sidhu, senior pharmacist at Sandwell Primary Care Trust, describes his journey to competence in initiating insulin and establishing a pharmacist-led diabetes clinic

Medicines management on the move

February 2010

The pharmacy department at Gateshead Health NHS Foundation Trust has commissioned a number of initiatives to enhance the medicines management service to patients having surgery. Mark Thomas, Neil Gammack, Lynsey Curry, Angela Hempel, Peter Clarke and Andrea Watt describe this continual service improvement and the introduction of bedside medicines management through a mobile dispensing unit

Onwards and upwards with target MURs

January 2010

As the Government looks to move forward with targeted medicines use reviews, what do we already know about which patients can be effectively targeted and how best to deliver the service? Carina Livingstone, associate director, clinical pharmacy, East and South East England Specialist Pharmacy Services, describes a range of target MUR projects at various stages of development and highlights some problems and successes 

Taking the apathy out of depression — is it time to revisit your formulary?

December 2009

Paul Jerram, head of medicines management at Isle of Wight NHS primary care trust, gives a personal view on antidepressant prescribing

Vision of a day when prescribing is embedded in pharmacy practice

October 2009

Nine months ago, Anne Fittock took up a part-time post as one of two national non-medical prescribing advisers at the National Prescribing Centre. Lin-Nam Wang talks to her about her role, the current state of pharmacist prescribing and her vision for the future

Peer review offers from NHS Education Scotland

August 2009

You might be happy with your consultation skills but have you ever wondered what your peers would make of them? Since May 2008, pharmacists in Scotland have had the opportunity to send video tapes or DVDs of their consultations to NHS Education for Scotland for peer review. Lin-Nam Wang reports 

Medicines management for one patient revealed gaps we could fill

July 2009

Lelly Oboh, consultant pharmacist, care of older people, and Jen Stevenson, STEP pharmacist, both at Lambeth Primary Care Trust, report on a case that highlights the need to develop local health community clinical pharmacy teams to lead joint working for older people 

New controlled drugs resource available online

July 2009

Pharmacists and anyone involved in the management and prescribing of Controlled Drugs now have access to a new online resource. The National Prescribing Centre has launched a micro-site to support the safe and effective use of CDs

Do we know how many of our MUR recommendations are followed?

June 2009

Many pharmacists work with targets for medicines use reviews in mind. They also make many recommendations that improve patient care as a result of MURs. But just how many of these recommendations are followed? Alf Choudhury, a community pharmacist in Great Yarmouth and Waveney, looked into the results of his MURs using patient medication records and patient feedback

How Stoke-on-Trent is keeping its prescribing budget under control

May 2009

Gareth Malson and Lin-Nam Wang talk to the head of medicines management at NHS Stoke-on-Trent, about incentive schemes to change prescribing behaviour and how switching from a macro- to micro-management system can lead to better control of resources 

How to ensure you are not failing warfarin patients

April 2009

The uptake of National Safety Patient Agency anticoagulant guidance has been slow. Susan Youssef, a community pharmacist and senior lecturer in pharmacy practice at DeMontfort University, explores some of the surrounding issues 

How we made monitored dosage systems an option for more patients

March 2009

Thinking of automation? Steve Mayers, pharmacy manager at Nottinghamshire Healthcare NHS Trust, a mental health and learning disabilities trust, explains why his pharmacy chose to automate the dispensing of monitored dosage systems and the benefits of doing so

Criminal justice sector prescribing

February 2009

Graham Parsons works for the Plymouth Primary Care Addiction Service, specialising in treating opioid dependence. He describes how pharmacist prescribing in the criminal justice sector operates and gives tips to pharmacists who want to get involved

Type 3 reviews in Brighton and Hove: a service in development

January 2009

Helena Stimpson, a pharmacist in East Sussex, describes her work developing and providing a type 3 clinical medication review service 

Patients with asthma: problems revealed by medicines use reviews

March 2008

Locum pharmacist Perry Melnick has been conducting medicines use reviews since May 2005. This year, with the help of pharmacy manager Lee Doherty, he has already performed over 300 at Manor Pharmacy, his regular locum spot in Letchworth. In this article, he shares some of his experiences of MURs for patients who have asthma

Drug Utilisation Research Group

March 2008

Lin-Nam Wang reports highlights from the 19th annual scientific meeting of the Drug Utilisation Research Group held in London in February 2008

NPC launches interactive prescribing and medicines management resource

December 2007

A novel online interactive learning resource, NPCi, aimed at NHS health care professionals and managers, has been launched by the National Prescribing Centre. According to Steve Morris, director of strategic development and operations at the NPC, despite significant efforts, there is patchy implementation of evidence and often a lack of access to high quality education and materials on therapeutics and medicines management

Current issues affecting PCO activity

December 2007

Peter Burrill, specialist pharmaceutical adviser for public health at Derbyshire County Primary Care Trust, looks at medicines management issues, including current target-driven prescribing, from the point of view of primary care organisations

Taking on new areas of practice by becoming an independent prescriber

December 2007

Lorraine Lanchbury describes how qualifying as an independent prescriber in February 2007 has increased the services she can offer

How supplementary prescribing can work in a substance misuse service

December 2007

Clare Bellingham finds out how one community pharmacist has set up a supplementary prescribing service in substance misuse, and worked out how to computer-generate prescriptions along the way

How mental health trusts are making changes to medicines management

July 2007

In January 2007, the Healthcare Commission published a report, “Talking about medicines”, which painted a picture of neglect of medicines management in mental health trusts (MHTs) in England and Wales. Lin-Nam Wang reports on the changes that have taken place since the report

First fellowship of FPMM announced

July 2007

Peter Burrill, a specialist pharmaceutical adviser in public health at Derbyshire County Primary Care Trust, qualified as the first fellow of the Faculty of Prescribing and Medicines Management in April 2007

Patients with diabetes: problems revealed by medicines use reviews

July 2007

Last year (2006), Nuria Laiglesia performed over 400 medicines use reviews at Alliance pharmacies in Norwich. In this article, she shares some of her experiences of reviews with patients who have diabetes

Independent prescribing — from back seat passenger to driver

July 2007

In February 2007, Alison Doherty was one of the first pharmacists to qualify as an independent prescriber in England. In this article she describes her first six months

Hampshire medicines management project saves NHS over £1 million

April 2007

Brian Curwain, chief pharmacist for Hampshire Primary Care Trust (West), reports on a combined savings effort across two PCTs

Secondary care can support PCT aims

April 2007

Better communication between primary and secondary care allows hospitals to help primary care trusts meet their prescribing targets, according to research presented at the annual scientific meeting of the Drug Utilisation Research Group in February 2007

Failings in the system: a case study (root cause analysis)

April 2007

One of the misconceptions about root cause analysis (RCA) is that its only purpose is to look at the primary cause of an incident. In fact, RCA looks for all the interventions after an incident or error that might have been an opportunity to rectify the problem. The case study in this article involves a patient who was prescribed two different beta-blockers for more than a year

Benefits of becoming an FPMM member

April 2007

Anil M. Patel, a community pharmacist and supplementary prescriber based in Kingston upon Thames, explains the benefits of becoming a member of the College of Pharmacy Practice's Faculty of Prescribing and Medicines Management

Why many GPs ignore MUR forms

December 2006

In this article, Howard Stoate, GP and chairman of the All Party Parliamentary Group on Pharmacy, gives his perspective on MURs

How I have used root cause analysis

December 2006

In this article, Graham Lavender, a supplementary prescriber in a Southampton GP practice, describes three cases in which medication reviews did not result in an intended outcome and how applying root cause analysis allowed him to learn from each

Collaborative awards presented at gala

December 2006

Last month the National Prescribing Centre hosted a gala ceremony to celebrate the medicines management collaboratives. Olivia Timbs (editor of The Pharmaceutical Journal) reports

What makes appropriate prescribing?

June 2006

By Stephen Chapman Since the original Crown Report on non-medical prescribing, we have moved rapidly from patient group directions and supplementary prescribing by non-medical health care professionals, to the dawn of independent prescribing by pharmacists and other non-medical health care professionals

Prescribing needs a recognised model

June 2006

Pharmacist prescribing is lacking a recognised national model that the health service understands. This is one of the emerging findings from a piece of research into pharmacist supplementary prescribing carried out by Amanda Evans, deputy head of medicines management and non-medical prescribing lead at Burntwood, Lichfield and Tamworth Primary Care Trust

How new prescribers can limit liability

June 2006

The Department of Health working definition of independent prescribing was published in April. This definition is important because of the weight that is likely to attach to it when courts have to decide whether independent prescribers are meeting standards, Alison Gulliver, a solicitor at Capsticks, said at a conference on non-medical prescribing held at the Royal Society of Medicine in May 2006

Is this the beginning of the end for supplementary prescribing?

June 2006

Independent prescribing became legal on 1 May 2006 with pharmacists in England being allowed to prescribe any licensed medicine (except Controlled Drugs) without clinical management plans

A new framework and accreditation process for membership of FPMM

June 2006

The Faculty of Prescribing and Medicines Management (FPMM) was established in 2001 as a distinct semi-autonomous professional body within the College of Pharmacy Practice. It provides professional support for pharmacists in the UK, from any professional background, who are working, or are interested in working, in the specialist area of prescribing and medicines management

Pharmacist prescribers: is finding a mentor a barrier to accreditation?

April 2006

By Clare Bellingham With more pharmacists taking up prescribing, there have been murmurs about a potential shortage of GP mentors. Clare Bellingham investigates. In order to enrol on a supplementary prescribing course, pharmacists need two things: a medical supervisor and a specified service for which prescribing will be required

Funding and lack of access to records could slow progress of independent pharmacist prescribing

April 2006

Concerns that a lack of funding could hinder the progress of independent prescribing were raised at a meeting in London

How to make MUR accreditation easy

April 2006

By Chris Rose Pharmacists who want to offer medicines use reviews need to get accredited. Chris Rose, communications lead for Essex Local Pharmaceutical Committee, describes a mass accreditation organised by his LPC

FPMM aligns with national agendas

April 2006

By Bruce Warner and Ros Grant Bruce Warner and Ros Grant, board members of the Faculty of Prescribing and Medicines Management, describe changes to faculty requirements

Awards for prescribing and medicines management

January 2006

Servier Laboratories has launched the Servier Prescribing and Medicines Management Awards. The awards support the implementation of educational and clinical initiatives and fund project development in the areas of osteoporosis, coronary heart disease and diabetes

Focus on prescribing science will grow

December 2005

In this article, Hugh McGavock, visiting professor at the University of Ulster, Northern Ireland, explains why prescribing science is important

Supplementary prescribing one year on

December 2005

Fiona Reid, primary care pharmacist for cardiovascular disease, describes her year with a hypertension and cardiovascular risk reduction clinic

Learning from practice experiences

December 2005

By Nina Barnett and Jane Nicholls Nina Barnett, specialist pharmacist for older people, North West London Hospitals NHS Trust, and Jane Nicholls, project lead, London Pharmacy Supplementary Prescribing Team, describe a two-year-old supplementary prescribing service for older people in Harrow

Contributing to a QOF assessment

December 2005

In August 2004, the medicines management team at Central Liverpool Primary Care Trust was faced with the challenge of contributing to the PCT's first annual Quality and Outcomes Framework assessment and review. Rachel Mullen, practice pharmacist, and Janet Decamp, deputy director of medicines management, both at Central Liverpool PCT, report

Helping to avoid hospital admissions

September 2005

Zoë Gross reports on Various initiatives, supported by the National Prescribing Centre's medicines management collaborative programmes, which are seeking to address how better medicines management can help avoid hospital admissions

Prescribing for hypertension and more

September 2005

Years of frustration with not being able to prescribe dissolved with the news that pharmacists were to be allowed to become supplementary prescriber. Mohammed Ahmed, a prescribing practitioner at Doncaster West Primary Care Trust, shares his experiences of supplementary prescribing

Thoughts on independent prescribing

September 2005

In this article, Hugh McGavock, visiting professor of prescribing science, University of Ulster, Northern Ireland, explains why he supports supplementary prescribing but not independent prescribing

How to implement supplementary prescribing in primary care clinics

September 2005

In this article, Bola Sotubo, pharmacist supplementary prescriber at Melbourne Grove Practice, Southwark, and Karen Acott, pharmacist supplementary prescriber and partner, Wallingbrook Health Centre, Devon, give tips for successful supplementary prescribing

Approaches to medication reviews

June 2005

By Clare Bellingham Do pharmacists, doctors and nurses take different approaches to medication review?

What PCTs achieve with the Medicines Management Services Collaborative

June 2005

Rachel Farrall and Ian Pye, both assistant programme developers in the medicines management team at the National Prescribing Centre, relate some achievements of primary care trusts through the Medicines Management Services Collaborative

Prescribing in a rheumatology clinic

June 2005

Mark Thomas, lead clinical pharmacist for ward services at the Queen Elizabeth Hospital, Gateshead, details his experience of setting up a supplementary prescribing rheumatology clinic

Making improvements across an SHA

June 2005

Sarah Alton and Steve Morris, member and chairman, respectively, of the Faculty of Medicines Management, describe the actions taken in South Yorkshire to encourage joint working and to improve medicines management across an entire health community

What the renal-specific medicines management document has achieved

March 2005

Next month sees the first anniversary of the Department of Health’s guidance on renal specific-medicines management (Renal specific management of medicines: a resource document for aspects specific to the NSF for Renal Services). In this article, Zoe Gross looks at how renal pharmacists have responded to the document over the past year and their plans for the future

Benzodiazepine withdrawal at a pharmacy technician-led clinic

March 2005

Prescribing support technician Helen Williams and prescribing adviser Maxine Orwin have almost done away with pharmacists! In this article they describe a benzodiazepine withdrawal scheme in North Eastern Derbyshire Primary Care Trust, which employs pharmacy technicians

Technicians — include or exclude?

March 2005

Steve Morris, chairman of the Faculty of Prescribing and Medicines Management board, asks who will support pharmacy technicians

When all pharmacists work together

December 2004

In one West Midlands PCT area pharmacists from the trust, practices and the community work together. Debbie Andalo reports

Supplementation with calcium and vitamin D: Isle of Wight PCT strategy

December 2004

In this article, Paul Jerram, head of medicines management, David Turner, chairman of the PCT prescribing committee, and Margaret Squibb, lead nurse Isle of Wight prescribing team, describe a local initiative to reduce hip fractures through supplementation with calcium and vitamin D 

Training receptionists on repeat prescribing designed to improve safety

December 2004

In this article, nurse Sam Bolankis, medicines management project facilitator at Kingston Primary Care Trust, describes a project undertaken over the past 10 months intended to improve the safety and efficiency of repeat prescribing

Scheme publicly puts to the test the industry’s confidence in its own drugs

December 2004 

Debbie Andalo describes a programme in which GP practices in North Staffordshire teamed up with a drug company with the aim of reducing patient risk of coronary heart disease, reducing costs to the NHS and meeting Government clinical targets

Gear up for Ask About Medicines Week

October 2004

Gear up for Ask About Medicines Week 2004, which is scheduled to take place in a month’s time during the first week of November.

How to encourage the general public to take their medicines responsibly

October 2004

Following the huge success of our Ask About Medicines event in 2003, a collaborative initiative between South and Central Manchester Primary Care trusts, South Manchester prescribing team is to host a further Ask About Medicines Week event on 4 November, says Ashley Harling

CPPE helps pharmacists incorporate concordance into everyday practice

October 2004

The Centre for Pharmacy Postgraduate Education has been running a concordance programme to help pharmacists become more involved in patient partnership. Zoë Gross investigates 

Supplementary prescribing provides a great deal of professional satisfaction

October 2004

Pharmacists have come a long way in a short time since they were allowed to become supplementary prescribers, says Debbie Andalo

Pharmacists in St Helens take on new services in advance of contract deal 

July 2004

Pilot projects in St Helens Primary Care Trust anticipate the new pharmacy contract. Debbie Andalo investigates 

How supplementary prescribing is working for pharmacists in practice

July 2004

At the start of this week, 97 pharmacists had registered with the Royal Pharmaceutical Society as supplementary prescribers and the number is rising all the time. Clare Bellingham finds out how the early starters are getting on 

Faculty goes from strength to strength

July 2004

Annie Coppel, chairman of the faculty of prescribing and medicines management, College of Pharmacy Practice, describes the faculty's work 

Pharmacists and GPs work together to support benzodiazepine withdrawal

March 2004

Many patients want to stop taking benzodiazepines. Debbie Andalo finds out how they can be helped 

Minor ailments scheme now involves over a third of Sheffield's pharmacists

March 2004

A community pharmacy minor ailments scheme in Sheffield is widening as increasing numbers of GPs opt in to the project and patients attest to its value. Naomi Kempner reports