Rational Prescribing Flashcards
1
Q
Rational Prescribing
A
- Parish states they prescribing should be
- Necessary
- Effective
- Safe
- Appropriate
- Economic
2
Q
Necessary
A
- Self limiting conditions
- To end a consultation
- Treat by lifestyle changes
- Iatrogenic disease
3
Q
Effective
A
- What is the evidence base
- Generally applies to a group of drugs
- NNT
- Approved by NICE
- Current guidelines
4
Q
Knowledge- Which ones are evidence based
A
- Undergrad education
- Postgrad education
- Journals
- Guidelines
- CCGs guidance
- Colleagues
- Pharmaceutical industry
5
Q
NNT/NNH
A
- NNT- expresses the number of people who would need to receive an intervention to prevent one event of interest
- NNT = 1/ARR
- NNH- Expresses the number of people who would need to receive an intervention for one person to suffer a harmful event of interest
6
Q
National Institute for Health and Care Excellence
A
- Procedure- evidence based guidance and advice for health, public health and social care practioniers
- Develop quality standards and performance metrics for those providing and commissioning health, public health and social care services
- Provide a range of informational services for commissioners, practioners and managers across the spectrum of health and social care
7
Q
Reliable sources of evidence
A
- NICE guidelines
- NICE
- NSF
- SIGN
- National specialist interest groups
- Cochrane
- CKS
8
Q
Levels of evidence
A
- 1- Meta-analysis, systematic review, RCT
- 2- Case control and cohort studies and systematic reviews
- 3- Non-analytical studies
- 4- Expert opinion
9
Q
What is evidence based practice
A
- EBP is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient
- It means integrating individual clinical expertise with the best available external clinical evidence from systematic research
10
Q
Safe
A
- Side effect profile
- Black triangle
- CHMP warnings
- Safe for that patient
11
Q
Appropriate
A
- Intentional and non-intentional, non-compliance
- Regimen, Ability to take/use
- Co-morbidity
- Renal/Hepatic function
- Drug interactions
12
Q
Economic
A
- The LAST, NOT the first thing to consider
- Cost-effectiveness not cost minimisation- think wider than drugs
- Premium-price preparations
- MR, isomers, posh delivery, modes
13
Q
Generic prescribing
A
- England, generic prescribing rate was 83.7% in 2017
- England, generic dispensing rate was 77.6% 2017
- Compared to early-mid 1990s
- Prescribed- 41%
- Dispensed-35%
14
Q
Generic prescribing- advantages
A
- Saves money
- One name reduces potential for confusion
- Guide to the drug’s pharmacology
- Improves stock control
15
Q
Generic prescribing- disadvantages
A
- Patient confidence and confusion because of differing
- Sizes, shapes, colours, packaging
- Different excipients can cause ADRs
- Problems recalling faulty medicines if using subcontractors to manufacture