Resources to support prescribing practice Flashcards
Examples of sources of medicines information:
- British National Formulary (BNF)
- BNF for Children
- Monthly Index of Medical Specialties (MIMS)
- Summary of Product Characteristics (SPC) available online as the Electronic Medicines Compendium
- College of Optometrists ‘Optometrists Formulary’
Features of British national formulary:
- Bi-annual publication produced jointly by the British Medical Association and the Royal Pharmaceutical Society of Great Britain
- The BNF is designed as a rapid reference source covering medicines that are generally prescribed in the UK
- For each drug indications i.e use , cautions, contraindications and side effects are listed
- Joint publication published twice a year
- It is published in book form in March and September each year and the latest BNF can be accessed online
Features of BNF for children:
- BNF for Children (BNFC) provides essential practical information to all healthcare professionals involved in the prescribing, dispensing, monitoring, and administration of medicines to children.
- It encourages the safe, effective, and appropriate use of medicines for the management of childhood conditions.
- As many medicines are not licensed for use in children, BNFC includes authoritative advice on licensed as well as unlicensed and “off-label” use of medicines for children from birth up to the age of 18 years.
- Produced in collaboration with institute of drug health
NICE BNF and BNFC Apps:
National Institute for Health and Clinical Excellence (NICE) has developed an App to improve access for NHS staff in England to the British National Formulary (BNF)
Features of monthly index of medical specialties:
- MIMS is published by Haymarket Medical Ltd and provides up-to date information about prescription medicines as well as a number of over-the-counter (OTC) preparations.
- At gps and pharmacies
- An annual subscription provides access to quarterly issues of MIMS in print (available upon request) as well as access to MIMS online https://www.mims.co.uk/
Features of Electronic Medicines Compendium:
- This online resource http://emc.medicines.org.uk/ provides the Summary of Product Characteristics (SPC) and Patient Instruction Leaflets (PIL) for the majority of medicines that are available in the UK.
- SPC provide comprehensive information about a particular drug e.g. indications, cautions, use in pregancy/lactation, contraindications, formulation
Features of Optometrists Formulary:
- Available to members of the College of Optometrists
- Contains information on all drugs available to optometrists
College of Optometrists Clinical Management Guidelines: History:
- The Report on the Review of Prescribing, Supply and Administration of Medicines (the Crown Review) was published in 1999 recommending non-medical prescribing
- Changes to the General Optical Council’s Rules of Referral, which came into effect on 1st January 2000
- A joint venture between the College of Optometrists and the Department of Optometry and Visual Science, City University, was established in 2001 to develop clinical management guidelines to inform and underpin optometric therapeutic prescribing practice when it came about
- Independent prescribing for optometrists was agreed by the Commission on Human Medicines (CHM) at its meeting on 15th June 2007 and training course began in 2008 and a specialist register of therapeutic prescribers was established by the GOC in the same year
College of Optometrists Clinical Management Guidelines: Background:
- CHM’s recommendation was that suitably qualified optometrists should be able to prescribe any licensed medicines (except for controlled drugs or medicines for parenteral (injected) administration) for ocular conditions affecting the eye, and the tissues surrounding the eye, within their recognised area of expertise and competence.
In making the recommendation, the Commission made clear that the extent of independent prescribing for optometrists would be controlled in detail through guidelines. - Therefore, while these amendments to medicines legislation enable an optometrist independent prescriber to prescribe any licensed medicine, except for controlled drugs or medicines for parenteral administration, the College of Optometrists will provide clinical guidelines, and the General Optical Council (GOC) will amend its rules, to ensure that optometrist independent prescribers only prescribe licensed medicines for ocular conditions affecting the eye, and the tissues surrounding the eye, within their recognised areas of expertise and competence
College of Optometrists Clinical Management Guidelines:
- Provide guidance to optometrists on the pharmacological and non-pharmacological management of eye disease
- Provides information on investigations and criteria for referral
- 58 guidelines have been developed
- Evidence-based (informed by current best research evidence)
- Developed by a team comprising ophthalmologists and optometrists
- Peer reviewed by a multidisciplinary group of optometrists and ophthalmologists
All CMGs conform to a common format. The clinical presentation and management of each condition is …
- Aetiology
- Predisposing Factors
- Symptoms
- Signs
- Differential Diagnosis
- Management by Optometrist
- Management category
- Possible management by Ophthalmologist
- Evidence base
Management category conditions
The management category provides referral guidance for optometrist therapeutic prescribers. Conditions are defined as sight-threatening (A) or not normally sight-threatening (B). These categories are sub-divided as follows:
A: conditions that are sight-threatening
1: emergency referral to an ophthalmologist
2: first aid measures followed by urgent referral to an ophthalmologist
3: urgent referral to an ophthalmologist
B: conditions that are not normally sight-threatening
1: possible prescription of drugs; routine referral
2: alleviation or palliation; no referral
3: management to resolution
