Minutes of Rotherham Medicines Optimisation Group (RMOG)

Transcription

1 Minutes of Rotherham Medicines Optimisation Group (RMOG) Date/time: Venue: Chair: Minutes: Wednesday 4 th October, 1pm 3pm Pharmacy Seminar Room, A level, Rotherham Hospital Osman Chohan, Chief Pharmacist TRFT Jill Brown/Surinder Ahuja 1 Attendance Osman Chohan (OC) (Chair) Surinder Ahuja (SA) Khuram Amini (KA) Stephen Davies (SDa) Susan Douglas (SDo) Umair Hamid (UH) Sophie Holden (SH) Stuart Lakin (SL) Diana Mowbray (DM) Ruth Roddison (RR) Carole Taylor (CT) Chief Pharmacist, TRFT Formulary/Governance Pharmacist Oncology Pharmacist Chief Pharmacist, RDaSH Consultant Surgeon (ENT) Medicines Information Service Manager GP Lead, RCCG Head of Risk Management CCG Clinical Pharmacist, Paediatrics TRFT NMP Lead Deputy Chief Pharmacist In Attendance Apologies Quoracy Joanne Rose agenda item 6.1, Dr Watve agenda item 6.2 Ellie Monkhouse The meeting was quorate 2 Declarations of interest None declared 3 Minutes of the last meeting Minutes of the last meeting were accepted as a true and accurate record. 4/5 Matters Arising /Action Log Minutes and Action log discussed. Actions on the action log taken in turn and log updated.

2 6 Formulary Requests 6.1 Opicapone (Ongentys ) Submitted by Joanne Rose, Parkinson s Specialist Nurse Indicated for or use as adjunct therapy to levopoda/ddci preparations in adults with Parkinsons Disease. To be prescribed/initiated on the advice of specialist in Parkinson s Disease. To be classed as an amber drug (Specialist to initiate and stabilise; GP to continue supply once stabilised) SL requested Ms Rose to attend a GP training event (to be organised). 6.2 Botulinum toxin (Dysport Submitted by Sachin Watve, Consultant Neuro-rehabilitation Indicated for Spasticity management Dysport has different potency to Xeomin. The Group wanted to know how Dr Watve intended to use Dysport brand of botox in order for Mr Watve to determine whether Dysport had a longer lasting effect than Xeomin brand. Dr Watve Dr Watve agreed to produce a flow chart describe exactly which patient group(s) would be included in the trial of Dysport brand and bring back to RMOG. Also to conduct an audit after 6 months of use and bring results to RMOG (likely approx. Aug/Sept 2018) To be cross charged to the CCG with Bluteq form completion. 6.3 Carfolzomib for previously treated multiple myeloma (NICE TA 457) Agreed for use in line with NICE and NHS England commissioning position. Funded through Cancer Drug Fund. A Bluteq entry and approval required from clinician before use. 7 RMOG Annual Work Plan Terms of Reference to be finalised at November meeting 8 Guidelines/ Policies/ Procedures Name of Committee: Rotherham Medicines Optimisation Group Page 2 of 6

3 8.1 Prescribing guidelines for patients with chronic open angle glaucoma and ocular hypertension subject to minor amendments. 8.2 Review of Omega 3 treatment NHS Rotherham Clinical Commissioning Group has requested that practices stop prescribing omega-3 supplements for the following conditions where the evidence base has historically been weak or limited: Autism Attention Deficient & Hyperactivity Disorder (ADHD) Depression Prevention of cardiovascular problems (heart attacks / strokes) Familial hypercholesterolemia To prevent side effects caused by certain drugs Patients wishing to continue taking omega-3 supplements will be advised that they can be purchased from supermarkets, pharmacies, discount stores and health food shops. SDa expressed concern that consultants at RDaSH had not been consulted. There is a risk that mental health patients, particularly those on the autism spectrum, who are on omega-3 products having exhausted other options may deteriorate if unable to get supplies through their GP. SDa reminded RMOG members of the potential impact of unilateral action and that the purpose of RMOG was for consultation and discussion between all partners. A clinician to clinician discussion about these patients and a review was suggested as a minimum. SDa asked that the letter to be sent to all affected patients be available in an appropriate reading level, especially if they are on the autism or ADHD spectrum, in order to communicate the intentions effectively SL Name of Committee: Rotherham Medicines Optimisation Group Page 3 of 6

4 9. PGD s (proposals and approvals) 9.1 Proposal: Lidocaine 1% - Breast screening 9.2 NHS England: Influenza vaccine Renewal: Local anaesthetics for colposcopy 10 Formulary Issues 10.1 Medicine Shortages Polyfax ointment - look for alternatives and communicate choices to areas currently using Polyfax (Dermatology, ENT and A&E) Piperacillin/tazobactam (generic) limited supplies available still; alternatives are being utilised Sastravi pack size 30 - only 100 pack size available SDa informed the Group that Disulfiram was out of stock with no alternative available. Generic Duloxetine is currently unavailable; supplies of the Cymbalta brand remain unaffected. UH 10.2 For Information Traffic Light classifications: Bupropion/naltrexone Mysimba - Red on account of unfavourable NICE guidance Liraglutide- Saxenda - Amber. GP to continue only if the patient is participating in a Public Health England commissioned weight loss programme that has initiated the medication. There is no weight management programme in Rotherham currently. 11 New NICE Guidance 11.1 Technology Appraisals/NICE Guidance Dimethyl fumarate for treating moderate to severe plaque psoriasis Ninety days to action. Bring to next RMOG Name of Committee: Rotherham Medicines Optimisation Group Page 4 of 6

5 12 Bulletins/Newsletters For Information To work with Dermatology consultants Specialist initiation Red drug MHRA Drug Safety Update September 2017 Miconazole (Daktarin): over-the-counter oral gel contraindicated in patients taking warfarin Loperamide (Imodium): reports of serious cardiac adverse reactions with high doses of loperamide associated with high doses of loperamide associated with abuse or misuse page 12.2 Items which should not routinely be prescribed in primary care: A Consultation on guidance for CCGs 12.3 Horizon Scanning September Quality (Safety, Effectiveness, Experience) Guidance recommends a blanket ban on prescribing Omega -3 treatment for resistant depression. SD expressed concern that RDaSH consultants were not consulted in the first place and that this type of patient would require appraisal before stopping prescribing Omega -3, the need to be mindful of the consequences for this group of patients. To be discussed at RDaSH meeting with a Rotherham CCG representative present. For Information Nil to note 14 Minutes of Sub Groups Medication Safety Group Minutes - noted 15 Minutes of other Groups Nil to note 16 Items approved by Chair outside of the meetings: Brivaracetam tablets: Consultant Neurologist Mucilage: Palliative Care Isosorbide dinitrate MR 20 mg: for a NOMAD 17 Items for escalation Name of Committee: Rotherham Medicines Optimisation Group Page 5 of 6

6 18 Any other business 18.1 Sterimar Nasal Spray On patient to buy CCG document. SDo expressed concern as this spray is used post-op and used 4-6 weeks after. Prescribed in clinic and GP for repeat prescription Pharmacy to look at ENT usage CCG to investigate OC SL 19 Date and time of next meeting Wednesday 1st November pm 3pm Boardroom, D Level, Rotherham Hospital Name of Committee: Rotherham Medicines Optimisation Group Page 6 of 6