Optimising Insulin Pen Needles Following a review of insulin pen needles NHS Telford and Wrekin CCG now recommends the use of GlucoRx FinePoint Pen Needles. GlucoRx FinePoint Pen Needles are a high quality screw on insulin pen needle which will fit all major insulin delivery pen devices currently available. (Appendix 1) GlucoRx FinePoint Pen Needles are available in a complete range of sizes from 4mm to 12mm. GlucoRx FinePoint Pen Needles Range Available Sizes Pack Sizes 4mm/31g 100 5mm/31g 100 6mm/31g 100 8mm/31g 100 10mm/29g 100 12mm/29g 100 Prescribing Guidance For most patients 4mm, 5mm, and 6mm pen needles are recommended For adults, there is no clinical reason for recommending needles longer than 8mm Following consultation if appropriate patients should be switched to a shorter length needle For children and adolescents, there is no clinical reason for using needles longer than 6mm. Using needles of a shorter length (6mm or less) helps to prevent intramuscular injection of insulin. (IM injection of insulin should be avoided as it can result in unpredictable blood glucose levels) All needles are for single use only. To avoid confusion, the needles should be prescribed by the brand name (i.e. GlucoRx FinePoint). To find the required GlucoRx needles that you wish to prescribe in EMIS, type GlucoRx and the needle length in the drug name box (e.g. GlucoRx 6) and then select GlucoRx FinePoint hypodermic insulin needles from the list. Identifying patients who should be switched to GlucoRx FinePoint Pen Needles A search identifying patients who are currently prescribed non formulary insulin pen needles can be found in Enterprise Search and Reports. Open the Switch Recommendations folder in the Medicines Management folder. The search is called Non Formulary Insulin Pen Needles. All patients highlighted in this search are suitable for a switch to an equivalent GlucoRx FinePoint Needle. On the following pages you will find screen shots of EMIS screens to support a switch to GlucoRx FinePoint Pen Needles. Messages should be added to the new pen needle to ensure the patient is aware of the change in prescription. A sample patient letter is also available if necessary (Appendix 2). If a change in needle size is considered necessary the patient should be contacted to arrange a review before their prescription is altered.
Standard Operating Procedure for switching to GlucoRx FinePoint Pen Needles 1) Insulin pen needles may be prescribed by brand name or generically as Hypodermic Insulin Needles For Insulin Pen Needles that are currently prescribed by brand name (e.g. BD Microfine)- highlight the currently prescribed Insulin Pen Needle. Right click on the item and select GT/Switch. For patients prescribed Pen Needles generically (i.e. Hypodermic Insulin Needles) go to step 4 2) A Generic/Trade switch box will appear - Select OK
3) The prescribed Pen needle will be switched to its generic name. 4) Highlight the generically prescribed Insulin Pen Needle. Right click on the item and select GT/Switch.
5) Select the equivalent GlucoRx Insulin Pen Needle A Generic/Trade switch box will appear. This new prompt will allow you to select the new equivalent branded GlucoRx preparation. Scroll down till you find the required preparation. 6) The new recommended preparation will now appear in the patient medication list
7) To communicate the prescription change you can add a message for the patient and the pharmacy Highlight the prescribed Insulin Pen Needle. Right click on the item and select EDIT 8) Add a message for the patients and the pharmacy to communicate the change Add a Patient / Pharmacy note to communicate the change in prescription. If you are reviewing multiple patients you can cut and paste these prescription notes. See below for guidance on the text to be added to these boxes. Text for Pharmacy Note Insulin Pen Needles have now been prescribed by the brand name GlucoRx FinePoint There are no changes to the needle size - Please let patient know about this change. Text for Patient Note Your Insulin Pen Needles have now been prescribed by the brand name GlucoRx FinePoint There are no changes to the needle size.
9) New formulary insulin pen needles appear in patient medication profile Patient / Pharmacy notes will appear below the new pen needle. These notes will also appear on the prescription to inform the pharmacy and the patient about the prescribing change
Appendix 1
Appendix 2 Sample patient letter (where there is no change to the patient s needle size) Dear. Medical Practice is currently reviewing all patients who are prescribed insulin pen needles. We are bringing our prescribing in line with local guidance. Next time you receive a prescription for your insulin pen needles you will notice that we have changed the brand that we prescribe. Insulin pen needles will now be prescribed by the brand name GlucoRx. These needles are the same as your previous insulin needles; they are just made by a different manufacturer. There is no change to how you use the needles and you should not notice any difference between GlucoRx and your previous needles. This change has been made to help doctors to continue to use high quality products whilst making the most effective use of available resources. We plan to introduce this change with your next prescription. Please finish your current pen needles before starting your new ones. Should you have any queries, please do not hesitate to contact the practice. Yours sincerely