Think Issue 19 July 2016 Medicines!Joint Prescribing Group Edition SHARED CARE

ORAL NUTRITIONAL NINTEDANIB for Idiopathic WHAT’S NEW OR CHANGED? SUPPLEMENTS (ONS) IN CARE pulmonary fibrosis. RASAGILINE for the treatment of HOMES CPJPG recommendation: SHARED CARE (prescribing to remain with idiopathic Parkinson's disease. Regulation 14 of the Care Quality secondary care, primary care to CPJPG recommendation: SPECIALIST Commission Guidance for Providers assume responsibility for INITIATION for patients who are intolerant is very clear that homes are monitoring). or have a contraindication to selegiline responsible for assessing and making Supporting resources: CCG Drug only. the necessary arrangements for the Classification Table, NICETA379, NOT RECOMMENDED as a neuro-protective/ provision of suitable nutrition and Shared Care Guideline. disease modifying therapy. hydration for all residents. Supporting resources: CCG Drug CICLOSPORIN (Neoral®) for Prescribing of ONS is no longer Classification Table, Evaluation Summary. inflammatory dermatoses. supported for care home residents CPJPG recommendation: SHARED DOSULEPIN for the treatment of symptoms except in defined circumstances: CARE. of depressive illness especially where an  Patients with motor neurone Supporting resources: CCG Drug anti-anxiety effect is required. disease. CPJPG recommendation: NOT Classification Table, Shared  Patients with head and neck RECOMMENDED. Care Guideline. cancer. Supporting resources: CCG Drug  Patients receiving sip feeds via a Classification Table, Evaluation Summary. PEG tube. GUIDANCE ON THE COVERT INSULIN DEGLUDEC (Tresiba®): an ultra-  Patients with pressure ulcers who ADMINISTRATION OF MEDICINES long acting basal analogue insulin. require a short term high protein IN CARE HOMES CPJPG recommendation: RECOMMENDED – diet to support healing. All care home providers must SPECIALIST INITATION. Prior approval form There is also the option of have clear procedures for to be completed by the initiating specialist purchasing “over the counter” arranging for covert (to follow). supplements such as Complan® or administration of medicines SACUBITRIL VALSARTAN (Entresto®) for Nurishment®. where there is potential risk to a treating symptomatic chronic heart failure resident if treatment is not The CCG policy and leaflets giving with reduced ejection fraction. continued. information on fortifying food and CPJPG recommendation: RECOMMENDED – recipes for supplements to replace The guidance will provide SPECIALIST HEART FAILURE CONSULTANT ONS are available on the recommendations around the INITATION in-line with NICE TA388 Cambridgeshire and Peterborough decision making process and the (HOSPITAL ONLY until Trust Joint Prescribing Group website. documentation required to implementation plans reviewed). administer medicines covertly i n a care home setting. WHERE CAN I FIND…? Each month we will be highlighting different resources that you can access via the All decisions are subject to CPJPG website. This months relates to PRESCRIBING FOR PATIENTS WITH A STOMA. approval and ratification by the CCG Governing Guidance has been produced regionally on the anticipated quantity of differing stoma Body. product types required each month in the majority of patient circumstances to help reduce over-ordering, wastage, poor communication, and inappropriate use. SUPPORT CLOTHING/UNDERWEAR: Several companies manufacture support clothing/ underwear for stoma and hernia patients available via prescription, online and via community pharmacies. These include briefs, shorts, and vests. CPJPG recommendation: NOT RECOMMENDED to prescribe.

Medicines Management Team [email protected] 01480 387126