Adult asthma: NICE NG80: Asthma: diagnosis, monitoring and chronic asthma management (November 2017), prompted a review of the current guidance, which is based on recommendations made by the British Throacic Society (BTS) and the Scottish Intercollegiate Guideline Network (SIGN). Formulary guidance continues to follow the recommendations made by BTS/SIGN, with minor changes to offer clarity to existing guidance and relevant product choices. Please see the formulary for further guidance.
Management of pain and opioids: Acute and chronic non-malignant painguidance, with consideration to the Opioids Aware resource hosted by the Faculty of Pain Medicine, has been added in the formulary. Please see the formulary for further guidance.
Commissioning Policy: The
routine commissioning of Tresiba® (insulin degludec)
is accepted in Devon for the treatment of patients with type 1
diabetes who meet specific criteria (See
Commissioning Policy for more information)
Commissioning Policy: The
routine commissioning of Tresiba® (insulin degludec) in Devon for the
treatment of type 2 diabetes is
unchanged and is
not accepted (See Commissioning Policy for more information)
Commissioning Policy: The
routine commissioning of Trelegy® Ellipta® (combination of fluticasone furoate,
umeclidinium bromide, and vilanterol trifenatate)
is accepted in Devon for maintenance treatment in adult patients
with moderate to severe chronic obstructive pulmonary disease (COPD) (See
Commissioning Policy for more details)
August 2018
AntiStatic Space Chamber Plus (medium-volume spacer device) standard and compact devices have been added into the formulary here to provide an antistatic spacer option at a lower acquisition cost than current formulary products
Octenisan wash mitts have been added into the formulary here for antiseptic bedside washing of lower limbs of patients with chronic ulceration
Pizotifen tablets 500microgram and 1.5mg have been removed from the formulary; the use of pizotifen as a prophylactic option for migraine in adults has been superseded. Patients that are already established on pizotifen and find it effective can continue to use it.
Darbepoetin alfa has been reclassified as red; prescribing and monitoring is by secondary care only. Previous shared care documents have been archived, and are available for reference only (here). See formulary entry here.
Anal irrigation systems: Brief guidance has been added to support GPs who may be asked to prescribe these appliances following recommendation from the NHS Bladder and Bowel Care team. Click here for more information.
Acute sinusitis: Following publication of NICE NG79: Sinusitis (acute): antimicrobial prescribing (October 2017), formulary guidance has been revised and updated. The guidance can be found here
Acute sore throat: Following publication of NICE NG84: Sore throat (acute): antimicrobial prescribing (January 2018), formulary guidance has been revised and updated. The guidance can be found here
Management of migraine: The formulary guidance has been reviewed and updated in line with NICE CG150: headaches in over 12s: diagnosis and management (updated November 2015). The guidance can be found here
Oral nutritional supplements: Following consultation with local dietitian specialists in North and East Devon, the choices of formulary oral nutritional supplements have been reviewed. Formulary recommended products can be found here
Parkinson's disease management: The formulary guidance has been reviewed and updated in line with NICE NG71: Parkinson's disease in adults (July 2017). Dopaminergic drugs used in Parkinson's disease have been reclassified as amber (specialist input). Click here for more information.
Vitamin and mineral supplementation following bariatric surgery: New formulary guidance has been added to the formulary to offer support to prescribers on the nutritional supplementation for patients who have undergone bariatric surgery. The guidance can be found here.
Following public consultation; NHS England and NHS Clinical Commissioners published guidance for CCGs on items which should not be routinely prescribed in primary care. Click here for more information. The following items have new guidance attached in the formulary:
Commissioning Policy: The routine commissioning of Relvar Ellipta is accepted in Devon for the treatment of asthma in adults and adolescents aged 12 years and older (see Commissioning Policy for more details).
June 2018
Desmopressin nasal spray 10micrograms/spray and 100micrograms/ml have been reclassified from a red drug (hospital only) to an amber drug (specialist input), for use in the treatment of diabetes insipidus
Desmopressin tablets 100microgram and desmopressin sublingual tablets 60microgram have been added into the formulary for consistency with the BNF recommended dose (see here).
Pentasa® prolonged-release granules 4g have been added into the formulary here, to offer another strength options of the current preparation.
Salofalk® gastro-resistant
prolonged-released granules
500mg, 1g, 1.5g, and 3g have been added to the formulary here, to
provide another option for the maintenance of remission in those patients who
have a high risk of relapses/ adherence difficulties.
Nausea and vomiting in pregnancy
and hyperemesis gravidarum:
The
formulary guidance has been amended to offer clarity on the use of ondansetron
as a 3
rd line treatment option. A link to the UK teratology
information website,
Best
Use of Medicines in Pregnancy
(BUMPS) has
been added as a helpful resource. The guidance can be found
here.
Commissioning Policy: The
routine commissioning of lurasidone is
not accepted in Devon
for patients with schizophrenia (see
Commissioning Policy for
more details)
