Medicine Pathways, Guidelines And Position Statements

The documents below have been agreed by the stakeholders working in North Central London and have been approved by the NCL Joint Formulary Committee (NCL JFC). They should be used to refer appropriate patients to his/her local anticoagulation clinic for initiation of anticoagulation.
Where appropriate, local anticoagulation clinics should add their own contact details on the relevant paperwork (i.e. referral proformas, notification and transfer of care forms)
Please note that these documents may be updated intermittently. Users are also reminded that the prescribing guidance is not definitive and that other sources such as the electronic medicines compendium (SPCs) should be used for the most recent drug information. This can be found at the following link: http://www.medicines.org.uk/emc/default.aspx

VTE: Choice of DOAC (Position Statement)
NVAF: Choice of DOAC (Interim Position Statement)

Other

Summary of Antiplatelet Options in Cardiovascular Disease
Sacubitril valsartan for heart failure position statement (NEL and NCL joint positioning)
Lipid management – medicines optimisation pathways
Stable angina prescribing guideline
Omega-3 Fatty Acids Position Statement
Guidance for the review of Omega-3 fatty acids
Guidance for the management of hypertriglyceridaemia

Respiratory system

Adult asthma inhaler choice – Full guideline
Adult asthma inhaler choice – Quick reference guide
Discontinuation of Phyllocontin® (aminophylline) memo

The following COPD guideline has been produced by the Camden, Haringey and Islington Responsible Respiratory Prescribing Group and applies to organisations that are constituent members. It has not been ratified by the NCL Joint Formulary Committee and does not apply to all organisations in NCL.

Stable COPD Treatment Guideline

Central nervous system

Parkinsons disease prescribing guideline
Lidocaine 5% Patch Position Statement
Co-proxamol Tablets Position Statement
Clozapine management for patients admitted to acute hospitals guidance
Cannabis-based medicinal products Position Statement
Cannabis-based medicinal products Patient Information

The “Adult ADHD: Additional information for prescribing in adults in primary care” document has been endorsed by C&I and BEH Mental Health Trust DTCs, and has been created to provide additional information to GPs when they consider requests to continue prescriptions for adult patients receiving stable doses for whom treatment was started by ADHD specialists working outside the NCL commissioned services (e.g., private organisations or overseas specialists).

The document can be found on the NCL GP website via the link below (note: you must login and have access to the NHS secure network to view this page):

Adult ADHD: Additional information for prescribing in adults in primary care

Infections

NICE and Public Health England (PHE) have brought together their information on managing common infections into a summary table. The North Central London Medicines Optimisation Committee (NCL MOC) support the use of the:

NICE/PHE Managing Common Infections summary table (hosted on BNF).

Fluoroquinolones safe prescribing Position Statement
Treatment of Infections due to Multi-Drug Resistant Gram Negative Pathogens

From 1 June, the Health Services Laboratories (HSL) microbiology laboratory will apply new antimicrobial susceptibility result definitions recommended by the European Committee on Antimicrobial Susceptibility (EUCAST). While the letters ‘S’, ‘I’ and ‘R’ are retained, the definitions for the letters ‘S’ and ‘I’ have changed.
Communication to clinicians: Changes to antibiotic susceptibility reporting
Standard and High Dose Antibiotic Dosing Regimens

HCID centres in England have produced prescribing information for oral tecovirimat. This is hosted on the NCL MON website to support local clinicians and has been adapted to include supply information within NCL.
Tecovirimat prescribing information