The DROP-List Items
Below is a list of the now 30 Drugs to Review for Optimised Prescribing items - along with links to where you can find the resources:
The DROP-List Bulletin v4.0 - July 2015The 2015/16 version of the DROP list and supporting documents can be found here. A slideset is also available for use locally.
The DROP-List and Self Care
Some of the items on the DROP-List are suitable for self care, we have been developing a separate self care webkit looking specifically at items suitable for self care and treating minor ailments therefore the self care items will eventually be removed from the DROP-List when we update the overarching document. You can visit the self care webkit by clicking the button below:
DROP-List Scorecard Mapped
DROP-List Webinar May 2015 - Covering DROP 2015 UpdateOn the 20th May 2015 we held the a webinar to introduce our 2015 update to the DROP-List - with Sajida Khatri - with a particular focus on the new inclusions such as NICE do-not-dos. You can now view this webinar below:
DROP-List Webinar April 2014 - Covering 2014 Optimisation of DROPOn the 9th April 2014 we held the all new DROP-List webinar - with Sajida Khatri - in advance of the new DROP List that was published in May 2014. You can now view this webinar below:
Self Care – AnalgesiaThis item on the DROP-List covers prescribing for analgesia items (excluding POM medicines), where these products are being prescribed for minor ailments such as acute mild pain, fever etc, they can be purchased over the counter as part of self care. The resources developed as part of the self care package are patient information resources that cover pain and fever.
Rubefacients (Excluding Topical NSAIDs)The rubefacients bulletin supports the PrescQIPP DROP list. It reviews the place in therapy of the rubefacients which also have a nice do not do attached to them. An audit and patient letter are available as supporting tools.
Travel Vaccines Not Prescribable on NHSThe travel vaccines bulletin identifies those vaccines that should not be prescribed on the NHS for travel as well as offering advice on developing a local policy on travel vaccines. A patient information leaflet is available via the low value medicines tab.
Trimipramine is a tricyclic antidepressant (TCA) that has been subject to significant price increases. Consequently, it does not represent a cost-effective choice of treatment.T his bulletin reviews the use of trimipramine with resources to support stopping or switching treatment in depression in adults. Audit tools including a template patient information/switch guide are provided to support implementation of change.
LiothyronineThis bulletin looks at the place in therapy of liothyronine and combination products containing levothyroxine and liothyronine. In light of a limited evidence base supporting its use and the increased cost of these products, a review of therapy is recommended. Supporting tools include an audit, patient information letter and community pharmacist notification letter
This bulletin looks at lidocaine plasters and provides the rationale for not initiating lidocaine plasters in new patients, and for current patients to be considered for discontinuation of their prescription for lidocaine plasters.
This bulletin supports the review of doxazosin MR prescribing and supports a switch to the immediate release formulation in line with the NHS England "Items which should not routinely be prescribed in primary care" guidance.
Fentanyl Immediate ReleaseUpdate coming soon.
Immediate release fentanyl has a NICE do not do as a first line treatment for breakthrough pain. This bulletin focuses on fentanyl immediate-release formulations and provides the rationale for new patients to be commenced on immediate-release morphine, and for current patients to be considered for a switch to immediate-release morphine or have their therapy reviewed and stopped where appropriate.
Tadalafil Once DailyOnce daily tadalafil is not a cost effective treatment option. Currently on demand sildenafil is the preferred option.
Omega-3 Fatty Acids and Other Fish OilsUpdate coming soon.
This bulletin focuses on omega-3 fatty acids and provides the rationale for therapy to be stopped or for patients to be switched to alternative agents and for new patients not to be started on omega-3 fatty acids.
Perindopril Arginine (Coversyl® Arginine) and Branded Coversyl®Update coming soon.
This bulletin, focuses on different perindopril formulations (salts) which are not directly equivalent. It provides the rationale for new patients to be commenced on generic perindopril erbumine, also known as tert-butylamine. Current patients can be considered for a switch from Coversyl® Arginine (perindopril arginine) to perindopril erbumine. Options for dose conversion in support of the switch, potential switch savings and information on perindopril adverse effects are also provided.
Antioxidant Vitamins for Age Related Macular Degeneration
The evidence to support the use of antioxidant vitamins to reduce the progression of age related macular degeneration is limited. This bulletin reviews the evidence available and supports reviewing and stopping treatment with antioxidant vitamins.
This bulletin discusses the use of co-proxamol and supports reviewing and discontinuing prescribing in patients still taking this unlicensed medicine. It supports the implementation of the NHS England items which should not routinely be prescribed in primary care guidance.
Oxycodone/Naloxone (Targinact®)Update coming soon.
This bulletin and resources provide further information on the evidence base for for using oxycodone/naloxone prolonged release tablets, the rationale to stop treatment and also suggests alternative treatment options. Support materials are also available for organisations to adapt and use to implement changes.
Herbal remediesThe MHRA allows herbal products to be marketed for minor health conditions that don’t require medical supervision, upon receipt of a Traditional Herbal Registration (THR). Claims to treat major health conditions are not allowed under a THR and would need a marketing authorisation. Under a THR there is no requirement to prove scientifically that a product works, the registration is based on longstanding use of the product. These products should be purchased as part of self care.
Homeopathic remediesIn 2010, a report by the House of Commons Science and Technology Committee found that the use of homeopathy was not evidence based and any benefits to patients was down to placebo effect.
DosulepinUpdate coming soon.
These resources review the place in therapy of dosulepin which is listed as a NICE 'do not do'. The drug has a very small margin of safety between the maximum therapeutic dose and potentially fatal doses. An audit is available to support review of current prescribing.
GlucosamineThere is limited evidence to support the use of glucosamine and chondroitin products and they are listed as a NICE do not do. This bulletin reviews the use of glucosamine (with or without chondroitin) preparations. Guidance on stopping treatments and patient information is available to support implementation.
Prescribable items of low priority for the NHS - NHSCC update webinarOn 24th May Julie Wood, Chief Executive of NHS Clinical Commissioners joined us for a follow up to the webinar on 7th February which identified a number of prescribable items of low value for NHS funding. The webinar provided an opportunity to get an update on progress and to feedback on current proposals for national action.
NHS England has taken action to reduce inappropriate prescribing of 18 medicines which will improve health and save millions of pounds a year. National guidance on medicines which should no longer be routinely prescribed in primary care has been published to ensure people receive the safest and most effective treatment available, and save the NHS up to £141 million a year. Guidance available here.
Other key links from NHS England and NHS CC: