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REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Adult Joint Formulary

Covid-19 related prescribing guidance

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General Guidance

General Medicines-Related Issues

Please click here for PrescQIPP's summary of guidance for COVID-19 medicine related issues (Note: PrescQIPP login required)

Please click here for PSNC summary of updates and guidance relating to community pharmacy and COVID-19

 Please click here for University of Liverpool COVID-19 drug interaction checker tool. 

Yellow Card Reporting

The MHRA have launched a dedicated Yellow Card reporting site for healthcare products that are used in Coronavirus (COVID-19) treatment to be easily reported: coronavirus-yellowcard.mhra.gov.uk (05.05.2020)

Healthcare professionals, patients and carers are asked to report all suspected side effects to medicines or medical device adverse incidents related to COVID-19 treatment. This also includes medicines that patients and healthcare professionals are using off-label to treat COVID-19. Reporting will enable the MHRA to rapidly identify new and emerging side effects and medical device issues which may not have been previously known about, including diagnostic tests for COVID-19. This includes any medicines taken by patients to manage long-term, or pre-existing conditions that may influence the disease or have any potential interactions.

 

High Risk Drug Monitoring 

Please click here for BNSSG Blood Monitoring for High Risk drugs during COVID-19 guidance.

There is also national guidance available - see under Inflammatory Bowel Disease, Rheumatology and Dermatology for further information. 

 

Care Homes

Please click here for the good practice guide from the British Geriatrics Society (BGS) on Managing the COVID-19 pandemic in care homes.

See Government guidance "Coronavirus (COVID-19): reuse of medicines in a care home or hospice" available here

Please click here for Care Homes Resources to support the Coronavirus (COVID-19): reuse of medicines in a care home or hospice guidance.

A Frequently Asked Questions document has also been developed to support this scheme locally. Please click here for FAQs.

 

Sick Day Rules

Please click here for BNSSG guidance on sick day rules (preventing dehydration during periods of acute illness) 

 

Medicines Delivery to patients during COVID-19

Please click here for GP referral pathways into the voluntary community social enterprise (VCSE) sector

Please click here for PSNC pandemic delivery service overview document for Pharmacy professionals.

 

Gastro-intestinal system

 

Inflammatory Bowel Disease

Please click here for advice from International Organization for the study of Inflammatory Bowel Disease during the COVID-19 outbreak.

Please click here for patient advice from Crohn's and Colitis UK during the COVID-19 outbreak.

Please click here for advice from British Society of Gastroenterology on use of immunosuppression during the COVID-19 outbreak.

There is also a local guideline available on blood monitoring for High Risk Drugs during Covid-19 which includes local recommendations on monitoring of immunosuppressants during Covid-19. Please click here for BNSSG Blood Monitoring for High Risk drugs during COVID-19 guidance.

Please click here for NICE COVID-19 rapid guideline: gastrointestinal and liver conditions treated with drugs affecting the immune response.

Cardiovascular System

ACEi/ARBs

Please click here for the MHRA alert regarding high blood pressure medication during the COVID-19 outbreak.

Please click here for the British Cardiovascular Society and British Society for Heart Failure's joint statement on use of ACEi and ARBs during the COVID-19 outbreak.

Please click here for the European Society of Cardiology's guidance on ACEi and ARBs during the COVID-19 outbreak.

 

Anticoagulation

Please click here for the NHSE advice regarding anticoagulation during the COVID-19 outbreak

Please click here for BNSSG guidance on switching between warfarin and DOACs during the COVID-19 outbreak and please click here for BNSSG 'Preferred DOAC decision making aid during the COVID-19 outbreak'.

Respiratory System

Resources from the British Thoracic Society (BTS)

Please click here for information, guidance and resources from the British Thoracic Society (BTS) to support the respiratory community during the COVID-19 pandemic

 

Inhaler Availability

Please click here for BNSSG guidance on inhaler availability as of 7th May 2020.

NICE 

Please click here for NICE COVID-19 rapid guideline on severe asthma. 

Please click here for NICE COVID-19 rapid guideline on community-based care of patients with COPD

Please click here for NICE COVID-19 rapid guideline on managing suspected or confirmed pneumonia in adults in the community. 

 

 

Central Nervous System

Analgesia

NSAIDs

Please click here for NHS advice on the use of ibuprofen during the COVID-19 outbreak. 

Please click here for CAS alert for the NHSE message regarding use of ibuprofen during the COVID-19 outbreak. (14/4/2020)

Please click here for NICE evidence summary on the use of ibuprofen during the COVID-19 outbreak (14/4/20)

Paracetamol

Please click here for Royal Pharmaceutical Society Advice to pharmacists regarding "packing down" of paracetamol during COVID-19 outbreak. 

 

Multiple Sclerosis

Please click here for the Association of British Neurologists (ABN) guidance on the use of Disease Modifying Therapies (DMARDs) during the COVID-19 outbreak.

 

Mental Health

Please click here to visit Avon and Wiltshire Mental Health Partnership (AWP) website for further information

Please click here for BNSSG Mental wellbeing toolkit during COVID-19 leaflet

Please click here for AWP Advice for Primary Care on Antipsychotic Long Acting Injection (LAIs) during the COVID-19 pandemic.

Sodium Valproate 

The MHRA have provided temporary advice for the 'Valproate Pregnancy Prevention Programme' during the Coronavirus (COVID-19) pandemic - available here

Infections

Antibiotic Prescribing Guidance

Please click here for BNSSG Guidance on Antibiotic Prescribing during COVID-19 outbreak

 

Endocrine

Diabetes 

Please click here for Primary Care Diabetes Society guidance on managing diabetes during the COVID-19 outbreak. 

Please click here for BNSSG guidance on use of SGLT-2 drugs during the COVID-19 outbreak.

Obstetrics and Gynaecology

Contraception

Please click here for specific advice from Faculty of Sexual and Reproductive Health (FSRH) regarding provision of effective contraception during the COVID-19 outbreak.

Malignant Disease and Immunosuppression

Rheumatology

Please click here for statement from British Society of Rheumatology on immunosuppresant medications during the COVID-19 outbreak.

Please click here for guidance from British Society of Rheumatology on identifying high risk patients on immunosuppression during the COVID-19 outbreak. 

There is also a local guideline available on blood monitoring for High Risk Drugs during Covid-19 which includes local recommendations on monitoring of immunosuppressants during Covid-19. Please click here for BNSSG Blood Monitoring for High Risk drugs during COVID-19 guidance.

 Please click here for COVID-19 rapid guideline: rheumatological autoimmune, inflammatory and metabolic bone disorders.

Renal Disease

Please click here for patient advice from Kidney Care UK during the COVID-19 outbreak.

 Please click here for NICE COVID-19 rapid guideline: chronic kidney disease.

Systemic Anti-cancer treatments

Please click here for NICE rapid guideline on delivery of systemic anticancer treatments during COVID-19 outbreak.

Nutrition and Blood

Vitamin B12 Deficiency

Please click here for BNSSG Guideline for the Management of Patients on Hydroxocobalamin IM injections during Covid-19 pandemic.

Supporting information also available here

Click here for template letters that have been provided to support GPs communicate changes in Vitamin B12 management during Covid-19. Practices may wish to edit these letters as appropriate. 

Dermatology

Please click here for statement from International Psoriasis Council on immunosuppresant medications during the COVID-19 outbreak.

Please click here for a Safe Prescribing and Monitoring Protocol for Systemic immunomodulatory therapies for immune-mediated inflammatory skin disease in the context of Coronavirus (COVID-19).

Note - there is a local guideline available on blood monitoring for High Risk Drugs during Covid-19 which includes local recommendations on monitoring of immunosuppressants during Covid-19. Please click here for BNSSG Blood Monitoring for High Risk drugs during COVID-19 guidance.