Medicines information

Vitamin B12 injections – 27 May 2021

Note: This is an interim review whilst the LAPC are reviewing all COVID related medicines guidelines.

Anticipatory / End of Life Medicines

Please continue to access anticipatory medicines in the usual way. Community pharmacies generally hold small stocks of these drugs and can order from wholesalers for daily delivery. A number of pharmacies in Leeds are commissioned by NHS England to hold larger stocks which are available for more urgent need. At the time of writing, it is not legal for care homes to maintain stocks of these medicines. Please read the briefing below which includes links to further clinical guidance.

Anticipatory / End of Life Medicines

Valproate pregnancy prevention programme: temporary advice for management during Covid-19 – 6 May 2020

Guidance for specialists for initiation of valproate in female patients and for annual review and pregnancy testing to support adherence to pregnancy prevention requirements during the pandemic. The contents of the guidance include:

• Initiation of valproate
• Annual review of existing patients
• Arrangements for annual review
• Pregnancy testing
• Call for reporting

See detailed guidance

Guide for alternative inhalers during stock shortages

Supply of some inhalers is becoming limited in primary care and alternative inhalers may need to be used. Guidance has been produced to support prescribers with this. You can view the guidance below:

• Guide for alternative inhalers during stock shortages

Drug shortage website – 7 April 2020

MIMS provide a live drug shortage tracker that practice staff can now access. You will need to register for this service with GP Online, the provider of MIMS.  The tracker is based on national stock shortages and may not necessarily reflect local stock levels – please confirm with the patient’s community pharmacy if there is a local shortage before switching a patient’s medicines to an alternative based on the data from MIMS.

Drug shortage website

Guidance on depot antipsychotics – 6 April 2020

The Leeds and  York Partnership NHS Foundation Trust have produced some guidance to support primary care in managing patients on depot antipsychotics.

Mental health medicines optimisation liaison service – 6 April 2020

During the COVID 19 outbreak there may be an increase in demand for mental health support from patients. Please contact the MOLS team for support about any mental health medication enquiries.

Diabetes and coronavirus – 6 April 2020

Coronavirus can cause more severe symptoms and complications in people with diabetes. In addition, some patients with diabetes may be at higher risk of developing diabetic ketoacidosis (DKA) which could put extra strain on the healthcare system. Diabetes specialists in Leeds and the Medicines Optimisation team have produced advice and resources for GPs and patients. This contains a list of locations of emergency stocks of blood ketone meters for primary care teams to access for patients who are unwell.

Diabetes & coronavirus resources

Safe management of patients on Warfarin for the management of non valvular AF – 6 April 2020

More than ever before the system needs to work together to optimise care and management for people receiving anticoagulation. To facilitate this we are proposing a collaborative approach between LTHT, LCH and Primary Care to ensure that identified patients suitable for switching from Warfarin to DOAC are reviewed and managed in a timely manner.

Our approach has resulted in the identification of key priorities, aims and next steps – please download the documents below for more information.

Electronic repeat dispensing – 3 April 2020

Guides to support practices setting up or changing electronic repeat dispensing.

Information regarding expedited discharge from LTHT

During the COVID-19 pandemic, Leeds Teaching Hospitals NHS Trust (LTHT) are rapidly discharging patients, often with shorter inpatient stays than they would normally have. This means patients will have a change to the normal discharge process. To maintain patient safety from a pharmacy perspective, a system has been developed to support patients with their medication post discharge and into primary care. The document shows the pathway through which patients will be referred by LTHT for pharmacy review and medicines reconciliation in the community post discharge from LTHT with supporting notes on how that will be managed and escalated if necessary.

Please note, this section is currently being updated.