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Prescribing

Direct oral anticoagulants in general practice

DOACs were first licensed in the UK for thromboprophylaxis following orthopaedic surgery. The phase III clinical trials assessed the DOACs (dabigatran, rivaroxaban and apixaban) to be non-inferior to...

Acute onset low back pain leading to a diagnosis of cauda equina syndrome: a case study

CES is documented as a rare and challenging neurological condition to diagnose (Greenhalgh et al, 2018). It is defined by Zusman et al (2020) as a significant compression of the nerve roots in the...

Prescribing errors in general practice

The Medicines and Healthcare products Regulatory Agency (MHRA, 2014) defines a medication error as: ‘a patient safety incident where there has been an error in the process of prescribing, preparing,...

Communication barriers that affect medication adherence in patients with learning disabilities

Adherence is described by the National Institute for Health and Care Excellence (NICE) as an acknowledged agreement between patient and prescriber concerning clinical recommendations and the extent to...

Shaping and delivering services in primary care: benzodiazepine and opiate withdrawal service

Good practice in prescribing opioid medicines for pain should reflect fundamental principles in prescribing generally. The decision to prescribe is underpinned by applying best professional...

The overtreatment of type 2 diabetes in frail older people

The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study found that people with tighter glycaemic control (HbA1c <42 mmol/mol) had excessive mortality, particularly in those with multiple...

Medicines adherence in respiratory disease

If adherence means compliance with recommended or prescribed therapy, non-adherence just means that the prescription, treatment or advice is not followed (Horne, 2005). Non-adherence can involve...

SAFER PRACTICES: reducing the risk of diagnostic errors

S = Serious. Have I excluded the serious, must-not-miss, causes for this symptom?.

SAFER: A mnemonic to improve safety-netting advice

The first step in safety-netting involves a formal, holistic assessment of whether it is appropriate to send the patient home to monitor themselves, rather than arranging for the patient to undergo a...

Less is more when reducing antimicrobial prescribing

AMR arises when the organisms that cause infection evolve methods to survive attempts to kill or suppress them. This can happen naturally, but it is accelerated by the inappropriate use of...

Polypharmacy and deprescribing in people with learning disabilities

Shared decision-making, a key component of universal personalised care in The NHS Long Term Plan (NHS, 2019), aims to provide people with the same choice and control over their mental and physical...

AMR: effective infection prevention and control measures

As a result of AMR, standard treatments become ineffective and infections persist and may spread to others. The O'Neill (2016a) report estimated that by 2050, 10 million lives a year and a cumulative...

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