Greater Glasgow and Clyde Medicines

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Do you use, write or review and approve NHSGGC clinical guidelines? 

If so, this blog contains key messages for safe, consistent and up-to-date practice.

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It is estimated that one in five general hospital beds in the UK are occupied by someone who has dementia, although this is likely an underestimate. Admission to hospital causes an increased risk of delirium developing, due to aspects such as infection, surgery, dehydration, as well as the disorientating and unfamiliar hospital environment. Refer to the Delirium: Medication Review in Acute blog for more details. All staff are likely to interact with someone who has dementia, and so should have the recommended skills and knowledge, as described in the Promoting Excellence Framework. Supporting modules for learning are available on Turas.

Patients with dementia may face challenges when communicating; staff may identify distress in people with dementia but not that pain is the underlying cause. This can lead to unrecognised, untreated or undertreated pain, which can cause further distress. Patients with dementia often receive less analgesia; a study has shown patients with dementia received one third of post-operative pain relief in comparison to their younger, non- cognitively impaired counterparts.

Effective pain assessment is fundamental in implementing effective pain management. Utilising a structured approach to identify and treat pain, and assess response to analgesia is imperative.

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This post summarises the latest NHS Greater Glasgow and Clyde decisions relating to new medicines assessed by SMC and considered by the Area Drug and Therapeutics Committee (ADTC) and uses a nationally developed format specifically aimed for patients and the public.

For full details of the medicines included in this post that are available for use, including any restrictions on prescribing, please see the relevant entry in the GGC Formulary.

Click here to access the full blog

Click here to access the full blog

• All breastfeeding women and children under three years of age (receiving less than 500ml of infant formula) in NHSGGC are eligible for a free Vitamin D3 supplement.

• Breastfeeding women are provided with one bottle of Vitamin D3 tablets from their maternity unit. Subsequent supplies should be obtained from community pharmacies free of charge.

• Infants and children under 3 years of age (receiving less than 500ml of infant formula) are eligible for Vitamin D3 drops free of charge from community pharmacies.

• Healthy Start® tablets are supplied to pregnant women by maternity services (in addition to vitamin D, Healthy Start® tablets also contain folic acid and vitamin C).

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• NHS Inform guidance suggests that people of all age groups should consider taking a vitamin D supplement of 10 micrograms (400 units) daily, particularly during the winter months (October to March).

• Breastfeeding women and children under 3 (receiving less than 500ml of infant formula daily) can obtain free supplies of vitamin D via their community pharmacy as detailed here. Pregnant women are supplied with Healthy Start® tablets (vitamin D, vitamin C and folic acid) by maternity services.

• Those who are not eligible for free supplies of vitamin D can purchase a vitamin D supplement at pharmacies, supermarkets and online.

• Some patient groups will be unable to purchase supplements themselves and GPs may be asked to prescribe, e.g. those who are institutionalised, frail or housebound or low income families. Refer to colecalciferol product of choice blog.

• If a combined calcium and vitamin D supplement is required, the preferred choices can be found in the GGC medicines formulary, and includes options for those who are unable to tolerate the first and second line preparations.

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• Vitamin D levels should NOT be measured routinely.
• Vitamin D loading doses may differ depending on indication.
• Check NHSGGC Formulary for vitamin D preparation of choice prior to prescribing.