Lincolnshire Prescribing and Clinical Effectiveness Forum (PACEF) was founded in 2007. It is the current strategic advisory network to NHS Lincolnshire CCG. PACEF has the responsibility for ensuring the cost-effective use of medicines and other healthcare interventions and their functional integration into healthcare delivery across Lincolnshire.

Representation on the group is comprised of leading professionals from the Lincolnshire Clinical Commissioning Group, primary care, the local Acute Trusts (United Lincolnshire Hospitals Trust and Lincolnshire Partnership Foundation Trust), Lincolnshire Community Health Services, Local Medical Council and Local Pharmaceutical Council. 

PACEF Bulletins

Title
PACE Bulletin Vol 13 No 12 Nov19

Description

Drug Summary Assessment.

Toujeo DoubleStar® pen approved as AMBER 2; prescribe by brand name only to avoid confusion.

Sorprobec® inhaler approved for inclusion on the formulary as first line for “beclomethasone only” MDI, with a GREEN status.

Kelhale® inhaler approved for inclusion on the formulary as first line for beclomethasone dipropionate (extrafine aerosol) MDI, for adults only (individuals 18 years and over), with a GREEN status.

Updates.

Antimicrobial guidelines.

Pain Management Guidance & Quick Reference Guide.

PACE Bulletin Vol 13 No 11 Oct19 Pen Needles

Description

Prescribing Advice for Pen Needles.

Insulin Pen Needles - preferred options update.

PACE Bulletin Vol 13 No 10 Sep19 DOACs

Description

Prescribing Advice for DOACs.

Guidance on the choice of Direct Oral Anticoagulants (DOACs) for patients with non-valvular atrial fibrillation (NVAF).

PACE Bulletin Vol 13 No 9 Sep19

Description

Drug AssessmentSummary.

Semglee® (insulin glargine biosimilar) approved as GREEN.

Glycopyrronium bromide 200mcg/ml oral solution Colonis brand not approved for use, classed as RED/RED (non-formulary).

Hydventia® tablets (hydrocortisone) classed as RED/RED (non-formulary)

Testavan® (testoterone 20mg/g transdermal gel) approved as AMBER 2.

Optive Fusion® eye drops approved as GREEN restricted for use when a combination of sodium hyaluronate 0.1%, carboxymethylcellulose 0.5% is required.

Menthoderm Cream® approved as GREEN - replaces Dermacool on the formulary.

Betesil® medicated plasters approved as GREEN replaces Fludroxycortide tape on the formulary.

Paliperidone M/R tablets formulary classification changed from RED/RED to AMBER 2.

DEKAs® (multivitamin) approved as AMBER 2.

Paravit CF® capsules and liquid (multivitamin) approved as AMBER 2.

Nadolol tablet approved as AMBER 2.

Alkindi® (Hydrocortisone granules) approved as AMBER 2.

Updates.

Antimicrobial guidelines.

Quick reference guide inhalers for COPD.

PACE Bulletin Vol 13 No 8 Aug19 Melatonin Recommendation for Prescribers

Description

Prescribing Advice for Prescribers for Melatonin Preparations

PACE Bulletin Vol 13 No 7 Jul19 Lidocaine Plasters

Description

Prescribing Advice for Lidocaine Plasters - NHS England Recommendations.

PACE Bulletin Vol 13 No 6 Jul19

Description

Drug Assessment Summary.

Gabapentin 6% gel – unlicensed product approved as RED.

Invicorp® (Solution for injection Aviptadil 25micrograms / Phentolamine 2mg approved as AMBER 2.

Ciprofloxacin 2mg/ml ear drops approved as GREEN,

Updates:

Clozapine – classed as RED on formulary. LPFT updated advice ensure use documented on primary care record.

MHRA Drug Safety Update:

GLP-1 receptor agonists- reports of diabetic ketoacidosis when concomitant insulin rapidly reduced or discontinued.

PACE Bulletin Vol 13 No 5 Jun19 COPD

Description

Prescribing Advice for COPD - changes to guidance, initial management and managing stable COPD patients.

PACE Bulletin Vol 13 No 4 May19

Description

Drug Assessment Summary:

Marol & Zytram – sustained release tramadol tablets approved as GREEN for use within primary care.

Semaglutide (Ozempic ®) once weekly GLP-1 approved as GREEN.

Ertugliflozin (Steglatro®) new SGLT- 2 inhibitor approved as GREEN.

Fusacomb® Easyhaler® (salmeterol/fluticasone) approved as GREEN.

Stalpex® (salmeterol/fluticasone) approved as GREEN.

Haloperidol 200 microgram/ml sugar-free oral solution - Halkid® not approved for routine use classed as RED/RED.

Naloxegol (Moventig) changed from RED to AMBER 2.

Updates:

Otovent – Removed from Drug Tariff, re-classed as RED/RED.

Review of venlafaxine MR capsules. Vensir XL approved for first-line use. Venlablue XL retained as second line option.

NICE/PHE Summary of antimicrobial prescribing guidance now on PACEF website.

MHRA Drug Safety Updates:

Fluoroquinolone antibiotics – new restrictions due to reports disabling and potentially long lasting and irreversible side effects.

Yellow fever vaccines and fatal adverse reactions.

Valproate medicines and serious harm in pregnancy.

PACE Bulletin Vol 13 No 3 Mar19

Description

Drug Assessment Summary:

Rivaroxaban 2.5mg tablets (Xarelto ®) approved as AMBER 2.

Hydrocortisone 0.335% Single use eye drops () approved as AMBER 2.

Insulin Lispro Sanofi approved as GREEN.

Mexiletine (Namuscula®) 167mg capsules approved as AMBER 2 for unlicensed use for treatment of life threatening arrhythmias.

Akizza brand of combined pill (Ethinylestradiol/gestodene) not approved for formulary classed as RED/RED.

Sodium Valproate sustained release – Epival CR® tablets not approved for use classed as RED/RED.

Solifenacin oral suspension 1mg/ml (Vesicare®) approved as GREEN.

Updates:

Enoxaparin (Inhixa) pre-filled syringes - deployment of the needle guard, difference to that of clexane brand.

MHRA Drug Safety Update:

Tapentadol - risk of seizures and reports of serotonin syndrome

Ipilimumab – reports of cytomegalovirus (CMV).

Carbimazole – increased risk of congenital malformations.

Carbimazole - risk of acute pancreatitis.

SGLT2 inhibitors – reports of Fournier’s gangrene.

PACE Bulletin Vol 13 No 2 Jan19 Blood Glucose Testing Strips

Description

Prescribing Advice for Blood Glucose Test Strips) BGTS - recommendations in type 2 diabetes.

PACE Bulletin Vol 13 No 1 Jan19

Description

Drug Assessment Summary:

Licensed Pentosan capsules (Elmiron) approved as AMBER 2.

Unlicensed pentosan capsules removed from formulary, classed as RED/RED.

Oxypro® prolonged release oxycodone approved as GREEN.

Updates:

Discontinuation of Zovirax® Eye ointment.

MHRA Drug Safety Updates:

Hydrochlothiazide, risk of non- melanoma skin cancer.

Fluroquinolones - small increased risk of aortic aneurysm.

MHRA reminder of Valproate Pregnancy Prevention Programme and required actions.

Emollients new information increased risk of severe and fatal burns.

Hydrocortisone buccal tablets should not be used for adrenal insufficiency in children.