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9th April 2009
The NHS Institute for Innovation and Improvement has recently released four Better Care, Better Value Indicators (BCBV) relating to prescribing. NPC includes resources which will help prescribers and prescribing teams address therapeutics and implementation issues arising from these indicators.
Action
Prescribers and medicines management teams may find the following resources useful:
Statins and lipid modification
Two BCBV indicators are listed:
- Increasing low cost statin prescribing, which is defined as “the number of prescription items for low cost statins (simvastatin and pravastatin). This is expressed as a percentage of the total number of prescriptions for all statins (excluding combination products).”
- Increasing low cost prescribing for lipid modification, which is defined as “the number of prescription items for low cost statins (simvastatin and pravastatin). This is expressed as a percentage of the total number of prescriptions for all statins including combinations of ezetimibe▼ with statins.”
Resources relating to the therapeutics of lipid modification including the NICE guidance on cardiovascular risk assessment and lipid modification and the evidence base for ezetimibe▼ can be found on the lipids section and the statins national support materials section of NPC. A wide range of implementation resources related to statins is also available on NPC.
Proton pump inhibitors
The BCBV indicator listed is increasing low cost PPI prescribing, which is defined as “the total number of prescription items for lower cost PPIs (omeprazole and lansoprazole excluding oro-dispersible forms of lansoprazole (Zoton FasTabs®) and omeprazole multiple unit pellet system [Losec MUPs®]). This is expressed as a percentage of the total number of prescriptions for lower and higher cost PPIs (excluding combination products for H. pylori eradication).”
Resources relating to the therapeutics around management of dyspepsia including the NICE guidance can be found on the dyspepsia section and the PPIs national support materials section of NPC. A wide range of implementation resources related to PPIs is also available on NPC.
Renin-angiotensin system drugs
The indicator listed is increasing low cost prescribing of drugs affecting the renin-angiotensin system, which is defined as “the percentage of items written for ACE-inhibitors (excluding combination products) as a percentage of the total volume of prescribing for drugs affecting the renin-angiotensin system (excluding combination products)”.
ACE-inhibitors and angiotensin-2 receptor antagonists (A2RA) drugs are used in a number of indications. Resources can be found on the hypertension section, the post-MI section, the heart failure section, the stroke section and the type 2 diabetes section of NPC. They are also used in chronic kidney disease, for which there is NICE guidance (see especially section 1.8).
Implementation resources related to this indicator are being reviewed and will be available shortly.
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