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Clinical Guidance and Prescribing Resources

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This section of the website contains prescribing resources and guidelines and has been organised into the following clinical areas:

Epilepsy

NICE | Anti-Epileptic Drug Categories

GOV.UK - Valproate use by women and girls

SPS - Specialist Pharmacy Service - Generic Antiepileptic Drugs in Epilepsy (Update Sept 2020)

Is Valproate the Right Epilepsy Treatment for Me?

Decision Support Tool - Bipolar Disorder: Is Valproate the Right Treatment for Me?

 

Mental Health and Wellbeing

Guidance | NICE | Depression in children and young people: identification and management

Guidance | NICE | Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults

SilverCloud - Online Mental Health Support - Powys Teaching Health Board (nhs.wales)

SilverCloud by Amwell® is a free online mental health support service available through NHS Wales without a GP referral. Through SilverCloud, you can access a range of guided self-help programmes to help you manage and improve your mental health and wellbeing. There’s support for mild-to-moderate anxiety, depression, stress, sleep difficulties and more.

Deprescribing of antidepressants for depression and anxiety

Tools hosted by SPS - Specialist Pharmacy Service to help practice teams address inappropriate prescribing.

 

Dementia

Management | Dementia | CKS | NICE

Dementia Friends UK

AWTTC - CEPP National Audit - Antipsychotics in Dementia

Antipsychotic Prescribing Toolkit for Dementia

AWTTC - All Wales protocol for the appropriate prescribing of antipsychotics for people living with dementia

 

Insomnia

Insomnia | Health topics A to Z | CKS | NICE

 

Hypnotics and Anxiolytics

AWTTC - Material to Support Appropriate Prescribing of Hypnotics and Anxiolytics across Wales

NICE - Educational Pack Material to Support Appropriate Prescribing of Hypnotics and Anxiolytics

 

Chronic Pain Management

AWTTC - Resources for Pharmacological Management of Pain

AWMSG - All Wales Analgesic Stewardship Guidance

Opioids Aware | Faculty of Pain Medicine

MD Calc - Morphine Dose Equivalence Calculator

Guidance | NICE | Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults

CKS | NICE | Assessment | Diagnosis | Chronic pain

 

Resources for Patients

Pain Toolkit

Faculty of Pain Medicine - Information for patients

AWMSG - Opioids in Palliative Care: A Patient Guide (Welsh) (English)

 

Relevant MHRA Alerts

Updated January 2024 - Valproate use by women and girls

November 2023 - Valproate: Organisations to prepare for new regulatory measures for oversight of prescribing to new patients and existing female patients

October 2023 - Valproate: Dispense Full Packs of Valproate-Containing Medicines

August 2023 - Valproate: Re-Analysis of Study on Risks in Children of Men Taking Valproate

April 2019 - Valproate Medicines and Serious Harms in Pregnancy: New Annual Risk Acknowledgement Form and Clinical Guidance from Professional Bodies to Support Compliance with the Pregnancy Prevention Programme

June 2023 - Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Potential Risks Following Prolonged Use After 20 Weeks of Pregnancy

Managing Infections in Primary Care

PTHB Antimicrobial Guidelines (formerly Microguide)

The MicroGuide provides advice on the effective and safe treatment of infections commonly presenting in primary care and are based on NICE and Public Health Wales advice with input from local experts.

AWTTC - Primary Care Antimicrobial Guidelines

AWTTC - Management of C.Diff Infection in Wales

AWTTC - Management of Recurrent Symptomatic Urinary Tract Infection in Adult Women

Urinary tract infection (lower) - women | CKS | NICE

PTHB - Silver Dressings Guidance

Resources for Patients

PTHB - Antibiotics Patient Information Leaflet: Understanding Your Antibiotics (English)

PTHB Antibiotics Patient Information Leaflet: Understanding Your Antibiotics (Welsh)

PTHB - Antibiotics Patient Information Leaflet: Why haven't I been given antibiotics? 

PTHB - Antibiotics Patient Information Leaflet: Why haven't I been given antibiotics? (Plain Text Version)

Safety Updates

AWTTC - Best Practice Reminder: Avoid Nitrofurantoin in the Treatment of Pyelonephritis

Prescriber Tools and Audits

Antimicrobial Prescribing and Stewardship (APS) Competency Framework

The APS competency framework can be used by both medical and non-medical prescribers in any care setting to support the development of their prescribing practice at any point in their professional development in relation to prescribing antimicrobials and embodying stewardship practices.

AWMSG - CEPP National Audit - focus on antibiotic prescribing

Using the correct antibiotics only when needed, with the correct dose and for the correct duration, is vital to help tackle growing antibiotic resistance. These audits aim to:

  • Promote antibiotic prescribing in accordance with existing guidelines; including the Primary care antimicrobial guidelines endorsed by AWMSG.
  • Support clinicians with quality improvement by promoting review of antimicrobial prescribing in their practice.

 

Local Clinical Guidance

PTHB Formulary

PTHB Antimicrobial Guidelines

 

Medicines Safety & Prescribing Support

MHRA - Yellow Card: Making medicines and medical devices safer

Report suspected side effects to medicines, vaccines, e-cigarettes, medical device incidents, defective or falsified (fake) products to the Medicines and Healthcare products Regulatory Agency to ensure safe and effective use.

Prescribing of branded generics in NHS Wales: Position statement - All Wales Therapeutics and Toxicology Centre

AWTTC - Prescribing Dilemmas - A Guide for Prescribers

Guidance to support prescribers with complex or uncertain prescribing situations, covering issues such as clinical responsibility, private prescriptions, unlicensed use, prescribing outside national guidance, and other common dilemmas.

Specialist Resources

NEWT Guidelines - Prescribing for Patients with Swallowing Difficulties

 

Evidence & Best Practice Tools

GP Evidence - Summaries of the evidence on the benefits and harms of treatments for long term conditions

Provides clear, evidence‑based summaries on the benefits and harms of treatments for common long‑term conditions, designed to support GPs and primary care clinicians in shared decision‑making.

PrescQipp - Improving Medicines and Polypharmacy Appropriateness Clinical Tool (IMPACT)

NHS England - Policy guidance: conditions for which over the counter items should not be routinely prescribed in primary care

 

Wider Evidence & Learning Resources

E-Library for Health - Home Page

Provides NHS Wales staff with quick access to trusted clinical evidence, journals, e‑books, medicines information and guidelines to support everyday patient care.

Access to the e-Library website and e-resources is instant to anyone connected to the NHS Wales network or otherwise by using an OpenAthens account. To register for an OpenAthens account to access NHS Wales e-Library resources, you must be employed by NHS Wales or hold an honorary contract with NHS Wales or be employed by the Health and Social Care Department and Education & Public Service Department of Welsh Government.

Information on medicine shortages can be found following the link below and selecting the medicine shortages tab

Medicines Safety - Powys Teaching Health Board

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