Audits - Central Nervous System

Please select from the following Audits.

Anticholinergic review in patients with dementia

This audit provides information on risk avoidance for patients with dementia treated with anticholinergic medication.

Anticholinergic review in patients with dementiaDownload File
(ACD audit in patients with cognitive impairment.pdf)

Date Uploaded: 15/07/2015

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Venlafaxine MR audit

This audit provides advice on the rationale behind providing a therapeutic switch from monitored release venlafaxine to normal release.

Venlafaxine MR auditDownload File
(Venlafaxine MR audit.pdf)

Date Uploaded: 15/07/2015

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Pregabalin and Gabapentin Cost-effective dosing review

This year, one of the National Therapeutic Indicators (NTI) asks practices to review their spend on gabapentin and pregabalin. Gabapentin is less costly if multiple lower strength capsules are taken in preference to the higher strength options. Conversely pregabalin is less costly if higher strength capsules are taken in preference to multiples of lower strengths. This review will only look at converting patients to a more cost-effective dosing regime of their current drug.

Pregabalin and Gabapentin Cost-effective dosing reviewDownload File
(Pregabalin & Gabapentin Cost Effective Dosing Review June 2013.pdf)

Date Uploaded: 04/06/2013

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Migraine Review Protocol

This prescribing review protocol is based on the recommendations for the management of migraine made in SIGN Guideline 107 and the NHS D&G Joint Formulary. It covers the use of opiates in migrane, triptan overuse and formulary compliance.

Migraine Review ProtocolDownload File
(Migraine - June 2013.pdf)

Date Uploaded: 04/06/2013

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Hypnotics Audit

After non-pharmacological measures, hypnotic drug therapy is considered appropriate only for the management of insomnia, which is severe, disabling or causing intolerable stress. Hypnotics should be prescribed for short periods of time only (ideally less than 2 weeks, zaleplon maximum 2 weeks, zolpidem and zopiclone maximum 4 weeks). The drug with the lowest purchase cost per defined daily dose (ddd) should be prescribed (includes other shorter-acting hypnotics). A total of 225k was spent on hypnotics and anxiolytics in Dumfries and Galloway last year and this could be reduced as well as improving the safety and well being of our patients in D and G.

Hypnotics AuditDownload File
(Hypnotic audit May 2013.pdf)

Date Uploaded: 23/05/2013

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Buspirone Review

Buspirone is licensed for the short-term management of anxiety disorders and the relief of symptoms of anxiety with or without accompanying depression. Studies have shown that the effectiveness of the drug is limited and therefore its use in the treatment of anxiety is not endorsed by NICE or any other national guideline.This protocol details a review process.

Buspirone ReviewDownload File
(Buspirone Review.pdf)

Date Uploaded: 03/08/2011

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Lithium Safety Audit

Lithium is a long-term treatment used clinically for bipolar disorder. Lithium has a narrow therapeutic/toxic ratio and maintaining patients within the appropriate therapeutic margin requires scheduled monitoring. A NPSA alert in Dec 2009 (NPSA/2009/PSA005) states that all prescribers check that blood tests are monitored regularly and it is safe to issue a repeat prescription. The monitoring should be in line with NICE guidance i.e. Lithium blood level measured every three months as standard, renal function tests and thyroid function tests every six months. In addition, yearly health checks and monitoring of weight are recommended.

Lithium Safety AuditDownload File
(Lithium audit 15thOct10.pdf)

Date Uploaded: 01/10/2010

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Orlistat review

Orlistat reduces the absorption of dietary fat. It is prescribed as an anti-obesity drug, in conjunction with a mildly hypocaloric diet, for individuals over 18 years of age with a BMI of 30kg/m2 or more, or in individuals with a BMI of 28kg/m2 in the presence of other risk factors e.g. Type 2 diabetes, hypertension or hypercholesterolaemia. It should only be used where diet, physical activity and behavioural changes are supported. Treatment should continue beyond 12 weeks only if the patient has lost at least 5% of initial body weight. Drug treatment should be discontinued if the individual regains weight at any time whilst receiving treatment.

This audit aims to determine whether patients prescribed orlistat are being managed in accordance with the product license.

Orlistat reviewDownload File
(Orlistat review audit June 20101.pdf)

Date Uploaded: 13/07/2010

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Review of antipsychotic prescribing in dementia

The aim of this review is to ensure the appropriate prescribing of antipsychotic medication in dementia. These drugs should only be used in dementia to treat severe behavioural changes when other approaches have failed and should only be used at a low dose.

Review of antipsychotic prescribing in dementiaDownload File
(Prescribing support team antipsychotic prescribingin dementia.pdf)

Date Uploaded: 17/02/2009

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Antidepressant

This audit aims to investigate the prescribing of antidepressants in primary care.

It will focus on which antidepressants are being prescribed, the duration of treatment and if appropriate monitoring is given to those taking antidepressants including concordance support.



AntidepressantDownload File
(Microsoft Word - antidepressant audit April 2008.pdf)

Date Uploaded: 11/04/2008

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Quetiapine Cost-efficiency Audit

This audit aims to provide the patient with the most cost-effective strength(s) of quetiapine tablets to meet their current dose requirements.

Quetiapine Cost-efficiency AuditDownload File
(QuetiapineFlatPricingProtocol.pdf)

Date Uploaded: 31/12/2007

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Co-Codamol Effervescent audit

All patients currently listed in the practice as requiring co-codamol as an analgesic should be taking co-codamol tablets. The purpose of this audit is to identify patients currently taking co-codamol capsules or effervecscent tablets and then switch the formulation of co-codamol for those patients to tablets.

Co-Codamol Effervescent auditDownload File
(co-codamol audit.pdf)

Date Uploaded: 31/03/2006

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Paracetamol Audit July 2006

All patients currently listed in the practice as requiring paracetamol as an analgesic should be taking paracetamol tablets. The purpose of this audit is to identify patients currently paracetamol 500mg capsules or soluble tablets and then switch the formulation of paracetamol for those patients to tablets.

Paracetamol Audit July 2006Download File
(paracetamol audit[1].pdf)

Date Uploaded: 20/02/2006

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