Measures considered and rejected

[richiecroker]

Following a trawl of the FoIs and other measures being used by CCGs, i've come up with a longlist of about 30 possible measures. However, there are a number that, although i'd like us to do, there is no simple way of accurately creating the data without a lot of input and continued management. It's worth noting this down however, in case this changes.

1. Eye Vitamins

There is poor evidence for prescribing these - if patients want them they can be bought OTC. PrescQIPP details here: https://www.prescqipp.info/-lutein-and-antioxidant-vitamins/send/133-lutein-and-antioxidant-vitamins/1707-bulletin-86-lutein-and-antioxidant-vitamins-drop-list-briefing

Problem: there is no chemical code for these products, they are all listed under 'Other Comp Vit/Mineral Formulation Preps' (091000000). There are currently 557 presentations listed under this code, of which only a small number are eye vitamins. Therefore each individual presentation code will need to be mapped.

2. Special order products

This is a commonly requested item. However, there appears to be no marker in either the BNF code or BNF name to identify what these drugs are. Therefore we would need regular FoIs from NHSBSA to maintain an up-to date list.

3. Gluten Free products

The BNF codes for items which could be considered less suitable for prescribing are not as clear as they could be. 'GF cakes and pastries' also includes things like crackers and crispbreads, which are less problematic.

**4. Prescribing of branded lithium carbonate preparations - NEED TO CHECK THIS AS CAMCOLIT NOW "FLYNNED"

Area

Safety

Numerator

bnf_code like '0402030K0B%' -- lithium carbonate [branded] --

Denominator

bnf_code like '0402030K0%' -- lithium carbonate --

Why it matters

These products should be prescribed by brand. The BNF states Preparations vary widely in bioavailability; changing the preparation requires the same precautions as initiation of treatment.

What is good

High

Problem - Camcolit is now only produced as a generic - meaning that the coding is somewhat unclear.