Audits - Musculoskeletal

Please select from the following Audits.

Etoricoxib review

This audit has been designed to ensure that patients prescribed etoricoxib have had their blood pressure measured and that etoricoxib is considered as a potential causal, or exacerbating, factor where hypertension is detected. The patient’s risk of adverse cardiovascular and gastrointestinal events will also be assessed and where appropriate an alternative NSAID may be suggested. All non-steroidal anti-inflammatory drugs should be prescribed at the minimum effective dose for the shortest possible duration.

Etoricoxib reviewDownload File
(Etoricoxib review May 2012.pdf)

Date Uploaded: 11/07/2012

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Quinine Discontinuation Letter

This is a template letter that can be sent to patients to encourage discontinuation of quinine.

Quinine Discontinuation LetterDownload File
(Microsoft Word - Quinine discontinuation patient information[1].pdf)

Date Uploaded: 16/05/2011

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Quinine discontinuation letter and PIL

NHS Dumfries and Galloway are currently reviewing all patients prescribed quinine sulphate tablets for the treatment of night time cramps and inviting patients to interrupt their treatment in order to determine whether their leg cramps have resolved, following recommendations detailed in the BNF. A letter and patient information leaflet is available to this end.

Quinine discontinuation letter and PILDownload File
(Quinine discontinuation and cramp self help.doc)

Date Uploaded: 17/02/2011

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Methotrexate audit

Methotrexate is an antineoplastic that acts as an antimetabolite of folic acid. It also has immunosuppressant properties and is most commonly used ingeneral practice as a disease modifying anti-rheumatic drug for the treatment of moderate to severe rheumatoid arthritis and psoriasis. Methotrexate is of value in the treatment of psoriasis but because of the risks associated with this use, it should only be given when the disease is severe and has not responded to other forms of treatment. Management of rheumatoid arthritis is conventionally begun with an analgesic and an NSAID for symptomatic relief, to which a disease-modifying antirheumatic drug (DMARD) is subsequently added in an attempt to retard the disease process.

It is now clear that irreversible joint damage commonly occurs in early disease and rheumatologists now generally add the DMARD shortly after rheumatoid arthritis has been diagnosed. Methotrexate is widely used, and is the DMARD of first choice in many patients. Systematic review has confirmed that methotrexate has significant benefit in the short-term treatment of the disease. In terms of cost methotrexate is an inexpensive drug however the National Patient Safety Agency (NPSA) issued an alert in July 2004 highlighting the potential hazards of this drug to NHS trusts. They requested that NHS organisations should take steps to ensure that this drug is prescribed and monitored safely and that patients receive the core patient information leaflets and monitoring documents produced by the NPSA. NHS organisations were also charged with self-assessing locally the safe prescribing, safe dispensing and safe administration checklists. This audit looks at safe prescribing and monitoring of oral methotrexate in general practices.

Methotrexate auditDownload File
(Methotrexate May 2010.pdf)

Date Uploaded: 31/05/2010

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Naproxen review

This audit aims to
review all patients who are currently prescribed a naproxen ec, Naprosyn, Naprosyn ec, Synflex or Napratec® to determine if they could be managed on a simple analgesic such as paracetamol
review all patients who require naproxen to determine if their prescription could be changed to generic Naproxen BP.
review all patients who require naproxen to determine if they should be co-prescribed a proton pump inhibitor for prophylaxis of NSAID-associated GI ulceration.

Naproxen reviewDownload File
(Naproxen audit July 2009.pdf)

Date Uploaded: 12/11/2009

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NSAID audit

This audit has been designed to ensure that patients prescribed an NSAID have had their risk of adverse GI events assessed. Patients who fit the criteria for prescribing a non-steroidal anti-inflammatory drug (NSAID) and who are a high risk of gastro-intestinal event will be co-prescribed a PPI.

NSAID auditDownload File
(NSAID audit April 2008.pdf)

Date Uploaded: 17/04/2008

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