Hi Eric
The same document has also hit North Wales. I share your concerns. I have
had a running issue with pharmacy departments with what now seems like all
my career about them producing documents such as this without our advice.
Like yourself I think the idea is laudable but feel that we ought to be more
involved than we seem to be.Pharmacists always seem to have the resources to
produce such work - because perhaps its more part of their job. Maybe the
era of Clinical Governance and Evidence based pratice will help sort out
this anomaly. In Wales there should be systems to ensure that things go
through the Welsh Scientific Advisory Committee where any anomalies would be
checked. But it does n't always happen. Perhaps its something that the ACB
should tackle.
Best wishes
Keith
Ysbyty Gwynedd
Bangor
North Wales
ps Just got back from holiday hence the delay in replying.
-----Original Message-----
From: Eric Hindle [mailto:[log in to unmask]]
Sent: 07 February 2003 14:31 PM
To: [log in to unmask]
Subject: Monitoring drug therapy
A GP colleague has just sent me a copy of a document from the North West
Medicines Information service entitled 'Drug Information Letter, Monitoring
Drug Therapy'. (NHS UKMi)
This six page document contains suggested monitoring and frequency of
biochemical and haematological markers for a variety of cardiovascular,
respiratory system, CNS, antipsychotic, endocrine system, and
musculoskeletal/joint disease drugs.
I am unsure how evidence based the recommendations are, but the main source
of reference appears to be BNF and the product summary characteristics.
The tests listed are said to be 'suggested monitoring', but I have grave
concerns that such a document ends up being quoted as gospel. I have also
no doubt that if the recommendations are followed there will be a further
uncontrolled and unresourced escalation in work load ( and may be this has
already happened).
Whilst a document of this nature is quite a good idea, there could
obviously be several debatable recommendations (for example does everyone
measure baseline CK on patients before starting statins... what is the
evidence and should I be?)
I have several concerns that it has been produced apparently without any
consultation at all with Laboratory professionals either within this Region
or Nationally. It is also rather embarrasing to be informed of such a
document via your General Practioners and for protocols to be invoked and
samples referred to your laboratory without knowledge of
the 'recomendations' they are following.
Are similar documents in circulation in other Regions, as I imagine there
is probably some networking of our Pharmacy colleagues and do we need to
do something to ensure that we are invited to participate in the production
of similar material.
Eric Hindle.
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