"Country Doctor"
JOIN CDA NEWS INDEX POLITICS DISPENSING EDUCATION FEATURES BOOKS SMALL ADS GP FEES LIGHT BITES LINKS FEEDBACK
GP transplants|
launched by Astellas Pharma Ltd, has been developed in consultation with Dr Varuna Aluvihare, Consultant Hepatologist and Transplantation Specialist, King's College Hospital. It is hoped that the guide will help to improve best practice in patient management
and help to reduce the number of inadvertent prescribing errors seen in
the area of transplantation. The guide has been launched as a result of ongoing prescribing and dispensing errors for patients receiving tacrolimus - an immunosuppressant with a narrow therapeutic index, given orally to prevent or treat organ transplant rejection1-4. Tacrolimus is currently available in three different formulations - these formulations are not interchangeable5. These reported errors have led
to significant consequences for patients, including increased drug
levels and cases of acute rejection of the transplanted organ5. By December 2008, the MHRA had received 55 case reports in seven EU countries, mostly from the UK, involving prescribing/dispensing errors in association with oral tacrolimus. These included: Six cases of prescribing errors by hospital doctor or GP, forty-one cases of dispensing errors by pharmacist related to generic or brand prescribing, and eight cases of administration errors by doctor, nurse or patient6. These inadvertent medication errors for transplant patients continue to occur in the UK, and remain an ongoing source of concern5. The guide includes a clear call to action for GPs when managing transplant patients:
not changed unless clearly directed and supervised by the transplant specialist
brand
specified by the transplant specialist along with clear guidance on
dosing frequency the correct formulation
them
to check that this is the formulation/brand that they are given when
collecting from their pharmacist Dr Varuna Aluvihare, Transplant Physician, King's College Hospital commented: "Whilst the number of transplant patients within each practice may be small, it is essential that we work together to do all that we can to prevent inadvertent prescribing and dispensing errors from occurring. This guide aims to ensure GPs feel confident in managing their transplant patients. By ensuring that the exact formulation or brand of oral tacrolimus is clearly written on each prescription, with guidance on dosing frequency, we can avoid the complications we know can occur through inadvertently switching and thereby help protect our transplant patients. I would urge every GP to familiarise themselves with these recommendations, and adhere to these simple steps to ensure they are doing the best for
their transplant patient." time for a kidney transplant in the UK is around 3 years for an adult8, it is important that all healthcare professionals and patients are aware
of the potential serious consequences of these medication errors. treatment of transplant patients, Professor Atholl Johnston, a leading expert in pharmacokinetics from Barts and The London, Queen Mary's School of Medicine and Dentistry, commented: "It is of paramount importance that primary care healthcare professionals responsible for the ongoing care of transplant patients are aware of the serious implications that an unintended medicine change can have on their patients. They must therefore ensure that all prescriptions for immunosuppressant medicines are written by brand, to
avoid these potentially fatal medication errors we have seen." dosed and stabilised on their medicines in a secondary care setting by a transplant specialist. On average there are one or two transplant
patients per GP practice9, and this guide aims to remind GPs of the
avoidable risks of prescribing and dispensing errors. immune
system that would normally attack the transplanted tissue. unintentional change in formulation can cause drug blood levels to change, increasing the risk of graft rejection, graft loss or complications due to drug toxicity1-4. Any such changes should only occur under the supervision of a transplant specialist and with
accompanying therapeutic blood level monitoring1-4. and education and sponsors a number of European and national professional bodies. In transplantation, Astellas manufactures immunosuppressants
for the prevention of organ rejection post-transplant and its pipeline
includes further products in this area. (11/8/10)
|
|
