Short Life Working Group On Prescription Medicine Dependence And Withdrawal: consultation

List of consultation questions

PHE Recommendation 1

“Increasing the availability and use of data on the prescribing of medicines that can cause dependence or withdrawal to support greater transparency and accountability and help ensure practice is consistent and in line with guidance.”

Scottish Context

Public Health Scotland considered the PHE analysis of prescribing data and replicated for Scotland, this enabled the SLWG to consider differences between England and Scotland and how recommendations in Scotland needed to be adjusted.

SLWG Recommendation 1

Make data available for all prescribers, health and social care partnerships and patients to allow monitoring of data and improvement in practice.

Question 1.1

Do you agree with this recommendation?

Question 1.2

On a scale of 1-5, where 1 is not effective at all and 5 is extremely effective how effective do you think that action will be?

Question 1.3

Comments:

PHE Recommendation 2

“Enhanced clinical guidance and the likelihood that it will be followed”

Scottish Context

There are multiple source of Guidance, such as Scottish Intercollegiate Guidance Network (SIGN) and National Institute for Health and Care Excellence (NICE).

Scottish Government also produces its own series of Quality Prescribing Guides in partnership with the NHS to support implementation in practice. Work has already started on guides for antidepressants, benzodiazepines and hypnotics and gabapentinoids. Scoping documents have been shared with the SLWG.

SLWG Recommendation 2

Develop or renew Quality Prescribing Guides for all classes of drugs covered by the SLWG: z-Drugs, benzodiazepines, gabapentinoids, opioids, antidepressants

Question 2.1

Do you agree with this recommendation?

Question 2.2

On a scale of 1-5, where 1 is not effective at all and 5 is extremely effective how effective do you think that action will be?

Question 2.3

Comments:

PHE Recommendation 3

“Improving information for patients and carers on prescribed medicines and other treatments, and increasing informed choice and shared decision making between clinicians and patients”

Scottish Context

Shared Decision Making is embedded in Scottish Health Policy and has been developed in partnership between patients, clinicians and policy makers. These are currently found in the Scottish polypharmacy app for patients and clinicians.

In terms of Prescription Medicine Dependence and Withdrawal, the SLWG agreed that further focused information should be produced and made available in an accessible format for patients.

SLWG Recommendation 3

Work with NHS Inform and NHS 24 to develop on-line guides and resources to support patients suffering from withdrawal from the 5 classes of medication covered by the review.

Develop decision aids for the medicines covered by the SLWG. Patients with lived experience to be involved in their development.

Make resources available in easy to use forms that maximise availability, including through the polypharmacy app.

Question 3.1

Do you agree with this recommendation?

Question 3.2

On a scale of 1-5, where 1 is not effective at all and 5 is extremely effective how effective do you think that action will be?

Question 3.3

Comments:

PHE Recommendation 4

“Improving the support available from the healthcare system for patients experiencing dependence on, or withdrawal from prescribed medicines”

Scottish Context

Patients experiencing withdrawal from prescription medicine need tailored support as side effects take many forms and can occur at any time of the day. NHS Scotland provides a range of services to support unscheduled care. In addition there are opportunities to ensure that these issues are considered in the development of future strategies including the Framework for Chronic Pain Service Delivery in 2021.

SLWG Recommendation 4

Work with NHS Inform and NHS24 to explore out-of-hours helpline to assist patients suffering from dependence and withdrawal from prescribed medicines.

Question 4.1

Do you agree with this recommendation?

Question 4.2

On a scale of 1-5, where 1 is not effective at all and 5 is extremely effective how effective do you think that action will be?

Question 4.3

Comments:

PHE Recommendation 5

“Further research on the prevention and treatment of dependence on, and withdrawal from, prescribed medicines”

Scottish Context

The PHE review made some recommendations for future research. The SLWG considered these in a Scottish context and made some additional recommendations. These are of relevance to research communities in Scotland, including the NHS Research Scotland Pain consortium who are already engaged in addiction related studies.

SLWG Recommendation 5

Promote SLWG recommendations for further research

Question 5.1

Do you agree with this recommendation?

Question 5.2

On a scale of 1-5, where 1 is not effective at all and 5 is extremely effective how effective do you think that action will be?

Question 5.3

Comments: