Therapeutic Handbook - GGC Prescribing

NHSGGC Adult Formularywww.ggcprescribing.org.ukNHS Greater Glasgow and Clyde aim to promote high-quality, cost-effective prescribing in all areasof care. This Therapeutics Handbook is one such tool for prescribers to help ensure that they areconsistently giving patients evidence-based treatment.Good prescribing dictates that the choice of therapy should be made on the basis of sound clinicalevidence of efficacy, safety and also takes into consideration patient acceptability and costeffectiveness.The Greater Glasgow and Clyde Adult Formulary takes the above into account when considering amedicine for inclusion and therefore prescribing from the Formulary is consistent with good clinicalpractice.All medicines referred to in this handbook are included in the NHSGGC Adult Formulary.Structure of the FormularyThe NHSGGC Formulary contains two main sections, the Preferred List and the Total Formulary.The Preferred List is composed of approximately 350 medicines which represent the first-line agentsfor many classes of medicine and cover many common conditions and diseases. It is primarily aimedat the generalist prescriber, and those specialists prescribing outwith their specialty. For that reason,various therapeutic areas are not suitable for inclusion in the Preferred List, for example oncologymedicines.The Total Formulary comprises all other Formulary medicines and generally contains specialistmedicines and second and third-line agents from classes included in the Preferred List.Non-Formulary prescribing and processesThe need for prescription of medicines from out with the Formulary (non-Formulary prescribing) isrecognised, but it is expected that:• Formal treatment guidelines / protocols will exclude non-Formulary drugs.• Non-Formulary status will apply to new medicines until accepted by the Scottish MedicinesConsortium (SMC) and the Area Drug and Therapeutics Committee (ADTC). Furtherinformation regarding the SMC, including all previous decisions, can be found on their website:www.scottishmedicines.org.uk• Non-Formulary prescribing may be necessary and approved in exceptional circumstances onlyfor individual patients.• If a non-Formulary prescription is proposed in the best interests of an individual patient, existingnon-Formulary processes should be followed.There are agreed non-Formulary processes in place within both the acute and primary care sectorsof the health board. Within acute sites, there are three categories of non-Formulary prescribing /medicines. The processes that need to be followed for each category differ.Level 1 Non-Formulary MedicinesMost non-Formulary prescribing is monitored retrospectively using pharmacy system data and noaction is required from the prescriber.Level 2 Non-Formulary MedicinesWhilst it is impractical for an Individual Patient Treatment Request (IPTR) form to be completed for allPage 10