Reducing suboptimal prescribing of glucagon-like peptide mimetics in type 2 diabetes | Correspondence

In 2016, spend on diabetes prescribing — and glucagon-like peptide 1 (GLP-1) mimetics, in particular — at NHS Hastings and Rother Clinical Commissioning Group (CCG) and NHS Eastbourne, Hailsham and Seaford CCG was significantly higher than expected, based on national prescribing patterns. There was also significant variation between GP practices. A project was undertaken by the medicines management (MM) team to support primary care diabetes teams to work with patients to optimise prescribing through implementation of the National Institute for Health and Care Excellence’s (NICE) guidelines for type 2 diabetes mellitus (T2DM).

The project aimed to review all patients prescribed GLP-1 mimetics at our GP surgeries to assess prescribing in accordance with NICE guidelines. The main objectives were to identify suboptimal prescribing, rationalise therapy, and improve quality of life for patients, while ensuring good value from the prescribing budget.

The project was a key part of our GP prescribing support scheme, which provides financial incentive for engagement. All key stakeholders were consulted during the project’s development. Opportunities to educate clinicians on diabetes medicines optimisation and share details of our project were utilised during GP engagement events. Inspirational speakers delivered key note sessions at our annual GP education event. Details of the project were shared with all key stakeholders through communications such as newsletters.

Before the project was implemented, training was provided for pharmacists undertaking reviews. Key resources used to standardise data collection included searches to identify appropriate patients and a template produced by EMIS Health.

Practices were required to meet with their MM pharmacist to discuss patient-level diabetes medication reviews and agree an action plan to improve prescribing in line with NICE guidelines. These reviews were intended to optimise diabetes medication, with a focus on blood pressure and cholesterol management; however, the reviews were holistic — other medication issues identified were highlighted and discussed. Action plans were agreed to ensure key messages became embedded into normal practice. An audit was then carried out to ensure the agreed actions had been implemented.

Leave a Reply

Your email address will not be published. Required fields are marked *