28 Mar 2013
In response to the National Institute for Health and Clinical Excellence’s (NICE) first good practice guidance on the subject – Developing and Updating Local Formularies – the Trust has developed a local medicines formulary.
The formulary is a list of medicines used for mental health indications for patients cared for in all settings of West London Mental Health NHS Trust.
It is intended to cover prescribing for mental health conditions and the management of adverse effects related to the medication for:
- Prescriptions written for inpatients
- Prescriptions or recommendations by Trust doctors in respect of outpatients or patients leaving hospital after an admission.
The evidence base for the formulary has been based on the Maudsley Prescribing Guidelines.
The formulary should be taken fully into account by prescribers when exercising their clinical judgement. However, it does not override the individual responsibility of prescribers to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer and informed by the summary of product characteristics of any medicines they are considering.
Prescribing outside of the formulary will require a discussion with the team pharmacist before the medication can be ordered by pharmacy and clinicians should be aware that items will not be kept in pharmacy and there may be a delay in supply.
People currently receiving a medicine that is not included in the formulary should have the option to continue until they and their clinicians consider it appropriate to stop.
West London Mental Health NHS Trust has a responsibility to ensure that treatments recommended by NICE are made available to patients. The Trust must also ensure any treatments that NICE recommend should not be used, are not used.
Mental Health medicines recommended by NICE technology appraisal guidance (TAG) will, where clinically appropriate, be included in the Formulary within 90 days of the date the TAG is published.
In West London Mental Health Trust, the Drugs and Therapeutics Committee has been designated as the local formulary decision making group and will review all new NICE technology appraisals and decide if they are relevant to the mental health services that the Trust provides.
This group has agreed that the following technology appraisals related to the use of medicines are relevant to the services we are responsible for providing:
TA77 – Zaleplon, zolpidem and zopiclone for the short-term management of insomnia
TA98 – Methylphenidate, atomoxetine, and dexamfetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents.
TA213 – Aripiprazole for the treatment of schizophrenia in people aged 15 to 17 years
TA217 – Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease
TA292 – Aripiprazole for moderate to severe manic episodes in adolescents with bipolar I disorder
The Drugs and Therapeutics Committee have made sure that the recommended medicines in these technology appraisals have been included in the trust’s local formulary.
The Drugs and Therapeutics Committee is responsible for managing the process for adopting, removing and updating new medicines or indications within the formulary.
Applications for the assessment of medicines to be reviewed for inclusion on the formulary should be submitted by a clinician using the addition of new medicines request form which is available from pharmacy.