Practical advise
Practical advise
There is an expanding repertoire of medicines available to manage ADHD and insomnia. It is helpful to maintain links with your LPC or area medicines management team to ensure you have sufficient stocks of formulary medication.
Slow-release methylphenidate preparations should be prescribed and dispensed by brand. The ‘12 hour’ formulations are marketed as bio-equivalent, but a proportion of patients notice a difference in efficacy and tolerance if switched between them.
If any slow-release preparations are prescribed generically, pharmacy teams must ascertain the patient’s usual brand by checking their dispensing records, asking parents or seeking clarification from the prescriber.
With a growth in licensed melatonin products, compelling justification is needed when dispensing preparations that are unlicensed or off-label in preference to a licensed product. The exceptions to this rule would be a recommendation by the area prescribing committee, the patient is stable on a legacy medication, or a licensed product has not met the patient’s needs. If an unlicensed liquid preparation is clinically appropriate, ensure you check for excipients such as alcohol, sugar, artificial colours and propylene glycol when obtaining it.
CPD evidence template for revalidation
Tip: GPhC expects this section to include three things – a learning objective, why this learning is relevant to your role, and how this learning will benefit the people who use your services.
Learning objective: e.g. To prepare myself and my team so they have better knowledge of the common side-effects of ADHD medication
Why this learning is relevant to my role: (For reader to add)
How it will benefit the people who use my services: (For reader to add)
Tip: This section is for the learning activities you are going to do. Completing this module is one learning activity but make sure you include others that show how you will be able to apply your learning.
- What will you and your team do to support parents who have questions about side-effects from their child’s ADHD medication?
- How will you make sure that members of your team know their role in your plan?
- What resources will you use (e.g. cBNF, Electronic Medicines Compendium, ADHD Foundation)?
Tip: Include statements about how you envisage your team and/or your customers and/or local general practices will benefit from your learning. Also, give an example of how someone actually benefited.
- e.g. This learning will benefit my team by...
- e.g. An example of a customer/parent who benefited from my learning is…
- e.g. An example of a practice-based pharmacist who benefited from my learning is…
Supply problems
Medication supply problems are troubling for parents and healthcare professionals alike. It can be hard to cover every eventuality, so the following is general guidance:
- Check with the manufacturer as to the extent of the shortage, what strengths are affected and the anticipated timeframe for resolution
- Liaise with local GP surgeries to inform them of the issue along with any advice on a workaround – often community pharmacy will know before the practice
- On a temporary basis, supply may be able to be maintained by ‘doubling up’ on lower strengths (although this puts supply pressure on those strengths and risks compounding the issue)
- Stopping the medication during non-critical times (e.g. weekends/summer holidays) is an option which can prolong supply, but parents should liaise with their specialist – especially if such a strategy has not been discussed before
- For the ‘12 hour’ preparations, the area prescribing committee may decide to use a second-line bio-equivalent product in the interim.