DROP Drugs
Here you'll find information on the Drugs to Review for Optimised Prescribing DROP-List.
Below is a list of the now 30 Drugs to Review for Optimised Prescribing items - along with links to where you can find the resources:
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The DROP-List Bulletin v4.0 - July 2015
The 2015/16 version of the DROP list and supporting documents can be found here. A slideset is also available for use locally. This bulletin includes Drop List searches in Systmone, EMIS Web and Vision.
DROP-List Searches
These searches incorporate all the items in the DROP list with instructions on using the searches.
The DROP List and self care
Some of the items on the DROP List are suitable for self care. We have developed a separate self care webkit looking specifically at items suitable for self care and treating minor ailments. The self care items will eventually be removed from the DROP List.
DROP-List visual scorecard
The DROP list scorecard has been combined with our other scorecards on visual analytics.
Analgesia
This bulletin covers prescribing for analgesia items (excluding POM medicines), where these products are being prescribed for minor ailments such as acute mild pain, fever etc.
Rubefacients
This bulletin reviews the place in therapy of the rubefacients which also have a nice do not do attached to them. An audit and patient letter are available as supporting tools.
Travel vaccines
This bulletin and supporting resources will support CCGs wishing to review their prescribing policies on travel vaccines. It identifies vaccines that should not be prescribed on the NHS for travel.
Antihistamines
Hayfever can be managed as part of self care and several antihistamines and nasal sprays are available to purchase over the counter. The self care resources on hayfever are patient information resources.
Lidocaine plasters
This bulletin looks at lidocaine plasters and provides the rationale for not initiating lidocaine plasters in new patients, and for current patients to be considered for discontinuation of their prescription for lidocaine plasters.
Nasal sprays OTC
Nasal sprays for the symptomatic relief of hayfever and congestion can be purchased by the as part of self care.
Doxazosin MR
This bulletin supports the review of doxazosin MR prescribing and supports a switch to the immediate release formulation in line with the NHS England "Items which should not routinely be prescribed in primary care" guidance.
Fentanyl
Immediate release fentanyl has a NICE do not do as a first line treatment for breakthrough pain. This bulletin will focus on fentanyl immediate-release formulations.
Male sexual dysfunction
PrescQIPP have produced two sets of resources in this area. One looking at male sexual dysfunction in general and treatment options available, and the other focusing specifically on once daily tadalafil.
Tadalafil once daily
PrescQIPP have produced two sets of resources in this area. One looking at male sexual dysfunction in general and treatment options available, and the other focusing specifically on once daily tadalafil.
Omega-3 fatty acids
These resources will support the review of Omega 3 fatty acid treatment in line with the NHS England guidance on items which should not routinely be prescribed in primary care.
Haemorrhoid treatments
There are several preparations available over the counter to treat haemorrhoids. The self care resources provide patient information.
Dental products on FP10
This bulletin has been developed to encourage dentists to prescribe and not refer to GPs for a prescription (which can take up valuable appointment time).
Co-proxamol
This bulletin discusses the use of co-proxamol and supports reviewing and discontinuing prescribing in patients still taking this unlicensed medicine.
Tramacet®
This bulletin focuses on Tramacet® (paracetamol 325mg/tramadol 37.5mg) and provides the rationale for new patients to be initiated on paracetamol or paracetamol with codeine.
Oxycodone/Naloxone (Targinact ®)
This bulletin and resources provide further information on the evidence base for for using oxycodone/naloxone prolonged release tablets, the rationale to stop treatment and also suggests alternative treatment options.
Antifungal nail pain
This bulletin focuses on topical antifungal nail treatment, i.e. amorolfine 5% nail lacquer (Loceryl®, Curanail®, Omicur®), tioconazole 28% cutaneous solution (Trosyl®) and salicylic acid, tannic acid and boric acid paint (Phytex®).
Vitamins and minerals
This bulletin reviews the place in therapy for the multivitamin and mineral supplements and also the vitamin B complex products. They are not recommended for prescribing as general pick me ups and should be reviewed and discontinued where appropriate.
Eflornithine
This bulletin focuses on eflornithine cream which is a low priority treatment considered as a cosmetic treatment for hirsutism in women. It provides the rationale for self-funded hair removal methods as the primary treatment option for women with hirsutism.
Perindopril arginine
This bulletin was originally developed in May 2018, however as the price of perindopril erbumine was higher than perindopril arginine it was not published. The prices and references have been updated in this resource and it has been published for those commissioners who still wish to review prescribing.
Antioxidant vitamins for AMD
The evidence to support the use of antioxidant vitamins to reduce the progression of age related macular degeneration is limited. This bulletin reviews the evidence available and supports reviewing and stopping treatment with antioxidant vitamins.
Cough and cold remedies
Coughs and colds are self limiting illnesses that can be managed with self care. These resources provide patient information.
Amiodarone
Review patients on amiodarone to ensure treatment is being appropriately monitored and that it is discontinued in indications where use is short-term only.
Minocycline
This bulletin focuses on minocycline for the treatment of acne vulgaris and provides the rationale for new patients to be commenced on an alternative antibiotic and for current patients to be considered for stopping therapy or a switch to an alternative antibiotic.
Aliskiren (Rasilez®)
NICE state there is insufficient evidence of the effectiveness of aliskiren to determine its suitability for use in resistant hypertension.
Complementary therapies, herbal supplements and homeopathy
There is a limited evidence base and a lack of robust randomised controlled trials directly comparing complimentary therapies with standard treatments. Some complimentary therapies are also associated with severe adverse effects, may significantly interact with other medicines and can delay accurate diagnosis of underlying pathology.
Glucosamine
There is limited evidence to support the use of glucosamine and chondroitin products and they are listed as a NICE do not do. This bulletin reviews the use of glucosamine (with or without chondroitin) preparations.
Management of infantile colic
The management of infantile colic bulletin covers the treatment of colic and the place in therapy for lactase, simeticone and gripe water products.
Probiotics
This bulletin provides is an update on probiotics. It focuses on reviewing prescribing of probiotics (including VSL#3® and Vivomixx®) and discontinuing therapy in light of the fact probiotic products are no longer approved under the ACBS scheme. An audit and patient letter are available for organisations considering reviewing this therapy area.
Cannabis sativa
Cost effectiveness evidence does not support use of cannabis sativa.
Sunscreens
The sunscreens resource has been added to the DROP list as an item where review of prescribing is recommended to ensure all prescribing is in line with ACBS criteria.
