PrescQIPP

PROP-List (Products to Review for Optimised Prescribing)

This has been one of our most popular pieces of work for a number of years with commissioners and clinicians. We first published the DROP-List (drugs) in 2011, built from an the top items on local lists of low priority treatments, and those where there is a limited evidence base to support use. Over the years it evolved to incorporate medicines optimisation principles, self care and most recently the NICE do-not-do’s. In 2016 a DROP-List for devices was developed which follows the same principles as the drugs list.

Between 2017 and 2019, NHS England released the guidance on items which should not routinely be prescribed in primary care and also self care guidance which incorporated some of the items in the DROP-List. 

The PROP-List now includes both drugs and devices, and items in the NHS England guidance (which are all covered in the low priority prescribing and self care webkits) have been removed in order to avoid duplication. 

Alimemazine

In children with ADHD and in children with autistic spectrum disorder, NICE recommend non-pharmacological interventions (e.g. sleep hygiene and behavioural therapy) first-line for sleep problems.  

 

Antifungal nail paint

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®).

Please note: this is an archived bulletin

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Belladonna adhesive plaster

Not recommended; there is insufficient evidence to recommend the use of belladonna adhesive plasters.

Cannabis sativa (Sativex®)

Complementary therapies (excluding herbal products, homeopathy, and Lutein and antioxidant vitamins.)

Not generally recommended for prescribing; products have largely not been adequately evaluated in clinical studies.

Cycloidal vibration accessories (Vibro-pulse® accessories)

Not recommended; there is currently insufficient evidence to recommend the use of cycloidal vibration therapy.

Deodorant (stoma)

If stoma correctly fitted, no odour should be apparent except when the bag is emptied or changed therefore deodorants not routinely needed. Household air-fresheners are sufficient in most cases and are widely available to buy. If odour is present at times other than changing or emptying, refer the individual for review.

Dry mouth products

Dry mouth products such as artificial saliva or salivary stimulants should only be prescribed if simple measures alone have been inadequate.

Eflornithine cream

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. 

Please note: this is an archived bulletin

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Electrical stimulating wound device (Accel-heal®)

Currently insufficient evidence to recommend use.

Inhalation solutions

This category refers to hypertonic sodium chloride solutions for nebulisation. It does not include sodium chloride 0.9% w/v used for dilution of solutions for nebulisation.

Insert for female stress incontinence

Not recommended; there is currently insufficient evidence to recommend the use of devices for female stress incontinence. NICE do not recommend their routine use.

Inspiratory muscle training devices

Not recommended for routine use, but inspiratory muscle training may be considered in those with COPD, non- CF bronchiectasis and upper spinal cord injuries.

Lymphoedema garments

This bulletin provides the rationale for ensuring lymphoedema garments are used as part of a local pathway that incorporates an ordering process which ensures the correct items are selected to avoid waste and delays in treatment.

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Nasal products

For managing the nasal symptoms of self-limiting conditions, saline nasal sprays can be purchased OTC for self care by those that wish to try them.

Needle-free insulin delivery system

Not routinely recommended unless there is a confirmed diagnosis of needle phobia which would result in the patient not injecting insulin.

Oscillating positive expiratory pressure device

Recommended for consideration when selecting an appropriate airway clearance technique in those with CF and non-CF bronchiectasis.

Ostomy underwear

This resource supports the review of the use of stoma underwear and belts. Recommendations for self care and quantities that should be prescribed where appropriate are included. A data pack is included to support local review.

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Pelvic toning devices

Not recommended; there is no evidence of additional benefit compared to undertaking pelvic floor exercises alone.

Plantar pressure offloading device

Ensure the use of plantar pressure offloading devices is part of a robust and clear local pathway for the prevention and management of diabetic foot problems.

Potassium hydroxide solution

Potassium hydroxide solution for treating molluscum contagiosum is not recommended for prescribing in primary care; there is currently insufficient evidence of efficacy and a risk of side-effects.

Pulsed electromagnetic stimulator

Not recommended for prescribing; there is currently insufficient evidence to recommend use.

Safety needles and safety lancets

Not recommended for routine prescribing: Safety needles and lancets (also known as ‘safer sharps’) are primarily for the benefit of healthcare workers to avoid needle stick injury, rather than for use by patients for self-administration. Therefore they should not routinely be prescribed on FP10s.

Bulletin 276: Lancets

Bulletin 103: Insulin needles

Synovial fluid

Not recommended; NICE guidance does not recommend offering intra-articular hyaluronan injections for the management of osteoarthritis.

Transanal irrigation

This bulletin reviews the use of transanal irrigation to ensure proper pathways are in place before prescribing and wastage is reduced through appropriate prescribing.

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Waterproof limb covers

Waterproof limb covers are reusable. Where prescribing is supported on a local pathway, they should not be placed on repeat prescription.