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NICE evidence summary of oral ketamine for chronic pain

27th February 2014

The National Institute for Health and Care Excellence (NICE) has published its evidence summary (ESUOM27) for the unauthorized (unlicensed)/off-label use of oral ketamine for chronic pain.

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First ever Global Atlas identifies unmet need for palliative care

25th February 2014

A new publication mapping the provision of palliative care around the world has been published jointly by the World Health Organization (WHO) and the Worldwide Palliative Care Alliance (WPCA). The Global Atlas identifies that only 1 in 10 people who need palliative care are receiving it, and calls on all countries to include palliative care as an essential component to every modern healthcare system. The importance of palliative care is also being emphasized by the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 and the most recent WHO essential medicines list which includes a specific section on medicines for palliative care (see our news item 18 July 2013). The documents can be downloaded from the links below.

Global Atlas

Global Action Plan for the Prevention and Control of NCDs 2013-2020

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ACMD recommends reclassifying ketamine

25th February 2014

The UK Advisory Council on the Misuse of Drugs (ACMD) has recommended that ketamine be controlled under the Misuse of Drugs Act 1971 as a Class B substance (currently Class C) and that there should be a consultation on reclassifying ketamine as Schedule II of the Misuse of Drugs Regulations 2001 (currently Schedule 4 part 1). This is based on the evidence of chronic bladder and urinary tract toxicity. The government minister for crime prevention has accepted these recommendations.

ACMD report on ketamine

Government response  

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Phosphate enema new contra-indication

25th February 2014

The UK SPC for Fleet Ready-to-use Enema (phosphate enema) has been updated to include a new contra-indication in patients with clinically significant renal impairment (not defined). In addition, precautions added include; conditions predisposing to dehydration, or drugs that may decrease GFR, affect electrolyte levels, prolong QT interval, affect renal perfusion or function, or hydration status.

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Opioid antagonists therapeutic review

11th February 2014

A therapeutic review on opioid antagonists has been published in the Journal of Pain and Symptom Management (JPSM):

Barnett V. et al (2014) Therapeutic Reviews: Opioid Antagonists. Journal of Pain and Symptom Management. 47:341 −352. 

This is the 16th article in the series; all are based on monographs featured in the Palliative Care Formulary.

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NICE consultation on enhancing the BNF with other prescribing resources: an opportunity to lobby for the Palliative Care Formulary

7th February 2014

NICE has opened a consultation on the future format of the British National Formulary (BNF) and how it can enhance the information it provides by linking to other authoritative sources of prescribing information.

This provides an opportunity for UK members of to highlight to NICE the value of the Palliative Care Formulary (PCF).

We encourage members to respond to the consultation and suggest that linking to the on-line PCF would enhance the BNF. This can only help in our endeavours to secure a national subscription and provide, once more, free-access for UK health professionals.

The feedback form takes 5–10min to complete and comprises a tick box question on how you currently access the BNF followed by three short questions.

The consultation closes at 9am 31 March 2014.

BNF consultation document (4 pages)

On-line response link

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SIGN guidance on lung cancer updated

6th February 2014

The Scottish Intercollegiate Guidelines Network (SIGN) have updated their guideline on the management of lung cancer (SIGN 137). This supersedes SIGN 80.

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