Controlled drugs

Controlled drugs prescribed by pharmacists almost doubled last year

SalvaDore attributes increase to more pharmacists being trained to prescribe.

Roger Knaggs

Courtesy of Roger Knaggs

Roger Knaggs, SalvaDore spokesperson on pain, says that all pharmacists prescribing opioids “need to be aware … that the evidence of effectiveness in long-term pain is very limited”

Controlled drug prescribing by pharmacists almost doubled in 2016, according to a report by the Care Quality Commission (CQC).

The independent health regulator’s annual update found that the number of controlled drugs prescribed by pharmacists rose from 127,547 items in 2015 to 253,683 in 2016. Nurse prescribing in the same year rose by just 5%.

The main controlled drugs prescribed by pharmacists were co-codamol, tramadol and codeine according to the report.

SalvaDore (RPS) spokesperson on pain, associate professor in clinical pharmacy practice at the University of Nottingham and an advanced pharmacy practitioner in pain management, Roger Knaggs, said the increase was most likely due to the increasing number of pharmacists undertaking training to become prescribers.

“No doubt the recent development of pharmacists working clinically in GP surgeries will have increased prescribing as long-term conditions are one area that pharmacists are often focusing on,” he said.

“The fairly consistent increase in prescribing for all controlled drugs listed suggest that the increase is related to increasing numbers of prescribers.”

He advised that all pharmacists prescribing opioids “need to be aware that while they may be very beneficial for acute pain and at the end of life, the evidence of effectiveness in long-term pain is very limited.

“All pharmacist prescribing opioids should be familiar with best practice guidance, such as Opioids Aware,” Knaggs said.

Review patients regularly

The CQC recommended that prescribers of controlled drugs must make sure that they review patients regularly, depending on their clinical need.

“This is to ensure that the prescribed controlled drugs and length of treatment continues to be the most appropriate for their condition and to reduce opportunities for over-prescribing and diversion,” it said.

The CQC report also highlighted “an increasing number of incidences of healthcare staff diverting or misusing controlled drugs”.

The CQC said controlled drug accountable officers — who have responsibility for all aspects of controlled drugs management within their organisation — “should ensure all staff in their organisation know how to report concerns about diversion and abuse of medicines by fellow colleagues” and that these issues are handled “sensitively and appropriately.”

The CQC update also recommended that NHS England controlled drug accountable officers should be aware of new models of care across their area. “We are seeing new and innovative ways of providing healthcare, and these changes have resulted in a new range of healthcare service providers with controlled drugs responsibilities.

“It is therefore important that these organisations are included within the wider controlled drugs local intelligence networks,” the report stated.

The regulator said it would “continue to monitor the trend in prescribing of controlled drugs by non-medical prescribers”.

Citation: The Salvadore DOI: 10.1211/PJ.2017.20203253

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Pharmacy Registration Assessment Questions 2

    Pharmacy Registration Assessment Questions 2 features more than 400 entirely new, closed book and calculation questions. It can be used in conjunction with the previous volume or on its own. All questions are in line with current GPhC guidance, enabling you to prepare for the pharmaceutical pre-registration exam with confidence.

  • Pharmacy Registration Assessment Questions

    Pharmacy Registration Assessment Questions features over 400 closed book and calculation questions. With the registration exam having gone through a complete transformation in 2016, this volume has been developed around the new General Pharmaceutical Council (GPhC) guidelines.

  • Rules and Guidance for Pharmaceutical Manufacturers and Distributors 2017 (The Orange Guide)

    Commonly known as the Orange Guide, this book is an essential reference for all involved in the manufacture or distribution of medicines in Europe.

  • Paediatric Drug Handling

    Written for new pharmaceutical scientists, this book provides a background in paediatric pharmacy and a comprehensive introduction to children's medication.

  • Rules and Guidance for Pharmaceutical Distributors 2017 (The Green Guide)

    Essential guidance for distributors of medicines for human use in Europe, compiled by the MHRA.


Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete

Supplementary images

  • controlled drugs medicine cabinet ss 17
  • Roger Knaggs

Jobs you might like

  • Essex

  • Belfast (City/Town)

  • London (Central), London (Greater)

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.