Drug and Therapeutics Bulletin current issue

No recycling

2012-05-08T21:01:06-07:00

The quantity of medicines that is ‘wasted’ remains an area of concern for all those involved in healthcare. An estimated £450m worth of prescription medicines are discarded every year in England, Scotland, Wales and Northern Ireland.1–3 It is thought that a fifth of the population has one or more unused medicines in their possession, and that on average, 75 prescription items are returned to each community pharmacy every month.1 Nationally, around 1% of dispensed items are eventually returned to a pharmacy or dispensing GP practice unused or partially used.1 The national health services pay for medicines to be dispensed and then pay for those that have been returned to be collected and destroyed. Patients, relatives and carers are always dismayed to discover that returned medicines cannot be recycled for use by another patient. And if not in this country,...

DTB Select: 5 | May 2012

2012-05-08T21:01:06-07:00

Every month, DTB scans sources of information on treatments, disease management and other healthcare topics for key items to bring to our readers' attention and help them keep up to date. To do this, we produce succinct, contextualised summaries of the information concerned. We also include comments on, for example, the strengths of the information, whether it contains anomalies, ambiguities, apparent error or omissions, or whether or how it affects current practice.

Very low calorie diets

2012-05-08T21:01:06-07:00

In the UK, over 50% of adults are overweight (body mass index [BMI] of 25–29.9kg/m²) or obese (BMI 30kg/m² or more); it is thought that over half of the UK population could be obese by 2050 because of the increasing availability of calorie-dense food and sedentary lifestyles.1–3 Interventions to achieve weight loss include diets, increased physical activity, behavioural modification strategies, drugs (e.g. orlistat) and bariatric surgery.4 Dietary interventions include low-calorie diets (LCDs; 1,000–1,200kcal/day for women and 1,200–1,600kcal/day for men), very low calorie diets (VLCDs; including Very Low Energy Diets [VLED]; below 800kcal/day) and Low Energy Liquid formula diets (LELD; above 800kcal/day).4,5 However, drop-out rates from such interventions are often high. Here we consider the safety and effectiveness of VLCDs and practical issues about their use.

{blacktriangledown} Indacaterol for COPD

2012-05-08T21:01:06-07:00

Indacaterol powder for inhalation (Onbrez Breezhaler – Novartis) is a long-acting beta2 agonist, licensed for once-daily use as maintenance bronchodilator therapy for chronic obstructive pulmonary disease (COPD). In this article, we consider the evidence for indacaterol and how its use fits with current management strategies for COPD.