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Shared-care Guidelines

 Click here for a downloadable word document of the shared care agreement forms: 

DMARDs Shared Care Agreement (Version 1.1) 

Generic Shared Care Agreement Form 

Adopted
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Adopted
Date Posted: 01 - November - 2018

Methylphenidate, Lisdexamfetamine, Dexamfetamine, Atomoxetine - For Attention Deficit Hyperactivity Disorder in adults aged over 17 years and in children and adolescents aged 6 to 17 years

Guanfacine - For Attention Deficit Hyperactivity Disorder in children and adolescents aged 6 to 17 years 

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Pending
Date Posted: 14 - January - 2021
Adopted
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Adopted
Adopted
Date Posted: 01 - November - 2014

Amisulpride, Aripiprazole, Olanzapine, Quetiapine, Oral Risperidone
This shared prescribing guideline for the second-generation antipsychotic medications listed above has been developed with due consideration to the appropriate NICE Clinical Guidelines (CG) e.g. Bipolar Disorder (CG185), Psychosis and Schizophrenia in Children and Young People (CG155), Psychosis and Schizophrenia in Adults (CG178), Schizophrenia- Aripiprazole (TA213), Bipolar Disorder- Adolescents (TA292).

Please note: Morecambe Bay CCG has now adopted this Shared-care guideline for all areas, including South Cumbria. 

 

Adopted
Pending
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Pending
Adopted
Adopted
Adopted
Date Posted: 01 - January - 2017

Refer to Local Commissioning Policy Before Use

Treatment of Parkinson’s Disease

 

 

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Adopted
Adopted
Adopted
Date Posted: 31 - August - 2018

This guidance does not replace the SPC’s, which should be read in conjunction with this guidance.

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

 

Adopted
Adopted
Adopted
Adopted
Adopted
Adopted
Adopted
Adopted
Date Posted: 01 - September - 2018

This guidance does not replace the SPC’s, which should be read in conjunction with this guidance

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

 

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Adopted
Adopted
Date Posted: 01 - April - 2018

Denosumab 60mg injection - Treatment of osteoporosis in postmenopausal women and in men at increased risk of fracture and treatment of bone loss
associated with long-term systemic glucocorticoid therapy in adult patients at increased risk of fracture

Not adopted
Adopted
Adopted
Not adopted
Adopted
Adopted
Adopted
Adopted
Date Posted: 01 - September - 2018

Treatment of active rheumatoid arthritis and active psoriatic arthritis

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

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Adopted
Date Posted: 01 - May - 2014

Licensed Indications

  1. In the management of acute mania or hypomanic episodes
  2. In the management of episodes of recurrent depressive disorders where treatment with other antidepressants has been unsuccessful
  3. In the prophylaxis against bipolar affective disorders
  4. Control of aggressive behaviours of intentional self-harm.
Not adopted
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Adopted
Not adopted
Adopted
Adopted
Adopted
Adopted
Date Posted: 01 - September - 2018

Rheumatoid arthritis, severe psoriasis, severe active juvenile idiopathic
arthritis, severe psoriatic arthritis, mild to moderate Crohn’s disease
Unlicensed: Severe Eczema, Lichen Planus, Felty’s syndrome, severe Crohn’s disease

N.B. Not all brands/formulations are licensed for all indications – please refer to individual SPCs

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

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Adopted
Adopted
Date Posted: 01 - September - 2018

This protocol only applies to the unlicensed indications listed below. Transplant protocols should be followed for licensed indications.

Unlicensed: Severe rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, connective tissue diseases with severe / organ-threatening manifestations, interstitial lung disease (not to be used in idiopathic pulmonary fibrosis IPF), vasculitidies, as maintenance post cyclophosphamide in patients for whom azathioprine is contra-indicated or is inappropriate.

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

Not adopted
Adopted
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Not adopted
Adopted
Adopted
Adopted
Adopted
Date Posted: 01 - September - 2018

Licensed: Severe active rheumatoid arthritis, including juvenile forms, Wilson's disease (hepatolenticular degeneration) in adults and children (0 to 18 years).

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

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Adopted
Date Posted: 01 - December - 2015

To extend life or the time to mechanical ventilation for adult patients with amyotrophic lateral sclerosis (ALS) 1,2, variant of Motor Neurone Disease (MND). Safety and efficacy of riluzole has only been studied in ALS. Therefore, riluzole should not be used in patients with any other forms of MND. Riluzole should only be initiated by a neurological specialist with expertise in the management of MND (as per NICE TA 20, 2001)

It is expected that most patients will be managed by secondary care however this guideline is those patients who need to be managed in community

Not adopted
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Adopted
Date Posted: 01 - September - 2018

Licensed – Active, progressive rheumatoid arthritis, progressive juvenile chronic arthritis especially if polyarticular or seropositive.
Unlicensed – skin diseases including pemphigus

This guidance does not replace the SPC’s, which should be read in conjunction with this guidance.

Not adopted
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Adopted
Adopted
Adopted
Adopted
Date Posted: 01 - September - 2018

Licensed: Rheumatoid arthritis; ulcerative colitis, Crohn’s disease in adults and children
Unlicensed: Sero-negative spondyloarthropathy including psoriatic arthritis and psoriasis.

***Please note: the clinical content of the DMARD shared care documents has now been updated in accordance with the relevant SPCs and national guidance. However, LSCMMG has approved an interim expiry of six months from June 2022 to allow for the completion of the DMARD shared-care pathway work which is still ongoing. We expect the full update to be published by December 2022. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

 

 

Adopted
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Adopted
Adopted
Adopted
Date Posted: 01 - November - 2018

For hypogonadism due to testosterone deficiency in adult men

Indication (licensed):Testosterone replacement therapy for male hypogonadism when testosterone deficiency has been confirmed by clinical features and biochemical tests.

 

Pending
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Date Posted: 15 - August - 2022

Unlicensed indication: As supplementation for postmenopausal women with low sexual desire if HRT alone is not effective.

***Please note: the shared care guideline for the use of testosterone by postmenopausal women with low sexual desire has been clinically approved by LSCMMG. In the absence of a commissioned service, it is for individual prescribers to assess their own competence to work to the shared care, that appropriate specialist initiation has occurred and that appropriate risk assessments have been undertaken. Please contact mlcsu.medicinesmanagement@nhs.net for further information***

Further patient information is available via the RCOG menopause hub:
https://www.rcog.org.uk/for-the-public/menopause-and-later-life/