Printer Friendly

Ophthalmic drug use in England.

Optometrists in the UK have used ophthalmic drugs for more than 70 years, principally for diagnostic purposes and to a limited extent in the treatment of certain ocular 'emergencies'. In 2005, secondary legislation was enacted that significantly expanded the scope of practice of optometry into therapeutics by establishing two categories of prescribing, termed Additional Supply and Supplementary Prescribing. In 2008, additional legislation represented a further landmark by enabling optometrists to become Independent Prescribers.

At June 2009, out of a total College of Optometrists membership of 13,236, in all 39 optometrists now hold the Diploma in Additional Supply (DipAS) and 43 have acquired the Diploma in Supplementary Prescribing (DipSP), and of 11,959 optometrists registered with the General Optical Council, 38 are included in the Additional Supply speciality register and 30 in the Supplementary prescribing register.

[ILLUSTRATION OMITTED]

[ILLUSTRATION OMITTED]

[ILLUSTRATION OMITTED]

The Information Centre of the NHS publishes annually a Prescription Cost Analysis (PCA) for England that provides details of all prescriptions dispensed in the community by pharmacists, appliance contractors, dispensing doctors and items personally administered by doctors. The majority of prescriptions were written by general medical practitioners but prescriptions from nurses, pharmacists, dentists, hospital doctors and non-medical prescribers are included. Prescriptions written in Wales, Scotland, Northern Ireland and the Isle of Man, and dispensed in England, are included while prescriptions written in England but dispensed outside it are excluded. Items dispensed in hospitals or from private prescriptions are also excluded. The numbers of prescriptions for individual preparations has been rounded in the PCA to the nearest 100.

The data for 2008 were based on the therapeutic grouping used in the British National Formulary (BNF) for September 2007, edition 54. In view of increasing optometric interest in ophthalmic drugs (represented by BNF chapter 11), information about them has been extracted and is presented in Tables 1 to 10 in order to provide an overview of their use in the past year. In these tables, the number of prescriptions dispensed in thousands is shown under the heading of 'Rxs' and, with the exception of Table 2, for each drug these numbers are expressed as the corresponding percentage under the heading of '%'. In the interests of simplicity and space, the tables show the generic names of drugs but the Prescription Cost Analysis includes further details such as the proprietary names, presentation and concentration of the drugs supplied.

+ This heading in Table 4 relates to proprietary products (Optrex Sore Eye Drops and Red Eye Drops).

References

Prescription Cost Analysis England 2008, The NHS Information Centre for Health and Social Care, 1 Trevelyan Square, Boar Lane, Leeds, LS1 6AE. Available from http://www.ic.nhs.uk/statistics-anddata-collections/ primary-care/prescriptions/prescription-cost-analysis-2008-[ns]

Having worked in multiple, independent and hospital practice, Richard Pearson has spent most of his career in optometric education. Mr Pearson is a co-author of the 5th edition of Ophthalmic Drugs: Diagnostic & Therapeutic Uses.
Table 1: Antibacterial preparations

Generic name                       Rxs (thousands)         %

Chloramphenicol                       1,964.028          69.08
Fusidic Acid                            732.744          25.77
Gentamicin Sulphate                      60.525           2.13
Ciprofloxacin                            42.619           1.50
Ofloxacin                                35.743           1.26
Propamidine Isetionate                    2.343           0.08
Dibrompropamidine Isetionate              2.117           0.07
Levofloxacin                              1.822           0.06
Polymyxin B Sulphate                      0.878           0.03
Framycetin Sulphate                       0.198           0.01
Neomycin Sulphate                         0.104           0.004

                                   TOTAL 2843.121

Table 2: Antiviral prepartions

Generic name                       Rxs (thousands)

Aciclovir                              39.029

Table 3: Corticosteroids

Generic name                       Rxs (thousands)         %

Dexamethasone                          462.902           51.68
Betamethasone Sodium Phosphate         141.560           15.80
Prednisolone Acetate                   131.714           14.70
Prednisolone Sodium Phosphate           74.216            8.29
Fluorometholone                         66.611            7.44
Rimexolone                             107.256            1.93
Hydrocortisone Acetate                   1.527            0.17

                                    TOTAL 895.786

Table 4: Other anti-inflammatory preparations

Generic name                       Rxs (thousands)         %

Sodium Cromoglicate                   1,129.120          69.90
Nedocromil Sodium                       220.018          13.62
Antazoline                               95.464           5.91
Olopatadine                              58.713           3.63
Azelastine Hydrochloride                 46.611           2.89
Lodoxamide Trometamol                    42.011           2.60
Emedastine                                8.765           0.54
Ketotifen Fumarate                        8.027           0.50
Epinastine Hydrochloride                  3.176           0.20
Other Preparations *                      2.422           0.15
Naphazoline Hydrochloride                 0.682           0.04
Flurbiprofen Sodium                       0.202           0.01
Hamamalis                                 0.078           0.005

                                   TOTAL 1615.289

Table 5: Mydriatics & cycloplegics

Generic name                       Rxs (thousands)         %

Atropine Sulphate                      53.528          51,4851.48
Cyclopentolate Hydrochloride           43.420               41.76
Tropicamide                             6.185                5.95
Homatropine Hydrobromide                0.575                0.55
Phenylephrine Hydrochloride             0.274                0.26

                                    TOTAL 103.982

TABLE 6: Treatment of glaucoma

Generic name                       Rxs (thousands)         %

Latanoprost                           2,430.044          34.52
Timolol                                 786.152          11.17
Dorzolamide & Timolol                   648.647           9.21
Bimatoprost                             598.648           8.50
Brinzolamide                            460.800           6.55
Travoprost                              416.225           5.91
Latanoprost & Timolol                   341.934           4.86
Dorzolamide                             291.568           4.14
Brimonidine Tartrate                    290.798           4.13
Levobunolol Hydrochloride               138.176           1.96
Carteolol Hydrochloride                 115.269           1.64
Betaxolol                               112.775           1.60
Timolol & Bimatoprost                   103.881           1.48
Pilocarpine Hydrochloride                92.515           1.31
Timolol & Brimonidine                    69.723           0.99
Acetazolamide                            68.625           0.97
Timolol & Travoprost                     57.737           0.82
Dipivefrine Hydrochloride                 8.731           0.12
Pilocarpine Nitrate                       4.828           0.07
Metipranolol                              2.297           0.03

                                   TOTAL 7039.373

Table 7: Local anaesthetics

Generic name                       Rxs (thousands)         %

Proxymetacaine Hydrochloride            0.597            32.68
Tetracaine Hydrochloride                0.583            31.91
Oxybuprocaine Hydrochloride             0.543            29.72
Lidocaine Hydrochloride                 0.104             5.69

                                     TOTAL 1.827

Table 8: Tear deficiency, ocular lubricants and astringents

Generic name                       Rxs (thousands)         %

Hypromellose                          2,028.680          38.03
Carbomer 940/980                      1,561.791          29.28
Liquid Paraffin                         585.514          10.98
Polyvinyl Alcohol                       502.315           9.42
Carmellose Sodium                       388.450           7.28
Sodium Chloride                          79.753           1.50
Paraffin Yellow Soft                     58.048           1.09
Hyetellose                               51.175           0.96
Acetylcysteine                           42.016           0.79
Carbomer 974P                            20.319           0.38
Povidone K 25                             5.896           0.11
Other Preparations *                      5.820           0.11
Zinc Sulphate                             2.695           0.05
Ciclosporin                               1.471           0.03
BJ6 (a)                                   0.052           0.001

                                   TOTAL 5333.995

* This heading relates to proprietary products (Bausch & Lomb
Duolube ointment and Novartis Lid-Care Eyelid Hygiene Solution
and wipes) (a) contains 0.25% hypromellose drops

Table 9: Peri-operative drugs

Generic name                       Rxs (thousands)         %

Ketorolac Trometamol                   45.622            66.64
Apraclonidine                          17.531            25.61
Diclofenac Sodium                       4.663             6.81
Loteprednol Etabonate                   0.647             0.95

                                    TOTAL 68.463

Table 10: Stains

Generic name                       Rxs (thousands)         %

Fluorescein Sodium                      0.953            53.60
Rose Bengal                             0.825            46.40

                                     TOTAL 1.778
COPYRIGHT 2009 Ten Alps Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2009 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:DATA REVIEW
Author:Pearson, Richard M.
Publication:Optometry Today
Geographic Code:4EUUK
Date:Jul 17, 2009
Words:1092
Previous Article:Early post-operative complications.
Next Article:New online locum service is to launch on Monday.
Topics:


Related Articles
FDA panel backs new fluoroquinolone for conjunctivitis.
The way we were: new NHS Information Centre statistics have revealed some key figures for England and Wales.

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters