Shared care Information
Specialist initiated drugs require more caution with prescribing than those drugs classed as first or second line choices. They are less frequently prescribed and specialist knowledge is required when initiating therapy. In some respects, it can often be thought of as a "third line choice" where patients have not responded well to the first and second line options and where specialist advice is sought. Hospital only drugs are restricted for use within a hospital environment. These drugs have been classified as such as it is not deemed appropriate for prescribing in the primary care setting, based on best available evidence. This could be for a number of reasons, for example: new drug therapy with limited safety profile; intravenous preparation; drug has particular cautions or requires specific monitoring.
With increased prescribing knowledge and changes in therapeutic management, it may become appropriate for some drugs to be reclassified, for example a drug moving from red to orange. In such circumstances, it may be appropriate to provide prescribers without specialist knowledge with supporting information to allow them to take over prescribing responsibility, if they wish to do so.
The Joint Formulary Committee is working together with appropriate specialists to produce Shared Care Information for prescribing.
By providing such supporting information, the Joint Formulary Committee is not expecting general practitioners to take on prescribing of these drugs, but to provide information to support them if they wish to do so. It must be remembered that the clinician who prescribes a drug legally assumes clinical responsibility for that drug and the consequences of its use. For this reason, no prescriber has an obligation to take on prescribing unless they feel clinically competent to do so.
Last updated by: Carol Webb on 02-12-2009 08:32