COVID-19 Clinical guidelines

Please find below a list of clinical resources spilt by therapeutic area which are being updated regularly.

Therapeutic Areas

Publication                                 Summary Date                        
Gastroenterology

NICE rapid guideline NG172

Gastrointestinal and liver conditions treated with drugs affecting the immune response

NICE rapid guideline published 23rd April 2020

Medicines related key message

23 April 2020

05 May 2020

Cardiovascular
SPS Summary of COVID-19 medicines guidance: Cardiovascular system disorders

This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and cardiovascular system disorders

26 June 2020
British Cardiovascular Society (BCS) and British Society for Heart Failure (BSH) joint statement on ACEi or ARB in relation to COVID-19

'There is no evidence to support the assertion that treatment with ACEi or ARB could predispose individuals to adverse outcomes; and that both organisations share the view of the European Society of Hypertension and the Renal Association that patients should continue treatment with ACEi and ARB unless specifically advised to stop by their medical team'

19 March 2020
NHSE & NHSI Speciality guide for the management of anticoagulant services during the coronavirus pandemic

This guidance provides advice for the safe switching of warfarin to NOACs for patients with non-valvular AF and venous thromboembolism (DVT / PE) during the coronavirus pandemic. It also provides guidance on whether switching is appropriate, how to switch, and NOAC monitoring and counselling.   

However locally we advise if switching to a NOAC from warfarin, the preferred NOAC is edoxaban

31 March 2020
Specialist Pharmacy Service (SPS) management of patients currently on warfarin during Covid-19

This page gives advice on the management of patients taking warfarin in primary care during the Covid-19 pandemic

01 April 2020
Supply of non-VKA oral anticoagulants (NOACs) during COVID-19
During COVID-19 an NHSE guideline advises that patients requiring initiation with an anticoagulant should be prescribed a NOAC, rather than warfarin, wherever clinically appropriate in order to reduce the requirement for INR testing - edoxaban remains our first choice for NVAF patients.  


10 June 2020

British Cardiovascular Society: COVID-19 Clinician's Resource Hub

The BCS is working together with our Affiliated Societies and following Public Health England advice to provide COVID-19 clinical guidance for the UK cardiovascular community

29 June 2020
Respiratory
SPS Summary of COVID-19 medicines guidance: Respiratory disorders

This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and respiratory disorders 

26 June 2020
Alternative inhalers due to shortages

Local guidance for prescribing alternative inhalers during stock shortages related to Coronavirus (COVID-19). Information on switching to alternative steroid containing inhalers.

03 April 2020

NICE rapid guideline NG165

Managing suspected or confirmed pneumonia in adults in the community 

NICE rapid guideline published 3rd April 2020

Medicines related key messages

03 April 2020

07 April 2020

NICE rapid guideline NG166

Severe asthma

NICE rapid guideline published 3rd April 2020

Medicines related key messages

03 April 2020

07 April 2020

NICE rapid guideline NG168

Community based care of patients with chronic obstructive pulmonary disease (COPD)

NICE rapid guideline published 9th April 2020

Medicines related key messages

09 April 2020

NICE rapid guideline NG170

Cystic fibrosis

NICE rapid guideline published 9th April 2020

Medicines related key messages

09 April 2020

British Thoracic Society

COVID-19 information for the respiratory community

BTS has produced information, guidance and resources to support the respiratory community during the COVID-19 pandemic 06 April 2020
Central Nervous System
Psychotropic medication and COVID-19 in Primary Care

Guidance produced by Derbyshire Healthcare NHS Foundation Trust. Includes general advice, advice on lithium monitoring, and management of lithium patients with suspected/confirmed COVID-19

31 March 2020
Infection  
SPS Summary of COVID-19 medicines guidance: Infection and infectious diseases

This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and infection and infectious diseases

26 June 2020
Endocrine
SPS Summary of COVID-19 medicines guidance: Endocrine system disorders

This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and endocrine system disorders

26 June 2020
Derby and Derbyshire CCG Diabetes COVID briefing

DDCCG guidance to ensure all patients with type 1 diabetes has access to blood ketone and glucose testing strips and emergency hospital helpline numbers

02 April 2020
NHS England and Improvement - Diabetes COVID-19 key information

People living with diabetes are more likely to be self-isolating or shielding themselves at home during the pandemic. The way hospitals are also delivering care is changing. This guidance has been co-produced (with the London clinical networks) to support the delivery of diabetes care in London during the pandemic. It also includes sick day rules for type 1 and type 2 diabetes

06 April 2020

NICE rapid guideline NG176

Chronic kidney disease

NICE rapid guideline published 15th May 2020

Medicines related key messages

20 May 2020
How to manage HRT provisions without face to face consultations during COVID-19 healthcare restrictions

The Primary Care Women's Health Forum has produced a useful tool for primary care practitioners to support HRT provision using telephone or virtual consultation during COVID-19 pandemic. The document includes a detailed checklist and HRT prescribing tool and is endorsed by the British Menopause Society.

17 June 2020

Kidney Care UK - Coronavirus (COVID-19) guidance for patients with kidney disease

The latest news and information about COVID-19 for kidney patients

29 June 2020
Obs, Gynae and Urinary tract
SPS Summary of COVID-19 medicines guidance: Obstetrics and gynaecology 
This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and obstetrics and gynaecology

26 June 2020
FSRH CEU clinical advice to support provision of effective contraception during the COVID-19 breakout

FSRH CEU clinical statement published 20th March 2020

Medicines related key messages

12 May 2020
Nutrition and blood
Guidance for managing Vitamin B12 (Hydroxocobalamin) injections in primary care during the coronavirus pandemic

Local guidance for managing Vitamin B12 (Hydroxocobalamin) injections in primary care during the coronavirus pandemic.

15 April 2020
Musculoskeletal and Joint Disease
Specialist Pharmacy Services guidance on the management of drugs requiring monitoring during COVID-19

SPS guidance on the management of drugs requiring monitoring during COVID-19.

To determine the level of risk to rheumatology patients of COVID-19 and advice on what precautions to take please refer to these risk stratification guide and scoring grid for rheumatology which will help identify which precautions patients should take; shield, self-isolate or social distance at patients discretion or maintain social distance due to their level of risk.

01 April 2020
NICE evidence summary on NSAIDs / Ibuprofen

NICE Evidence summary states that no evidence from published scientific studies was found to determine whether acute use of NSAIDs is related to increased risk of developing COVID-19 or increased risk of more severe illness. The available evidence suggests that, although the anti-inflammatory effects of NSAIDs reduce acute symptoms (such as fever), they may either have no effect on, or worsen, long-term outcomes, possibly by masking symptoms of worsening acute respiratory tract infection.

The Commission of Human Medicines Expert Working Group on COVID-19 has concluded that there is currently insufficient evidence to establish a link between use of ibuprofen, or other NSAIDs, and susceptibility to contracting COVID-19 or the worsening of its symptoms. Patients can take paracetamol or ibuprofen when self-medicating for symptoms of COVID-19, such as for fever and headache. Usual cautions and contraindications for NSAIDs still apply.

22 April 2020

NICE rapid guideline NG167

Rheumatological autoimmune, inflammatory and metabolic bone disorders

NICE rapid guideline published 3rd April 2020

Medicines related key messages

03 April 2020

07 April 2020

Management of patients with musculoskeletal and rheumatic conditions who are on corticosteroids, require initiation of oral/IV corticosteroids or a corticosteroid injection

The British Society for Rheumatology and other partners have published this guidance that relates to musculoskeletal (MSK) service provision across primary, community and secondary care and is applicable to adults and children. The use of steroid medication is one of the management options for a range of MSK conditions and in particular rheumatic conditions, and this guidance aims to assist decisions on the use of such medication during the pandemic.

22 June 2020
Eye
Ear, Nose and Oropharynx
Advice for people experiencing voice problems after COVID-19 The British Voice Association has produced advice to help vocal recovery for people who as a result of COVID-19, may experience some temporary changes to their voice and to their comfort and effort levels when using it. 12 May 2020
Skin

NICE rapid guideline NG169

Dermatological conditions treated with drugs 

NICE rapid guideline published 9th April 2020

Medicines related key messages

09 April 2020

22 April 2020

End of Life
SPS Summary of COVID-19 medicines guidance: Palliative and End of Life Care

This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and palliative and end of life care

26 June 2020

NICE rapid guideline NG163

Managing symptoms (including at the end of life) in the community

NICE rapid guideline published 3rd April 2020

Medicines related key messages

03 April 2020

07 April 2020

Derbyshire Alliance for End of Life Care2

Toolkit designed collaboratively by professionals who work across Derbyshire to help teams plan and deliver care for people in their last months, weeks and days of life

31 March 2020
British Geriatric Society: guidance on end of life care in older people

The British Geriatric Society has produced a resource collating guidance on end of life care in older people in the context of COVID-19 including specific advice for end of life care for patients with COVID-19 who have dementia

11 August 2020
NHS England SOP for children and young people with palliative and end of life care needs

SOP for children and young people with palliative and end of life care needs who are cared for in a community setting (home and hospice) during the COVID-19 pandemic

11 August 2020
Miscellaneous
Specialist Pharmacy Services drug monitoring: factors to consider during COVID-19 Background information and factors to consider for drug monitoring during COVID-19 01 April 2020
East Midlands Cancer Alliance (EMCA) letter supporting the preservation of cancer services 

This letter details the role of the EMCA to support the preservation of cancer services as best as possible during this pandemic and to ensure an agreed consistent way of working so that patients receive the best and most appropriate care in accordance with guidance

30 March 2020

NICE rapid guideline NG174

Children and young people who are immunocompromised

NICE rapid guideline published 1st May 2020

Includes advice on managing underlying conditions and modification to usual care

06 May 2020
NHS Education for Scotland - Management of Acute Dental Problems During COVID-19 Pandemic

Patients should be encouraged to manage their symptoms at home where possible as treatment options are severely restricted at this time. Mild and moderate dental symptoms should be managed remotely by providing advice and analgesics and/or antimicrobials where necessary.

12 May 2020
Dexamethasone in the treatment of COVID-19

Dexamethasone has been demonstrated to have a clear place in the management of hospitalised patients with COVID-19. There were no excess harm identified in using this dose of dexamethasone in this patient population. Clinicians should therefore consider dexamethasone for the management of hospitalised patients with COVID-19 who require oxygen or ventilation. Out of hospital treatment is not appropriate.

The Department of Health and Social Care (DHSC) and MHRA have announced restrictions of dexamethasone on parallel exported from the UK. View the full export parallel ban list here.

18 June 2020
SPS Summary of COVID-19 medicines guidance: Policy, Commissioning and Managerial

This page summarises and signposts to medicine related guidance from professional and government bodies relating to Policy and Commissioning during the coronavirus pandemic 

26 June 2020
SPS Summary of COVID-19 medicines guidance: Allergy and immunology

This page summarises and signposts to medicine related guidance from professional and government bodies relating to coronavirus and respiratory disorders

26 June 2020

NICE rapid guideline NG179

Arranging planned care in hospitals and diagnostic services

NICE rapid guideline published 27th July 2020

To help healthcare professionals deliver efficient planned care while minimising the risk of COVID-19 in the context of increasing or decreasing local prevalence. The guidance also aims to help patients make decisions about their planned care

27 July 2020

 

 

Derby and Derbyshire CCG

Derby and Derbyshire CCG