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
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
NHS Derby and Derbyshire CCG Holding Statement on Novel Oral Anticoagulants (NOACs)
Derby and Derbyshire CCG have released a holding statement in response to the NHS England and Improvement communication relating to the Direct (or Novel) oral anticoagulants rivaroxaban and apixaban.


 29 May 2020
Respiratory
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
Endocrine
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
Obs, Gynae and Urinary tract
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 (including DMARDs)

SPS guidance on the management of drugs requiring monitoring during COVID-19, which includes specific advice on DMARD monitoring (azathioprine, leflunomide, mercaptopurine, methotrexate, sulfasalazine, ciclosporin and penicillamine)

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

NHS England Clinical guide for the management of patients with musculoskeletal and rheumatic conditions on corticosteroids during the coronavirus pandemic

NHSE/NHSI advice on the administration of corticosteroid injections for MSK/rheum conditions during COVID. Take patient factors into consideration, consider reduced doses, use PPE and do not inject in confirmed COVID cases. 13 May 2020
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

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
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

 

 

Derby and Derbyshire CCG

Derby and Derbyshire CCG