Prescribing of Lidocaine Patches in Medicines of the Elderly (MOE) Wards in The Royal Infirmary of Edinburgh and Western General Hospital, Edinburgh

Abstract

Abstract: Introduction: Lothian Analgesic Guidelines for severe or distressing acute musculoskeletal pain in frail adults were released in February 2017 and recommended starting with oral analgesics before using topical analgesics. Lidocaine patches (one of the topical analgesics) are among the top 20 most expensive items on the list of Medicines of Elderly (MOEs) budget in Western Gen- eral Hospital (WGH) & Royal Infirmary Edinburgh. It is to be hoped that this audit will improve the quality of provided healthcare to the patients, eliminate factors that prevent doctor’s adherence to pain management guideline in MOEs wards and positively contribute in the release of pain management guideline new version. Methodology: A prospective audit a was conducted with all patients who were admitted to the Medicines of Elderly (MOE) wards in Western General Hospital (WGH) and the Royal Infirmary (RIE) in Edinburgh. Between them they contain 336 beds which could be used to identify patients who had been using or had stopped using lidocaine patches. This information was gathered using the patients’ most recent medication chart at the time of review. The audit took place between the hours of 9am and 5pm for 7 business days during the period 05/8/2019 to 15/8/2019. Results: The audit identified 35 different episodes of lidocaine patches that were prescribed for 30 pa- tients (9%). 53 patients (16%) were on topical NSAIDS treatment (47 patients were on Ibu- profen gel & 6 patient were on Diclofenac gel). The medication charts showed that the re- maining 249 patients received neither NSAIDS nor lidocaine patches. The total number of patients included in the audit was 332 patients. Conclusion: There is a risk of a lack of service provided to patients. Medication efficacy is important and patient care in this respect should be effective. Two major problems for prescribers doing the reviewing will continue to be the shortage of the time and lack of clarity about the guidelines. If the lidocaine patches are not used effectively patients will complain. However, greater awareness about how to effectively prescribe lidocaine patches must be achieved through an education programme.