We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.
You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.
To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:
On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.
On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.
Please get in touch with ann.wales3@nhs.scot with any questions.
Sanofi the manufacturer of Modecate injection (Fluphenazine decanoate) ceased production of the preparation in 2018 and all licensed stock will cease to be available by August 2020. An unlicensed version can be imported from Germany to enable treatment to be maintained for those legacy patients unable to switch to a licensed alternative long acting injection.
Fluphenazine decanoate was licensed for the treatment and maintenance of patients with schizophrenia and paranoid psychoses5.
Informed consent
Due to its unlicensed status, explanation for the rationale of treatment choice should be given at a suitable time during the patient’s treatment. Patient information explaining unlicensed medication in general terms is available via the Choice and Medication, as is a specific fluphenazine decanoate leaflet.
Documentation
The consultant psychiatrist must make a clear record of the rationale for prescribing an unlicensed medication within the patient’s case notes and document the discussion with the patient1. Nursing staff in the ward must be informed of the medicine’s unlicensed status and ward clinical pharmacists must ensure that staff are aware of the unlicensed status.
When ordering fluphenazine decanoate injection, the patient’s initials and CHI should be included on the requisition as well as the phrase “as per protocol” for the order to be processed.
A record of administration of unlicensed medication must be kept (as per unlicensed medication policy3). When entering administration on HEPMA, the drug batch number and expiry date should be recorded when prompted. It is the responsibility of the nurse in charge to ensure this occurs.
When supplying fluphenazine decanoate injection from pharmacy, pharmacy staff must ensure that batch numbers are documented on the requisition.
Patients must be reviewed and monitored in accordance with NHS GG&C Policy, MHS 30 Good Practice Statement for the use of Depot and Long Acting Antipsychotic Injections4.
Adults: a test dose of 12.5mg should be administered by deep intramuscular injection into the gluteal region.
Elderly: elderly patients may be particularly susceptible to extra-pyramidal reactions. Consequently a reduced initial dose (6.25mg) and a lower maintenance dose may be required.
The onset of action generally appears between 24 and 72 hours after injection and the effects of the drug on psychotic symptoms become significant within 48 to 96 hours.
Subsequent injections and the dosage interval are determined in accordance with the patient’s response. When administered as maintenance therapy, a single injection may be effective in controlling schizophrenic symptoms for up to four weeks or longer.
It is desirable to be as flexible in the dose as possible to achieve the best therapeutic response with the least side effects. Most patients are successfully maintained within the dose range 12.5 – 100mg given at an interval of 2 to 5 weeks.
Patients suffering a relapse following cessation of fluphenazine decanoate may be restarted on their previous dose although the frequency of injections may need to be increased in the early weeks of treatment until satisfactory control is obtained.
Very common (>1 in 10) 2,5
Common (> 1 in 100)
Rare (> 1 in 1000)
Contraindications5
Cautions5
Interactions5
MyPsych App