Appendix B: Sick Day Guidance: Information for healthcare professionals and patients

Polypharmacy guidance: realistic prescribing
Scottish Government Effective Prescribing & Therapeutics Division
Polypharmacy icon of two pills

The Sick Day  guidance is a useful resource for patients, carers and health professionals as it promotes better management of long-term conditions through safer, more effective and person-centred use of medicines. The cards highlight the potential harms which could be caused if patients continue to take certain medicines whilst suffering from illnesses where dehydration can occur.

The Scottish Patient Safety Programme (SPSP) has produced a briefing for professionals and one for patients. The briefing leaflet for professionals provides some examples of what advice to give to patients to ensure that they understand the importance of stopping certain medicines when sick. An example of the Sick Day Rules Card (old name for Sick Day Guidance)  is displayed below, copies of these can be downloaded from the SPSP website .

    

 

Through their electronic formulary, NHS Lothian utilise facilities to put sick day rules guidance on prescriptions. These messages are then printed onto dispensing labels.

Autopopulation of electronic prescription dosing instructions

One method to implement the Sick Day  guidance is to include the advice within the dosing instruction on the prescription. This provides a number of triggers to discuss with the patient the importance of temporarily stopping these medicines during a potentially dehydrating illness: when issuing the prescription at consultation; when the medicine is dispensed and when referring to the dosing instruction on the medicine pack.

Each GP IT system has a way to autopopulate the prescription with the Sick Day Rules guidance, e.g. in EMIS, the formulary EFM-file can be edited to include this dosing instruction which will be installed in each practice as the file is updated; in Vision the dosing instruction can be set by each practice using the default doses functionality. NHS Lothian has an advanced clinically driven electronic formulary called eLJF-CLINICAL, built as a guideline in Vision, which uses the above dosing instruction to autopopulate each relevant prescription. The suggested dosing schedule above, also prints on community pharmacy labels without further editing.