Metformin | Right Decisions

Please update your RDS mobile app to version 4.7.1

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.

See section on metformin for further information.

Metformin remains first line treatment for the majority of patients. This NTI should have a high percentage for this indicator.

Metformin should be prescribed first line unless there is a contraindication (eGFR<30ml/min, or lactic acidosis) or true intolerance (which can be reduced by prescribing sustained release preparations).
There should be a high percentage of patients who are prescribed metformin.

Metformin as percentage of all people prescribed an anti-diabetic drug

Action required by boards/clusters/practices

NHS Boards/MCNs/Prescribing groups should review their data in comparison to other boards to determine areas of unwarranted variation.
GP clusters and practices can review their data with other practices or cluster regions to show variation in their prescribing practices.
Identify missing individuals: Clusters and practices should identify those who are suitable for metformin but not currently prescribed this. Prioritise younger individuals for more aggressive treatment.
Safety consideration: Ensure appropriate dosage in line with renal function, e.g. metformin dose should be reduced if eGFR falls below 45 and stopped if eGFR<30.
Medication should be reviewed in line with the 7 Steps process.