<commit_before>{
	"name": "Seven Day Prescribing for Long Term Conditions",
	"title": [
		"Seven Day Prescribing for Long Term Conditions"
	],
	"description": [
		"Total quantity where a prescritpion is for seven tablets or",
		"capsules of common LTC medicines as a proportion of all tablets or capsules for common LTC medicines "
	],
	"why_it_matters": [
		"The <a href='https://www.bma.org.uk/advice/employment/gp-practices/service-provision/prescribing/prescribing-in-general-practice'> British Medical Association reports</a>",
		"growing requests to prescribe seven day quantities of medicines to fund supply of medicine compliance aids (MCAs) ",
		"However the price of the generic has now fallen and is the cheapest option to prescribe.",
		"As well as increasing safety concerns, The Royal Pharmaceutical Society has issued",
		"<a href='https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Support/toolkit/rps-mca-july-2013.pdf'> guidance</a> stating that while",
		"some may think of MCAs as a pancea, there is limited eveidence base to support their use, the",
		"use of original packs of medicines with appropriate support is the preferred option of supplying medicines and every patient identified as having medicines adherence",
		"issues should have a robust individual assessment to identify the best intervention based on ",
		"their needs and the evidence currently available. We propose a measure of seven day prescriptions",
		" for long-term conditions as a surrogate measure for MCAs. Caveats include; a seven day prescription may be clinically",
		"relevant even for long-term conditions in certain circumstances,  some pharmacies will supply a MCA without a seven day prescritpion after making",
		" an individual assessement and some local areas may fund provision of MCAs via a seperate payment. Please note that this is an experimental measure.",
		"We would be grateful for any feedback at <a href='mailto:<EMAIL>'> <EMAIL>.</a>.  You can read ",
		"more detail on the measure definition/notebook/blog"
	],
	"numerator_short": "seven day quantities",
	"denominator_short": "total quantities",
	"url": null,
	"is_percentage": true,
	"is_cost_based": false,
	"low_is_good": true,
	"tags": [
		"core",
		"safety"
	],
	"numerator_type": "custom",
	"numerator_columns": [
		"SUM(total_quantity) AS numerator ,"
	],
	"numerator_from": "{hscic}.raw_prescribing_normalised",
	"numerator_where": [
		"quantity_per_item=7",
		"AND",
		"(",
		"bnf_code LIKE '0205051R0%' OR  ##ramipril \n",
		"bnf_code LIKE '0212000B0%' OR ##atrovastatin \n",
		"bnf_code LIKE '0212000Y0%' OR ##simvastatin \n",
		"bnf_code LIKE '0602010V0%' OR ##levothyroxine \n",
		"bnf_code LIKE '0206020A0%') ##amlodipine \n",
		"AND",
		"(",
		"bnf_name LIKE '%_Tab%' or bnf_name LIKE '%_Cap%' ##this restricts to tablets or capsules \n",
		")"
	],
	"denominator_type": "custom",
	"denominator_columns": [
		"SUM(total_quantity) AS denominator , "
	],
	"denominator_from": "{hscic}.raw_prescribing_normalised",
	"denominator_where": [
		"(",
		"bnf_code LIKE '0205051R0%' OR  ##ramipril \n",
		"bnf_code LIKE '0212000B0%' OR ##atrovastatin \n",
		"bnf_code LIKE '0212000Y0%' OR ##simvastatin \n",
		"bnf_code LIKE '0602010V0%' OR ##levothyroxine \n",
		"bnf_code LIKE '0206020A0%') ##amlodipine \n",
		"AND",
		"(",
		"bnf_name LIKE '%_Tab%' or bnf_name LIKE '%_Cap%' ##this restricts to tablets or capsules \n",
		")"
	]
}<commit_msg>amend why it matters<commit_after>{
	"name": "Seven Day Prescribing for Long Term Conditions",
	"title": [
		"Seven Day Prescribing for Long Term Conditions"
	],
	"description": [
		"Total quantity where a prescritpion is for seven tablets or",
		"capsules of common LTC medicines as a proportion of all tablets or capsules for common LTC medicines "
	],
	"why_it_matters": [
	  "There is no current consensus on durations of prescriptions across the NHS and prescribers are advised that they should write a ",
    "prescription for a duration that is clinically appropriate. ",
    "The <a href='https://www.bma.org.uk/advice/employment/gp-practices/service-provision/prescribing/prescribing-in-general-practice'>",
    "British Medical Association reports</a> growing requests to prescribe seven day quantities of medicines to fund supply of ",
    "medicine compliance aids (MCAs), adding to GP workload. The Royal Pharmaceutical Society has issued ",
    "<a href='https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Support/toolkit/rps-mca-july-2013.pdf' ",
    "guidance</a> stating that while some may think of MCAs as a panacea, there is limited evidence base to support their use, ",
    "and safety incidents have been reported to the National Reporting and Learning System.",
    "<p>We propose this measure of seven day prescriptions for long-term conditions as a surrogate measure for MCAs. Caveats ",
    "include; a seven day prescription may be clinically relevant even for long-term conditions in certain circumstances, some",
    "pharmacies will supply a MCA without a seven day prescritpion after making an individual assessement, and some local areas",
    "may fund provision of MCAs via a seperate payment. Locally you may wish to review presciptions of seven duration for clinical",
    "appropriateness.",
    "<p>The medicines we have used for the measure are generally used once daily for longterm conditions: atorvastatin, ",
    "simvastatin, levothyroxine, amlodipine and ramipril.",
    "<p><b>Please note that this is an experimental measure. We would be grateful for any feedback at",
    "<a href='mailto:<EMAIL>?Subject=7-day%20prescribing%20measure'><EMAIL></a>.</b></p>",
    "You can read more detail on the <a href='https://github.com/ebmdatalab/jupyter-  notebooks/blob/master/new_measures/Seven%20Day%20Prescribing%20for%20Long%20Term%20Conditions/Seven%20Day%20Prescribing%20for%20Long%20Term%20Conditions.ipynb'>",
    "measure definition notebook</a> and on our [blog]."
  ],
	"numerator_short": "seven day quantities",
	"denominator_short": "total quantities",
	"url": null,
	"is_percentage": true,
	"is_cost_based": false,
	"low_is_good": true,
	"tags": [
		"core",
		"safety"
	],
	"numerator_type": "custom",
	"numerator_columns": [
		"SUM(total_quantity) AS numerator ,"
	],
	"numerator_from": "{hscic}.raw_prescribing_normalised",
	"numerator_where": [
		"quantity_per_item=7",
		"AND",
		"(",
		"bnf_code LIKE '0205051R0%' OR  ##ramipril \n",
		"bnf_code LIKE '0212000B0%' OR ##atrovastatin \n",
		"bnf_code LIKE '0212000Y0%' OR ##simvastatin \n",
		"bnf_code LIKE '0602010V0%' OR ##levothyroxine \n",
		"bnf_code LIKE '0206020A0%') ##amlodipine \n",
		"AND",
		"(",
		"bnf_name LIKE '%_Tab%' or bnf_name LIKE '%_Cap%' ##this restricts to tablets or capsules \n",
		")"
	],
	"denominator_type": "custom",
	"denominator_columns": [
		"SUM(total_quantity) AS denominator , "
	],
	"denominator_from": "{hscic}.raw_prescribing_normalised",
	"denominator_where": [
		"(",
		"bnf_code LIKE '0205051R0%' OR  ##ramipril \n",
		"bnf_code LIKE '0212000B0%' OR ##atrovastatin \n",
		"bnf_code LIKE '0212000Y0%' OR ##simvastatin \n",
		"bnf_code LIKE '0602010V0%' OR ##levothyroxine \n",
		"bnf_code LIKE '0206020A0%') ##amlodipine \n",
		"AND",
		"(",
		"bnf_name LIKE '%_Tab%' or bnf_name LIKE '%_Cap%' ##this restricts to tablets or capsules \n",
		")"
	],
"date_reviewed": [
    "2019-10-09"
  ],
  "next_review": [
    "2020-10-09"
  ],
  "authored_by": [
    "<EMAIL>"
  ],
  "checked_by": [
    "<EMAIL>"
  ],
  "measure_complexity": [
    "low"
  ],
  "measure_notebook_url": [
    "https://github.com/ebmdatalab/jupyter-notebooks/blob/master/new_measures/Seven%20Day%20Prescribing%20for%20Long%20Term%20Conditions/Seven%20Day%20Prescribing%20for%20Long%20Term%20Conditions.ipynb"
  ]
}
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