From c2b8b5f0ccea1df93b6ebda8541594ae4ca6e85b Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 13:56:33 +0100 Subject: [PATCH 01/16] Update lpherbal.json --- .../measure_definitions/lpherbal.json | 17 ++++++++++++++++- 1 file changed, 16 insertions(+), 1 deletion(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 1c4813e2c4..65f019c1ab 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -19,7 +19,22 @@ "is_cost_based": true, "low_is_good": true, "numerator_type": "bnf_cost", - "numerator_bnf_codes_query": "SELECT DISTINCT bnf_code FROM {dmd}.amp WHERE lic_auth = 4 AND bnf_code NOT LIKE '190203%'", + "numerator_bnf_codes_query": [ + "numerator_bnf_codes_query": [ + "SELECT DISTINCT v.bnf_code, v.nm FROM dmd.vmp v ", + "INNER JOIN dmd.vtm t ", + "ON t.id = v.vtm ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", + "AND v.bnf_code IS NOT NULL ", + "UNION ALL ", + "SELECT DISTINCT a.bnf_code, a.nm FROM dmd.amp a ", + "INNER JOIN dmd.vmp v ON a.vmp = v.id ", + "INNER JOIN dmd.vtm t ON t.id = v.vtm ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", + "AND a.bnf_code IS NOT NULL ", + "UNION ALL", + "SELECT DISTINCT bnf_code, nm FROM dmd.amp WHERE lic_auth = 4 AND bnf_code NOT LIKE '190203%'" + ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", "checked_by": "christopher.wood@phc.ox.ac.uk", From 97918a559c9d83d3029e84c4c99b8ad0ba8cef5a Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 13:58:13 +0100 Subject: [PATCH 02/16] Update lpherbal.json typo --- openprescribing/measure_definitions/lpherbal.json | 1 - 1 file changed, 1 deletion(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 65f019c1ab..a23543e4e2 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -20,7 +20,6 @@ "low_is_good": true, "numerator_type": "bnf_cost", "numerator_bnf_codes_query": [ - "numerator_bnf_codes_query": [ "SELECT DISTINCT v.bnf_code, v.nm FROM dmd.vmp v ", "INNER JOIN dmd.vtm t ", "ON t.id = v.vtm ", From e84c7dfeeea384f88149dc5ca88ff590462d7de5 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 13:59:59 +0100 Subject: [PATCH 03/16] Update lpherbal.json fix typo --- openprescribing/measure_definitions/lpherbal.json | 8 ++++---- 1 file changed, 4 insertions(+), 4 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index a23543e4e2..fcab5a3b3e 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -19,20 +19,20 @@ "is_cost_based": true, "low_is_good": true, "numerator_type": "bnf_cost", - "numerator_bnf_codes_query": [ - "SELECT DISTINCT v.bnf_code, v.nm FROM dmd.vmp v ", + "numerator_bnf_codes_filter": [ + "SELECT DISTINCT v.bnf_code FROM dmd.vmp v ", "INNER JOIN dmd.vtm t ", "ON t.id = v.vtm ", "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", "AND v.bnf_code IS NOT NULL ", "UNION ALL ", - "SELECT DISTINCT a.bnf_code, a.nm FROM dmd.amp a ", + "SELECT DISTINCT a.bnf_code FROM dmd.amp a ", "INNER JOIN dmd.vmp v ON a.vmp = v.id ", "INNER JOIN dmd.vtm t ON t.id = v.vtm ", "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", "AND a.bnf_code IS NOT NULL ", "UNION ALL", - "SELECT DISTINCT bnf_code, nm FROM dmd.amp WHERE lic_auth = 4 AND bnf_code NOT LIKE '190203%'" + "SELECT DISTINCT bnf_code FROM dmd.amp WHERE lic_auth = 4 AND bnf_code NOT LIKE '190203%'" ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", From b1723b1e3d2508b18085109238345280b0d2b5b6 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 16:47:28 +0100 Subject: [PATCH 04/16] Update lpherbal.json whitespace --- openprescribing/measure_definitions/lpherbal.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index fcab5a3b3e..d960757c72 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -33,7 +33,7 @@ "AND a.bnf_code IS NOT NULL ", "UNION ALL", "SELECT DISTINCT bnf_code FROM dmd.amp WHERE lic_auth = 4 AND bnf_code NOT LIKE '190203%'" - ], + ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", "checked_by": "christopher.wood@phc.ox.ac.uk", From 7e0c70f4a1fa933d740b9fb2ac1e493478e48755 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 16:53:46 +0100 Subject: [PATCH 05/16] Update lpherbal.json reformat sql --- openprescribing/measure_definitions/lpherbal.json | 12 +++++++----- 1 file changed, 7 insertions(+), 5 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index d960757c72..5d4eadfdbf 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -20,19 +20,21 @@ "low_is_good": true, "numerator_type": "bnf_cost", "numerator_bnf_codes_filter": [ - "SELECT DISTINCT v.bnf_code FROM dmd.vmp v ", - "INNER JOIN dmd.vtm t ", + "SELECT DISTINCT v.bnf_code FROM dmd.vmp v ", + "INNER JOIN dmd.vtm t ", "ON t.id = v.vtm ", "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", "AND v.bnf_code IS NOT NULL ", "UNION ALL ", "SELECT DISTINCT a.bnf_code FROM dmd.amp a ", - "INNER JOIN dmd.vmp v ON a.vmp = v.id ", + "INNER JOIN dmd.vmp v ON a.vmp = v.id ", "INNER JOIN dmd.vtm t ON t.id = v.vtm ", "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", "AND a.bnf_code IS NOT NULL ", - "UNION ALL", - "SELECT DISTINCT bnf_code FROM dmd.amp WHERE lic_auth = 4 AND bnf_code NOT LIKE '190203%'" + "UNION ALL ", + "SELECT DISTINCT bnf_code FROM dmd.amp ", + "WHERE lic_auth = 4 ", + "AND bnf_code NOT LIKE '190203%' " ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", From 545af63708d3915af2092bc04d9bb6eb53d59253 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 16:56:01 +0100 Subject: [PATCH 06/16] Update lpherbal.json whitespaces --- .../measure_definitions/lpherbal.json | 30 +++++++++---------- 1 file changed, 15 insertions(+), 15 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 5d4eadfdbf..3df3e395a8 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -20,21 +20,21 @@ "low_is_good": true, "numerator_type": "bnf_cost", "numerator_bnf_codes_filter": [ - "SELECT DISTINCT v.bnf_code FROM dmd.vmp v ", - "INNER JOIN dmd.vtm t ", - "ON t.id = v.vtm ", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", - "AND v.bnf_code IS NOT NULL ", - "UNION ALL ", - "SELECT DISTINCT a.bnf_code FROM dmd.amp a ", - "INNER JOIN dmd.vmp v ON a.vmp = v.id ", - "INNER JOIN dmd.vtm t ON t.id = v.vtm ", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%') ", - "AND a.bnf_code IS NOT NULL ", - "UNION ALL ", - "SELECT DISTINCT bnf_code FROM dmd.amp ", - "WHERE lic_auth = 4 ", - "AND bnf_code NOT LIKE '190203%' " + "SELECT DISTINCT v.bnf_code FROM dmd.vmp v", + "INNER JOIN dmd.vtm t", + "ON t.id = v.vtm", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%')", + "AND v.bnf_code IS NOT NULL", + "UNION ALL", + "SELECT DISTINCT a.bnf_code FROM dmd.amp a", + "INNER JOIN dmd.vmp v ON a.vmp = v.id", + "INNER JOIN dmd.vtm t ON t.id = v.vtm", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%')", + "AND a.bnf_code IS NOT NULL", + "UNION ALL", + "SELECT DISTINCT bnf_code FROM dmd.amp", + "WHERE lic_auth = 4", + "AND bnf_code NOT LIKE '190203%'" ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", From d8c464ba26540dcfb10cbb27a0c569c93b5aeb1b Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 21 Aug 2023 16:58:49 +0100 Subject: [PATCH 07/16] Update lpherbal.json change filter to query --- openprescribing/measure_definitions/lpherbal.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 3df3e395a8..e903609c89 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -19,7 +19,7 @@ "is_cost_based": true, "low_is_good": true, "numerator_type": "bnf_cost", - "numerator_bnf_codes_filter": [ + "numerator_bnf_codes_query": [ "SELECT DISTINCT v.bnf_code FROM dmd.vmp v", "INNER JOIN dmd.vtm t", "ON t.id = v.vtm", From 0e60e567f564ed2d7cf4181c8df6c1ba88059820 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 22 Aug 2023 09:30:36 +0100 Subject: [PATCH 08/16] Update lpherbal.json still trying to fix --- openprescribing/measure_definitions/lpherbal.json | 6 +++--- 1 file changed, 3 insertions(+), 3 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index e903609c89..a0cb5243e0 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -23,19 +23,19 @@ "SELECT DISTINCT v.bnf_code FROM dmd.vmp v", "INNER JOIN dmd.vtm t", "ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%')", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%'OR LOWER(t.nm) LIKE '%almond_oil%') ", "AND v.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT a.bnf_code FROM dmd.amp a", "INNER JOIN dmd.vmp v ON a.vmp = v.id", "INNER JOIN dmd.vtm t ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus oil%' OR LOWER(t.nm) LIKE '%almond oil%')", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%'OR LOWER(t.nm) LIKE '%almond_oil%') ", "AND a.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT bnf_code FROM dmd.amp", "WHERE lic_auth = 4", "AND bnf_code NOT LIKE '190203%'" - ], + ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", "checked_by": "christopher.wood@phc.ox.ac.uk", From a9c7c018d9042701359f65c66974bd2faa28db46 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 22 Aug 2023 09:31:29 +0100 Subject: [PATCH 09/16] Update lpherbal.json --- openprescribing/measure_definitions/lpherbal.json | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index a0cb5243e0..b050320a19 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -23,13 +23,13 @@ "SELECT DISTINCT v.bnf_code FROM dmd.vmp v", "INNER JOIN dmd.vtm t", "ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%'OR LOWER(t.nm) LIKE '%almond_oil%') ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%' OR LOWER(t.nm) LIKE '%almond_oil%') ", "AND v.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT a.bnf_code FROM dmd.amp a", "INNER JOIN dmd.vmp v ON a.vmp = v.id", "INNER JOIN dmd.vtm t ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%'OR LOWER(t.nm) LIKE '%almond_oil%') ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%' OR LOWER(t.nm) LIKE '%almond_oil%') ", "AND a.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT bnf_code FROM dmd.amp", From 7f470710f56959f465daae4a96b16d5ccd06fb86 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 22 Aug 2023 09:39:31 +0100 Subject: [PATCH 10/16] Update lpherbal.json test to look at all "oils" --- openprescribing/measure_definitions/lpherbal.json | 4 ++-- 1 file changed, 2 insertions(+), 2 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index b050320a19..4c3c454473 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -23,13 +23,13 @@ "SELECT DISTINCT v.bnf_code FROM dmd.vmp v", "INNER JOIN dmd.vtm t", "ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%' OR LOWER(t.nm) LIKE '%almond_oil%') ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%oil%') ", "AND v.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT a.bnf_code FROM dmd.amp a", "INNER JOIN dmd.vmp v ON a.vmp = v.id", "INNER JOIN dmd.vtm t ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%eucalyptus_oil%' OR LOWER(t.nm) LIKE '%almond_oil%') ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%oil%') ", "AND a.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT bnf_code FROM dmd.amp", From ba7f0dc77ede1c730e9476f236c52ec10d9533b8 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 22 Aug 2023 09:51:30 +0100 Subject: [PATCH 11/16] Update lphomeopathy.json amended to match new guidance text --- .../measure_definitions/lphomeopathy.json | 25 ++++++++++++++++--- 1 file changed, 21 insertions(+), 4 deletions(-) diff --git a/openprescribing/measure_definitions/lphomeopathy.json b/openprescribing/measure_definitions/lphomeopathy.json index e8ed44150e..06261a16b4 100644 --- a/openprescribing/measure_definitions/lphomeopathy.json +++ b/openprescribing/measure_definitions/lphomeopathy.json @@ -9,13 +9,23 @@ "numerator_short": "Homeopathy cost (£)", "denominator_short": "1000 patients", "why_it_matters": [ - "In 2010 House of Commons Science and Technology Committee found that the use of homeopathy was ", - "not evidence-based, and any benefits to patients was due to placebo effect. " + "

", + "NHS England guidance states:

", + "

Homeopathy seeks to treat patients with highly diluted substances that are administered orally.

", + "

During the consultation we received a range of submissions pertaining to homeopathy and it was deemed necessary to have a further review to include the up to date evidence; this was conducted by the ", + "Specialist Pharmacy Service. ", + "This review found no clear or robust evidence to support the use of homeopathy on the NHS.

", + "

NHS England recommend that GPs:", + "

    ", + "
  • Do not initiate.
    • ", + "
  • Deprescribe in patients currently prescribed this medicine.
    • ", + "
" ], "tags": [ "cost", "efficacy", - "lowpriority" + "lowpriority", + "lowpriority_noexceptions" ], "url": null, "is_percentage": false, @@ -26,4 +36,11 @@ "190203 # Other Homeopathic Preps" ], "denominator_type": "list_size" -} \ No newline at end of file + "authored_by": "richard.croker@phc.ox.ac.uk", + "checked_by": "", + "date_reviewed": "2023-08-22", + "next_review": "2025-08-22", + "measure_complexity": "low", + "measure_type": "bnf_code", + "radar_exclude": false +} From ad4864632d527cddb6e16933ec17ccac39df564a Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 22 Aug 2023 10:12:38 +0100 Subject: [PATCH 12/16] Revert "Update lphomeopathy.json" This reverts commit ba7f0dc77ede1c730e9476f236c52ec10d9533b8. --- .../measure_definitions/lphomeopathy.json | 25 +++---------------- 1 file changed, 4 insertions(+), 21 deletions(-) diff --git a/openprescribing/measure_definitions/lphomeopathy.json b/openprescribing/measure_definitions/lphomeopathy.json index 06261a16b4..e8ed44150e 100644 --- a/openprescribing/measure_definitions/lphomeopathy.json +++ b/openprescribing/measure_definitions/lphomeopathy.json @@ -9,23 +9,13 @@ "numerator_short": "Homeopathy cost (£)", "denominator_short": "1000 patients", "why_it_matters": [ - "

", - "NHS England guidance states:

", - "

Homeopathy seeks to treat patients with highly diluted substances that are administered orally.

", - "

During the consultation we received a range of submissions pertaining to homeopathy and it was deemed necessary to have a further review to include the up to date evidence; this was conducted by the ", - "Specialist Pharmacy Service. ", - "This review found no clear or robust evidence to support the use of homeopathy on the NHS.

", - "

NHS England recommend that GPs:", - "

    ", - "
  • Do not initiate.
    • ", - "
  • Deprescribe in patients currently prescribed this medicine.
    • ", - "
" + "In 2010 House of Commons Science and Technology Committee found that the use of homeopathy was ", + "not evidence-based, and any benefits to patients was due to placebo effect. " ], "tags": [ "cost", "efficacy", - "lowpriority", - "lowpriority_noexceptions" + "lowpriority" ], "url": null, "is_percentage": false, @@ -36,11 +26,4 @@ "190203 # Other Homeopathic Preps" ], "denominator_type": "list_size" - "authored_by": "richard.croker@phc.ox.ac.uk", - "checked_by": "", - "date_reviewed": "2023-08-22", - "next_review": "2025-08-22", - "measure_complexity": "low", - "measure_type": "bnf_code", - "radar_exclude": false -} +} \ No newline at end of file From 21e5ca9c4679d884ca49868a9448018646ecd582 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 19 Sep 2023 09:30:45 +0100 Subject: [PATCH 13/16] Update lpherbal.json updated text and removed "oil" --- .../measure_definitions/lpherbal.json | 37 ++++++++++++++----- 1 file changed, 27 insertions(+), 10 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 4c3c454473..3fbc80ffa2 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -5,9 +5,25 @@ "numerator_short": "Herbal medicines cost (£)", "denominator_short": "1000 patients", "why_it_matters": [ - "Under a Traditional Herbal Registration there is no requirement to prove scientifically that a product works, ", - "the registration is based on longstanding use of the product as a traditional medicine, and therefore there is ", - "a lack of robust evidence of clinical effectiveness for these products." + + "

", + "NHS England guidance states:

", + "

Under a traditional herbal registration (THR) there is no requirement to prove scientifically that a product works; the registration is based on longstanding use of the product as a traditional medicine.

", + "

Due to the lack of scientific evidence required to register these products with the MHRA, the joint clinical working group felt that they were suitable for inclusion in this guidance.

", + "

In addition to herbal treatments with a THR, other natural products without robust evidence of clinical effectiveness should not be prescribed at NHS expense and fall within these recommendations. ", + "These include:", + "

    ", + "
  • natural oils, eg eucalyptus and almond
    • ", + "
  • coenzyme Q10 (ubiquinone and ubidecarenone)
    • ", + "
  • evening primrose (gamolenic acid).
    • ", + "
", + "

", + "

MHRA withdrew the licence for 2-gamolenic acid preparations in 2002 due to a lack of evidence of efficacy.

", + "NHS England recommend that GPs:", + "
    ", + "
  • Do not initiate.
    • ", + "

", + "

Please note: this measure is under review, and does not currently include natural oil preparations." ], "tags": [ "cost", @@ -23,13 +39,13 @@ "SELECT DISTINCT v.bnf_code FROM dmd.vmp v", "INNER JOIN dmd.vtm t", "ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%oil%') ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%') ", "AND v.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT a.bnf_code FROM dmd.amp a", "INNER JOIN dmd.vmp v ON a.vmp = v.id", "INNER JOIN dmd.vtm t ON t.id = v.vtm", - "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%' OR LOWER(t.nm) LIKE '%oil%') ", + "WHERE (LOWER(t.nm) LIKE '%gamolenic%' OR LOWER(t.nm) LIKE '%ubidecarenone%') ", "AND a.bnf_code IS NOT NULL", "UNION ALL", "SELECT DISTINCT bnf_code FROM dmd.amp", @@ -38,10 +54,11 @@ ], "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", - "checked_by": "christopher.wood@phc.ox.ac.uk", - "date_reviewed": "2023-04-18", - "next_review": "2024-04-18", - "measure_complexity": "low", - "measure_type": "bnf_code" + "checked_by": "", + "date_reviewed": "2023-09-19", + "next_review": "2024-09-19", + "measure_complexity": "medium", + "measure_type": "dmd", + "radar_exclude": false } From 6776dff0d3d43e2f9cb7d71ffb1d2b885cd2cc5d Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 19 Sep 2023 09:32:38 +0100 Subject: [PATCH 14/16] Update lpherbal.json amended title --- openprescribing/measure_definitions/lpherbal.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 3fbc80ffa2..7a6b487166 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -1,5 +1,5 @@ { - "name": "NHS England Low Priority Treatment - herbal medicines", + "name": "Items which should not routinely be prescribed in primary care - herbal medicines", "title": "Herbal medicines cost per 1000 patients", "description": "Cost of herbal medicines per 1000 patients", "numerator_short": "Herbal medicines cost (£)", From 04917a3576b4169ecb4892a973fab04f197be38f Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Tue, 19 Sep 2023 09:42:42 +0100 Subject: [PATCH 15/16] Update lpherbal.json fixed formatting typo --- openprescribing/measure_definitions/lpherbal.json | 3 ++- 1 file changed, 2 insertions(+), 1 deletion(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 7a6b487166..7da4ca41a4 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -22,8 +22,9 @@ "NHS England recommend that GPs:", "

    ", "
  • Do not initiate.
    • ", + "
  • Deprescribe in patients currently prescribed this medicine.
    • ", "

", - "

Please note: this measure is under review, and does not currently include natural oil preparations." + "

Please note: this measure is under review, and does not currently include natural oil preparations." ], "tags": [ "cost", From 870a3f6c38be199cfd9e477b15300148f45f2649 Mon Sep 17 00:00:00 2001 From: Richard Croker Date: Mon, 20 Nov 2023 13:39:35 +0000 Subject: [PATCH 16/16] Update lpherbal.json amended NHS text and statement on natural oils --- openprescribing/measure_definitions/lpherbal.json | 7 ++++--- 1 file changed, 4 insertions(+), 3 deletions(-) diff --git a/openprescribing/measure_definitions/lpherbal.json b/openprescribing/measure_definitions/lpherbal.json index 7da4ca41a4..e61842b3a5 100644 --- a/openprescribing/measure_definitions/lpherbal.json +++ b/openprescribing/measure_definitions/lpherbal.json @@ -11,6 +11,7 @@ "

Under a traditional herbal registration (THR) there is no requirement to prove scientifically that a product works; the registration is based on longstanding use of the product as a traditional medicine.

", "

Due to the lack of scientific evidence required to register these products with the MHRA, the joint clinical working group felt that they were suitable for inclusion in this guidance.

", "

In addition to herbal treatments with a THR, other natural products without robust evidence of clinical effectiveness should not be prescribed at NHS expense and fall within these recommendations. ", + "These products do not have a THR, are not recognised as supplements in the NHS Drug Tariff and do not appear as medicines in the BNF. ", "These include:", "

    ", "
  • natural oils, eg eucalyptus and almond
    • ", @@ -24,7 +25,7 @@ "
  • Do not initiate.
    • ", "
  • Deprescribe in patients currently prescribed this medicine.
    • ", "

", - "

Please note: this measure is under review, and does not currently include natural oil preparations." + "

Please note: this measure does not currently include natural oil preparations." ], "tags": [ "cost", @@ -56,8 +57,8 @@ "denominator_type": "list_size", "authored_by": "richard.croker@phc.ox.ac.uk", "checked_by": "", - "date_reviewed": "2023-09-19", - "next_review": "2024-09-19", + "date_reviewed": "2023-11-20", + "next_review": "2024-11-20", "measure_complexity": "medium", "measure_type": "dmd", "radar_exclude": false