Download Bimatoprost 0.03% Eye Drops - NHS Education for Scotland

NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
GG&C PGD ref no:
YOU MUST BE AUTHORISED BY NAME, UNDER THE CURRENT VERSION OF THIS
PGD BEFORE YOU ATTEMPT TO WORK ACCORDING TO IT
Clinical Condition
Indication:
Reduction of elevated intraocular pressure in chronic open-angle
glaucoma and ocular hypertension in line with guidance document
for use of PGDs in glaucoma clinic.
Inclusion criteria:
Adults who are newly diagnosed as having raised intra-ocular
pressure in open angle glaucoma or ocular hypertension according
to defined protocols for diagnosis.
Adults who have a prior diagnosis of glaucoma or ocular
hypertension and are found to have inadequate control of
intraocular pressure on current treatment, or are found to have
glaucomatous progression e.g. Optic disc change or visual field
progression.
Exclusion criteria:
Individuals (age less than 18)
Patients with any of the following know conditions:
 Recent Cataract surgery (within 3 months)
 Patients with aphakia or pseudophakia with torn posterior
capsules.
 Cystoid macular oedema
 Patients with known history of iritis/uveitis
 Known renal impairment
 Known hepatic impairment
 History of significant ocular viral infections eg. Herpes simplex
 Known hypersensitivity/ allergy to bimatoprost or prostaglandin
analogues or any constituent of the product
 Pregnancy
 Lactation
Cautions/Need for further
advice/Circumstances
when further advice
should be sought from
the doctor:
Action if patient declines
or is excluded:
Advice should be sought from a doctor if any uncertainty regarding
diagnosis, exclusion criteria, or cautions for use
Referral arrangements for
further advice / cautions:
Refer to Ophthalmologist
Date Approved:
Review Date:
Template Version:
Advice from ophthalmic medical staff regarding patient’s condition
and referral to consultant clinic
Version:
Expiry Date:
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NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
Drug Details
Name, form & strength
of medicine:
Bimatoprost 0.03% eye drops
Route/Method of
administration:
Topical ocular administration
Systemic absorption may be reduced by compressing the lacrimal sac
at the medial canthus for one minute during and following the instillation
of the drops.
Each bottle is intended for use for 28 days only after which they must
be discarded and a repeat prescription obtained from the general
practitioner. A letter detailing initiation of therapy and requesting
continuation of supply will be sent to the General Practitioner.
Dosage (include
maximum dose if
appropriate):
Frequency:
One drop into the affected eye(s)
Duration of treatment:
28 Days
Maximum or minimum
treatment period:
Minimum duration of 4 weeks to assess ocular response to treatment
(maximum IOP lowering effect occurs 5-6 weeks after commencing
treatment) and possible life long treatment if effective
Quantity to
supply/administer:
One 3ml bottle supplied to patient
▼Black Triangle
Drug:*
No
Legal Category:
POM
Is the use outwith the
SPC:**
No
Storage requirements:
No special storage requirements
Once daily in the evening
* The black triangle symbol (▼) identifies newly licensed medicines that are monitored
intensively by the MHRA/CSM
** Summary of Product Characteristics
Date Approved:
Review Date:
Template Version:
Version:
Expiry Date:
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NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
Warnings including
possible adverse
reactions and
management of these:
Refer to Summary of Product Characteristics (SPC) available at
http://medicines.org.uk and/or BNF for full list of potential adverse
effects, interactions and cautions for use.
Adverse Effects
Common side effects include headache, increased iris pigmentation,
darkening of eyelashes, conjunctival hyperaemia, ocular pruritus,
superficial punctuate keratitis, corneal erosion, ocular burning, ocular
irritation, allergic conjunctivitis, blepharitis, worsening visual acuity,
asthenopia, conjunctival oedema, foreign body sensation, ocular
dryness, eye pain, photophobia, tearing, eye discharge, visual
disturbance, hypertension, eyelid erythema, eyelid pruritus,
pigmentation of periocular skin
Adverse reactions will be documented in patient’s notes and discussed
with a member of medical staff.
If necessary the Yellow Card System will be used to report adverse
drug reactions. Yellow Cards and guidance on its use are available at
the back of the BNF or online at http://yellowcard.mhra.gov.uk
Advice to patient/carer
including written
information provided:
Patients or carers will be advised that vision may be blurred for a few
minutes after instillation and that the patient should not drive or
operated hazardous machinery if affected. Drops may sting for a few
moments after instillation and may produce mild redness of the eyes.
Patients will be advised to read the patient information leaflet contained
with their medication.
Patients with asthma or COPD will be advised to contact the eye clinic
as detailed below if they have any exacerbation of symptoms.
Patients will be advised and shown the best way to self administer eye
drops and will be advised on the importance of compliance - and the
risks to the sight of non-compliance. Patients will be advised to contact
the eye clinic at the hospital which they normally attend during working
hours or NHS 24 outwith working hours to report any unusual or severe
side effects, either ocular or systemic.
Patients will be advised of the potential for harmless increased
pigmentation of the iris as well as pigmentation and lengthening of the
eyelashes
Remove soft contact lenses prior to application and wait at least 15
minutes before reinsertion.
Monitoring (if
applicable):
Following initiation of new treatment or any treatment change, the
patient will be reviewed in the glaucoma clinic within 2 months to
assess the effect of treatment.
Follow up:
Patients will be reviewed periodically in glaucoma clinics and
effectiveness of treatment monitored according to clinic protocols.
Date Approved:
Review Date:
Template Version:
Version:
Expiry Date:
Page 3 of 7
NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
Staff Characteristics
Professional
qualifications:
Registered Orthoptist (registered with health professions council)
Optometrist (registered with general optical council)
Specialist competencies
or qualifications:
Local accreditation in Glaucoma diagnosis and management by
consultant glaucoma specialist
Completion of in-house training on use of Patient Group Directions.
Annual update of Patient Group Direction training.
Continuing education &
training:



All healthcare professionals are personally accountable for their
practice and, in the exercise of their professional accountability
there is a requirement to maintain and improve their professional
knowledge and competence.
In-house training carried out by relevant medical, nursing and
pharmacy staff.
All authorised orthoptists/optometrists must re-read the patient
group direction on an annual basis and when any changes,
additions or deletions are made following a period of prolonged
absence, leave or sabbatical.
Referral Arrangements and Audit Trail
Referral arrangements
New and review patients attending shared care Glaucoma service
Records/audit trail:
Clinical decision and prescribing information recorded in patient case
notes.
Departmental records kept of patient name, date of birth, unit number
and CHI number to record batch number and expiry of medications
supplied, as well as details of who prescribed and who dispensed the
medication.
References/Resources
and comments:
Date Approved:
Review Date:
Template Version:
Guidance document for use of PGDs in glaucoma clinic.
NICE guidelines on diagnosis and management of Glaucoma
Scottish Medicines Consortium
British National Formulary 59
Electronic Medicines Compendium http://www.medicines.org.uk/EMC
Version:
Expiry Date:
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NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
This Patient Group Direction must be agreed to and signed by all healthcare professionals involved in its
use. The original signed copy will be held at PPSU, Queens Park House, Victoria Infirmary. The PGD must
be easily accessible in the clinical setting.
Organisation:
NHS Greater Glasgow & Clyde
Professionals drawing up PGD/Authors
Designation and Contact Details
*Name:
Signature:
Designation:
Date:
Name:
Signature:
Designation:
Date:
Name:
Signature:
Date:
E-mail address:
Designation:
Date:
Name:
Signature:
E-mail address:
Designation:
Name:
Signature:
E-mail address:
E-mail address:
Designation:
Date:
E-mail address:
* Lead Author
Date Approved:
Review Date:
Template Version:
Version:
Expiry Date:
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NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
AUTHORISATION:
NHSGG&C PGD & Non-medical Prescribing Sub-Committee of ADTC
Chairman
Signature:
Date:
in BLOCK CAPITALS
Lead of the professional group to which this PGD refers:
Name:
Signature:
Date:
in BLOCK CAPITALS
Pharmacist representative of PGD & Non-Medical Sub-Committee of ADTC
Name:
Signature:
Date:
in BLOCK CAPITALS
Antimicrobial use
If the PGD relates to an antimicrobial agent, the use must be supported by the NHS
GG&C Antimicrobial Management Team (AMT). A member of this team must sign
the PGD on behalf of the AMT.
Designation:
Microbiology Name:
approval
Signature:
Date:
(on behalf of NHS GG&C AMT)
Date Approved:
Review Date:
Template Version:
Version:
Expiry Date:
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NHS Greater Glasgow & Clyde
Patient Group Direction (PGD) for
Optometrists & Orthoptists
Bimatoprost 0.03% Eye Drops
Local Authorisation:
Service Area for which PGD is applicable:
I authorise the supply/administer medicines in accordance with this PGD to patients cared for in this service
area.
Lead Clinician for the service area (Doctor)
Name:
Signature:
Designation:
Date:
E-Mail contact address:
I agree that only fully competent, qualified and trained professionals are authorised to operate under the
PGD. Records of nominated individuals will be kept for audit purposes.
Name (Lead Professional):
Signature:
Designation:
Date:
E-Mail contact address:
Description of Audit arrangements:
Frequency of checks:
(Generally annually)
Names of auditor(s):
PGDs DO NOT REMOVE INHERENT PROFESSIONAL OBLIGATIONS OR
ACCOUNTABILITY.
It is the responsibility of each professional to practice only within the bounds of their own
competence and in accordance with their own Code of Professional Conduct.
Note to Authorising Managers: authorised staff should be provided with an individual copy of the clinical
content of the PGD and a photocopy of the document showing their authorisation.
I have read and understood the Patient Group Direction. I acknowledge that it is a legal document and agree
to supply/administer this medicine only in accordance with this PGD.
Name of Professional
Date Approved:
Review Date:
Template Version:
Signature
Date
Version:
Expiry Date:
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