Welcome to the May issue of Journal of Prescribing Practice, my first since taking the reins as editor last month. This edition of the journal has a focus on sexual health and contraception in women over 40, a group who have specific needs as they transition towards and through the menopause. There has been plenty of recent discussion, and indeed debate, on menopause in the media, with a spotlight on the difficulties some women face when seeking help from the NHS for a range of symptoms that they struggle with in their everyday lives. These symptoms can come as a surprise to many, highlighting the lack of information and education around the transition and the effect of the hormonal changes on a variety of systems of the body.
It has been widely reported that a new drug is in development in the US which aims to provide relief for some of the most troubling symptoms. In March 2023, results from SKYLIGHT 1, a Phase III clinical study of the treatment of moderate-to-severe hot flushes due to menopause were published in The Lancet (Lederman et al, 2023). The study was placebo-controlled for 12 weeks followed by a 40-week blinded extension to assess the maintenance of effect. The authors concluded that the data support the clinical use of fezolinetant as a non-hormonal treatment for vasomotor symptoms associated with menopause. NICE is due to conduct an appraisal of the drug in December 2023.
In the UK, from April pharmacies were given the option to register for the Pharmacy Contraception advanced service, ‘an integrated pathway between existing services and community pharmacies to enable greater choice and to widen access to services and support for high-risk communities and vulnerable patients’. NHS England (2023) says the NHS Long Term Plan highlights ‘the importance of NHS services complementing the action taken by local government to support the commissioning of sexual health services. It also facilitates exploration of the future commissioning arrangements to widen access and create capacity where it is needed.’ Thus, the contraception service was established to meet these aims.
Patients have the choice to self-refer to the advanced service or be referred by their GP or sexual health clinic. The pharmacist will offer a confidential consultation and as part of that will reach a shared decision with the person on the ongoing supply of their current oral contraception, ensuring clinical appropriateness. This is an NHS service and so the supply of oral contraception will be exempt from any prescription charges.
Please do get in touch with any comments or questions at prescribingpractice@markallengroup.com.