Vitamin B vs thiamine by practices in NHS DUDLEY

Why it matters: One of the most common reasons why vitamin B has been prescribed is to prevent Wernicke's encephalopathy in chronic alcohol disorders. However, a 2019 position statment from the Regional Medicines Optimisation Committee (RMOC) provided the following guidance:

• Do not initiate vitamin B compound or vitamin B compound strong tablets for any of the following indications:
  • Prevention of WE in alcoholism
  • Dietary supplementation
  • Prevention of deficiency
  • Maintenance treatment following treatment of deficiency
• Review all existing patients prescribed vitamin B complex preparations with a view to stopping treatment in all but exceptional circumstances, such as in those patients with a medically diagnosed deficiency due to lifelong or chronic condition, or following surgery that results in malabsorption. If all relevant patient factors have been taken into account and it is considered appropriate to stop, treatment may be stopped immediately.
• The decision to discontinue treatment should be carefully explained to the patient, and should emphasise the positive aspects of discontinued prescribing of drugs with a low clinical value.
• Advise patients who wish to use these vitamin B preparations as dietary supplements to purchase them over the counter
• Prescribe prophylactic oral thiamine 200 to 300 mg daily in divided doses to harmful or dependent drinkers for prevention of WE continued for as long as malnutrition is present and/or during periods of continued alcohol consumption.
• Review patients prescribed thiamine with a view to stopping if the patient has been abstinent for 6 weeks or more and has regained adequate nutritional status.
• Patients who require continued treatment with thiamine should be reviewed at appropriate intervals depending on individual circumstances.

Please see our other measure: Vitamin B per 1000 patients.

Description: Prescribing of vitamin B complex (normal and strong tablets) as a percentage of prescribing of vitamin B and thiamine tablets

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Tagged as: Efficacy, NICE, Cost Saving (or browse all measures for this Sub-ICB Location)

Practices are ordered by mean percentile over the past six months, with the worst-performing at the top. Each chart shows the results for the individual practice, plus deciles across all practices in the NHS in England.

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