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Practices advised to prescribe Tamiflu despite concerns


Clinicians are being encouraged to prescribe Tamiflu to care and nursing home patients as a preventative measure, despite concerns about its effectiveness.

A joint letter from NHS England and Public Health England sent to all GP practices in the Thames Valley area stresses the “expectation” they would follow national guidelines to prescribe the drug to prevent influenza.

The letter, seen by Nursing Times’ sister magazine HSJ, describes a recent “steep rise” in influenza cases including “outbreaks in residential homes” resulting in hospital admissions and some deaths.

Marked “strictly private and confidential”, it calls for the “co-operation” of practices in “protecting a particularly vulnerable patient group”.

However, it also acknowledges controversy surrounding the drug’s effectiveness.

Public Health England

Paul Cosford

Research by the Cochrane Collaboration published last year found Tamiflu reduced symptoms by between a day and a day and half but there was “no good evidence” to support claims it cut flu-related hospital admissions or flu complications.

The letter follows “recent email exchanges” between NHS England and PHE and the Thames Valley local medical committee, which represents GPs.

Patient charity National Voices raised concern about a lack of transparency and patient involvement.

However, Paul Cosford, PHE’s director of health protection and medical director, said current guidance was based on a thorough review of available evidence and recommended the use of antivirals in care homes as a preventative measure during flu outbreaks.

He said PHE was particularly concerned some prescribers – who may include nurse prescribers – might have the impression “the use of antivirals is never appropriate” and wanted to ensure clinicians “are aware of, and can follow, national guidance on appropriate antiviral use”.


Readers' comments (2)

  • michael stone

    Margaret McCartney was writing about this in the BMJ about a week ago:

    There is a problem, with guidance: it isn't the same as 'law' so it doesn't carry the legal weight of a statute, but the 'expectation' that guidance should be followed, makes the existence of guidance which doesn't seem correct for the situation at hand very 'awkward' for the professionals involved.

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  • michael stone
    michael stone | 29-Jan-2015 2:17 pm



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