Care and support of people growing older with learning disabilities

  • NICE guideline
  • NG96
  • Published: 
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Injectable anti-obesity medications in specialist weight management services: supporting people with complex needs

Reviewing current services and implementation

Reviewing current services

A weight management nurse was recruited in November 2022, and they began by contacting people already having liraglutide. According to patient feedback, there was:

  • poor communication with the department (busy lines, no call backs)

  • no support with side effects

  • poor communication from the pharmacy (no prescription issued or collected)

  • a long time between appointments.

In March 2023, NICE recommended semaglutide 2.4 mg, which needed to be prescribed by NHS Specialist weight management services and alongside lifestyle and behavioural advice. While the specialist service was in operation, at this time they had no established clinical pathway for monitoring people on these medications.

Implementation

Based on patient feedback and the need to comply with the guidance, in 2023, the weight management nurse:

  • established specialist clinics for initiation and follow up of people having injectable medications, providing education, support and monitoring through their treatment. This included:

    • seeking to restart people having liraglutide who were previously lost to follow up or discontinued treatment due to side effects

    • providing education to pharmacy staff and developing a template for pharmacies to email patients to collect their repeat medication (no calls or relying on answer machines)

    • designing specific computer-generated prescriptions to allow safety and audit

    • establishing a dedicated mailbox for patients to request prescriptions or wrap around care

    • developing handouts for managing side effects with some visual aids for people with neurodiversity

    • setting aside a dedicated phone line for people with neurodiversity or sensory deficit who have no support at home or require more regular contact

  • established clinics for genetic testing for obesity

  • to meet the high demand of prescriptions and to ensure efficiency of the service, completed the independent prescribing course in May 2024.

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