BNF Past, Present and Future

1
BNF Past, Present and Future

• Professor Martin Kendall

2
The BNF

• How did it all begin?
• Rebirth 1981
• What have we achieved?
• BNF for Children BNFC 2005
• The future

3
The Early Days

• 1939 1945 War
• 1948 NHS
• 1949, 1952 and 1955 The National Formularies
  BMA and Pharmaceutical Society
• 1957 British National Formulary

4
National Formulary 1949 Preface

• Section headings conform to established custom,
  formulae grouped according to method of use, as
  Collutoria (mouth washes), Injectiones
  (injections), Lincti (linctuses)
• Formulae arranged alphabetically by Latin names
• Realisation that medicines for children present
  special problems

5
National Formulary 1955Preface

• The 1952 edition introduced English subheadings
• But compromise proved unwelcome to majority
• Committee reverted to the traditional style
  Latin for the titles

6
The Hardback BNF
7
Hardback BNF Contents
8
The BNF Hardback

• Formulations
• Pharmaceutics
• Rudimentary therapeutics
• Produced from time to time

9
BNF 1981 Number 1

• Preface
• Includes information on most of the products
• available to prescribers
• relevant notes for prescribers
• economical prescribing - making the best use of
  available resources
• It has been necessary to redesign the book
  completely

10
The Paperback Era (1)

• Executive Editor and team of experienced
  pharmacist-editors
• Revised and updated continuously
• 60 expert clinicians advising on the content
  twice a year

11
The Paperback Era (2)

• A Joint Formulary Committee (JFC) oversees and
  considers proposed changes
• JFC Chairman who takes credit for the work done
  by all the above

12
BNF Today

• Provides
• Guidance on prescribing
• Relevant information on prescription drugs in UK
• Appendices on drug interactions and
• prescribing in pregnancy, whilst
• breast feeding and for those with liver
• or kidney disease

13
Guidance on Prescribing
14
(No Transcript)
15
(No Transcript)
16
Appendix
17
The BNF is

• The best available
• Up to date published every 6 months
• Succinct
• Accurate
• Also available as BNF.org

18
Who gets the BNF in the UK?

• About 250,000 copies are published which go to
  all
• Doctors
• Medical students
• Pharmacists
• Pharmacy students
• Hospital wards and clinics
• Plus dentists and nurse prescribers

19
Who gets the BNF overseas?

• Licensed translations for Spain, Turkey and Italy
• Unlicensed use in many countries
• Pharmaid sends 6-12 month old BNFs to
  Commonwealth countries
• BNF.org available across the world

20
The BNF for Children BNFC

• Children are a challenge
• Come in different sizes
• Grow and develop
• and
• Clinical trials difficult
• Data very limited
• Many drugs not licensed for use in children

21
What could the BNF do? (1)

• How could we help the
• Nurse on the neonatal unit?
• Junior doctor just starting paediatrics?
• General practitioner from Burnley?

22
What Could the BNF do? (2)

• Establish team of professional editors to collect
  and assess data on prescribing for children
• Take advice from nationally recognised
  paediatrics experts
• Produce a BNF for Children BNFC

23
The BNFC was born

• An obvious solution
• But you had better check with
• RCPCH, RCGP, CSM, ABPI, BMA, RPSGB and
• OUTC
• and persuade the DH of the need to make it
  widely
• available throughout the NHS
• They all said sounds like a good ideaBUT

24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
The BNFs future

• Making the BNF better
• - Side-effects
• - Interactions
• - Pregnancy
• Coping with expanding pool of prescribers
• - Dentists, nurses, pharmacists and others

28
The electronic era

• Handheld devices
• Integration with electronic prescribing and
  electronic medical record

29

• Patients details
• Disease
• Drugs
• Demographics

Education (UG/PG)
THE PRESCRIBER
What have the other prescribers done?
Information about the drug
30

• Patients details
• Disease
• Drugs
• Demographics

Information about the drug
What have the other prescribers done?
PRESCRIBER
31
Male, 88
6 other drugs
Heart failure
Diabetes
Right Drug
32
Diagnosis
BNF data
Demographics
Drugs
Diseases
DOCTOR
33
Computer-based prescribing

• Must be supported by information and
• guidance about drugs and their use which is
• Up to date
• Accurate
• Authoritative
• Available in a useable form

34
BNF

• 1981
• Start of the paperback BNF
• 2005
• 1st BNFC
• 50th BNF
• The electronic era

35
Published September 2005