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Scotland brings in medicine card to avoid kidney injury after dehydration

Patient information cards that warn patients to temporarily stop taking specific medicines if they have a dehydrating illness are being introduced across Scotland. Clare Morrison, pictured, lead pharmacist (north) at NHS Highland, created the cards

Clare Morrison, who created the ‘Medicine Sick Day Rules’ patient information cards, says the response from patients and professionals has been overwhelmingly positive

Pocket-sized patient information cards that warn patients to temporarily stop taking specific medicines if they have a dehydrating illness are being introduced across Scotland. 

The roll out of ‘Medicine Sick Day Rules’ cards follows the success of the scheme that was first launched in NHS Highland in 2013. 

The credit card-sized cards advise patients to stop taking named medicines if they develop a dehydrating illness because they could be at risk of developing acute kidney injury (AKI). 

The medicines to avoid are ACE inhibitors, anti-inflammatory painkillers, diuretics and metformin, which is prescribed for diabetes. 

Since the cards were introduced in the Highlands there has been a small fall in the number of patients admitted to hospital with AKI, according to the results of an evaluation published in April 2015. Patients also followed the advice on the card and re-started their medicines within 48 hours of recovering from the dehydrating illness, it found. 

Clare Morrison, lead pharmacist (north) at NHS Highland, who created the cards, says: “The response we have had to the cards from patients and professionals alike has been overwhelmingly positive.”

Martin Wilson, consultant physician at Raigmore Hospital, Inverness, adds: “Increasing patient awareness of these rules is important, given how common dehydrating illnesses are and how frequently many of the targeted medicines are prescribed.”

The ‘Medicine Sick Day Rules’ cards are currently being tested in Salford in a pilot run by NHS England; a similar scheme is already running in some parts of Wales.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20068839

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