Patient and medication

Midland-based NHS trusts collaborate with university in PERT study

A new study — in collaboration with a range of Midland-based NHS trusts, and a team from the University of Birmingham — found almost half of people diagnosed with inoperable pancreatic cancer, were not prescribed Pancreatic Enzyme Replacement Therapy (PERT) tablets. The tablets are considered essential in helping patients digest food properly, and remain healthy enough to tolerate pancreatic cancer treatments.

The study — due to be published in the Pancreatology journal — utilised an audit of the records of 1,350 patients with pancreatic cancer, between April and August 2018 in the UK.

The research found huge variations in prescription rates for PERT across 84 NHS hospitals (59 non-specialist and 25 specialist surgical hospitals). The study showed that of the patients who were diagnosed too late to have surgery, just 45% were prescribed PERT tablets. But those whose cancer was considered operable, 74% were prescribed PERT.

Richard Wilkin, Clinical Lecturer at the University of Birmingham and corresponding author of the research, said: “Our important research has highlighted that, despite national guidance, there is a wide variation and under-treatment with Pancreatic Enzyme Replacement Therapy.

“This is a very simple tablet that allows patients with pancreatic cancer to absorb their food and is a vitally important part of their treatment.

 “Given that most patients with pancreatic cancer cannot be treated with surgery and are treated in non-surgical hospitals — where prescribing is lowest — strategies to disseminate best practice and overcome barriers to prescribing are urgently required.”

In response to the latest findings, the Pancreatic Cancer UK charity launched its ‘Transform Lives: Prescribe’ campaign on Wednesday, urging the NHS to ensure everyone who could benefit from the tablets, are prescribed them when diagnosed.

PERT is already recommended for people with pancreatic cancer by NICE, but there appears to be a lack of awareness around the medication, which research shows is the main reason they are not prescribed more often.

Keith Roberts, Pancreatic Subspecialty Lead, at the Royal College of Surgeons of England, said: “People with heart, lung or kidney failure would not be left untreated, but far too often pancreas failure is. This leads to very predictable problems namely weight loss, abdominal cramps and lack of ability to undergo treatment. Pancreas enzyme replacement therapy is simple and corrects this.”

Diana Jupp, CEO of Pancreatic Cancer UK, said: “Nobody should have to watch someone they love waste away from pancreatic cancer when proven, inexpensive medication is available to stop that from happening. It needs to become second nature to see people with pancreatic cancer prescribed PERT tablets.

 “We need targeted action now across the NHS to raise awareness of PERT tablets and ensure everyone who needs them is prescribed them – regardless of whether or not their cancer is curable. A simple prescription could give so many people with pancreatic cancer more – and better quality – time with their loved ones.”

NHE Sept/Oct 21

NHE Sept/Oct 21

Improving care for long-term conditions

Join us in our September/October edition of National Health Executive, as we explore a range of topics impacting and improving the care that we can deliver to patients, the facilities within which we deliver them, and the opportunities in the digital space to accent and evolve our care capabilities

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NHE365 Virtual Festival: Digital Healthcare

The integration of new technology, such as using virtual outpatient appointments instead of face-to-face reviews of patients in the hospital. Adapting the ways in which our NHS workers serve people has been critical in continuing to provide high-quality treatment, a positive patient experience and preventing Covid-19 transmission during the pandemic. Our healthcare sector has the potential to transform the way we continue to provide essential services while also improving patient care. But how easy is the integration of these innovations into routine NHS practice?

On the 28th of October, at the NHE365 Virtual Hospitals & Technology Enabled Care online event, we will be discussing patient flow and experience, reducing waiting times, reducing the patient backlog and increasing technology adoption. Will you be attending? 

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