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Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost

Patients with phenylketonuria (PKU) are reliant on special low protein foods (SLPFs) as part of their dietary treatment. In England, several issues regarding the accessibility of SLPFs through the national prescribing system have been highlighted. Therefore, prescribing patterns and expenditure on a...

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Autores principales: Wood, Georgina, Pinto, Alex, Evans, Sharon, Daly, Anne, Adams, Sandra, Costelloe, Susie, Gribben, Joanna, Ellerton, Charlotte, Emm, Anita, Firman, Sarah, Ford, Suzanne, French, Moira, Gaff, Lisa, Giuliano, Emily, Hill, Melanie, Hunjan, Inderdip, Newby, Camille, Mackenzie, Allison, Pereira, Rachel, Prescott, Celine, Robertson, Louise, Seabert, Heidi, Skeath, Rachel, Tapley, Simon, Terry, Allyson, Tooke, Alison, van Wyk, Karen, White, Fiona J., White, Lucy, Woodall, Alison, Rocha, Júlio César, MacDonald, Anita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8620831/
https://www.ncbi.nlm.nih.gov/pubmed/34836232
http://dx.doi.org/10.3390/nu13113977
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author Wood, Georgina
Pinto, Alex
Evans, Sharon
Daly, Anne
Adams, Sandra
Costelloe, Susie
Gribben, Joanna
Ellerton, Charlotte
Emm, Anita
Firman, Sarah
Ford, Suzanne
French, Moira
Gaff, Lisa
Giuliano, Emily
Hill, Melanie
Hunjan, Inderdip
Newby, Camille
Mackenzie, Allison
Pereira, Rachel
Prescott, Celine
Robertson, Louise
Seabert, Heidi
Skeath, Rachel
Tapley, Simon
Terry, Allyson
Tooke, Alison
van Wyk, Karen
White, Fiona J.
White, Lucy
Woodall, Alison
Rocha, Júlio César
MacDonald, Anita
author_facet Wood, Georgina
Pinto, Alex
Evans, Sharon
Daly, Anne
Adams, Sandra
Costelloe, Susie
Gribben, Joanna
Ellerton, Charlotte
Emm, Anita
Firman, Sarah
Ford, Suzanne
French, Moira
Gaff, Lisa
Giuliano, Emily
Hill, Melanie
Hunjan, Inderdip
Newby, Camille
Mackenzie, Allison
Pereira, Rachel
Prescott, Celine
Robertson, Louise
Seabert, Heidi
Skeath, Rachel
Tapley, Simon
Terry, Allyson
Tooke, Alison
van Wyk, Karen
White, Fiona J.
White, Lucy
Woodall, Alison
Rocha, Júlio César
MacDonald, Anita
author_sort Wood, Georgina
collection PubMed
description Patients with phenylketonuria (PKU) are reliant on special low protein foods (SLPFs) as part of their dietary treatment. In England, several issues regarding the accessibility of SLPFs through the national prescribing system have been highlighted. Therefore, prescribing patterns and expenditure on all SLPFs available on prescription in England (n = 142) were examined. Their costs in comparison to regular protein-containing (n = 182) and ‘free-from’ products (n = 135) were also analysed. Similar foods were grouped into subgroups (n = 40). The number of units and costs of SLPFs prescribed in total and per subgroup from January to December 2020 were calculated using National Health Service (NHS) Business Service Authority (NHSBSA) ePACT2 (electronic Prescribing Analysis and Cost Tool) for England. Monthly patient SLPF units prescribed were calculated using patient numbers with PKU and non-PKU inherited metabolic disorders (IMD) consuming SLPFs. This was compared to the National Society for PKU (NSPKU) prescribing guidance. Ninety-eight percent of SLPF subgroups (n = 39/40) were more expensive than regular and ‘free-from’ food subgroups. However, costs to prescribe SLPFs are significantly less than theoretical calculations. From January to December 2020, 208,932 units of SLPFs were prescribed (excluding milk replacers), costing the NHS £2,151,973 (including milk replacers). This equates to £962 per patient annually, and prescribed amounts are well below the upper limits suggested by the NSPKU, indicating under prescribing of SLPFs. It is recommended that a simpler and improved system should be implemented. Ideally, specialist metabolic dietitians should have responsibility for prescribing SLPFs. This would ensure that patients with PKU have the necessary access to their essential dietary treatment, which, in turn, should help promote dietary adherence and improve metabolic control.
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spelling pubmed-86208312021-11-27 Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost Wood, Georgina Pinto, Alex Evans, Sharon Daly, Anne Adams, Sandra Costelloe, Susie Gribben, Joanna Ellerton, Charlotte Emm, Anita Firman, Sarah Ford, Suzanne French, Moira Gaff, Lisa Giuliano, Emily Hill, Melanie Hunjan, Inderdip Newby, Camille Mackenzie, Allison Pereira, Rachel Prescott, Celine Robertson, Louise Seabert, Heidi Skeath, Rachel Tapley, Simon Terry, Allyson Tooke, Alison van Wyk, Karen White, Fiona J. White, Lucy Woodall, Alison Rocha, Júlio César MacDonald, Anita Nutrients Article Patients with phenylketonuria (PKU) are reliant on special low protein foods (SLPFs) as part of their dietary treatment. In England, several issues regarding the accessibility of SLPFs through the national prescribing system have been highlighted. Therefore, prescribing patterns and expenditure on all SLPFs available on prescription in England (n = 142) were examined. Their costs in comparison to regular protein-containing (n = 182) and ‘free-from’ products (n = 135) were also analysed. Similar foods were grouped into subgroups (n = 40). The number of units and costs of SLPFs prescribed in total and per subgroup from January to December 2020 were calculated using National Health Service (NHS) Business Service Authority (NHSBSA) ePACT2 (electronic Prescribing Analysis and Cost Tool) for England. Monthly patient SLPF units prescribed were calculated using patient numbers with PKU and non-PKU inherited metabolic disorders (IMD) consuming SLPFs. This was compared to the National Society for PKU (NSPKU) prescribing guidance. Ninety-eight percent of SLPF subgroups (n = 39/40) were more expensive than regular and ‘free-from’ food subgroups. However, costs to prescribe SLPFs are significantly less than theoretical calculations. From January to December 2020, 208,932 units of SLPFs were prescribed (excluding milk replacers), costing the NHS £2,151,973 (including milk replacers). This equates to £962 per patient annually, and prescribed amounts are well below the upper limits suggested by the NSPKU, indicating under prescribing of SLPFs. It is recommended that a simpler and improved system should be implemented. Ideally, specialist metabolic dietitians should have responsibility for prescribing SLPFs. This would ensure that patients with PKU have the necessary access to their essential dietary treatment, which, in turn, should help promote dietary adherence and improve metabolic control. MDPI 2021-11-08 /pmc/articles/PMC8620831/ /pubmed/34836232 http://dx.doi.org/10.3390/nu13113977 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wood, Georgina
Pinto, Alex
Evans, Sharon
Daly, Anne
Adams, Sandra
Costelloe, Susie
Gribben, Joanna
Ellerton, Charlotte
Emm, Anita
Firman, Sarah
Ford, Suzanne
French, Moira
Gaff, Lisa
Giuliano, Emily
Hill, Melanie
Hunjan, Inderdip
Newby, Camille
Mackenzie, Allison
Pereira, Rachel
Prescott, Celine
Robertson, Louise
Seabert, Heidi
Skeath, Rachel
Tapley, Simon
Terry, Allyson
Tooke, Alison
van Wyk, Karen
White, Fiona J.
White, Lucy
Woodall, Alison
Rocha, Júlio César
MacDonald, Anita
Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost
title Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost
title_full Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost
title_fullStr Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost
title_full_unstemmed Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost
title_short Special Low Protein Foods Prescribed in England for PKU Patients: An Analysis of Prescribing Patterns and Cost
title_sort special low protein foods prescribed in england for pku patients: an analysis of prescribing patterns and cost
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8620831/
https://www.ncbi.nlm.nih.gov/pubmed/34836232
http://dx.doi.org/10.3390/nu13113977
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