Switch Information and Agreement Sheet
[Important: The information in this sheet should be read in conjunction
with the detailed information in the BNF and the products’ Summary of
Product Characteristics]
Action
Rationale
Review of Blood Glucose Test Strips in Primary Care
Blood glucose testing is used to determine the plasma
glucose level in patients with diabetes.
The primary objectives of blood glucose testing are to
monitor for hypoglycaemia and to measure the effects of
treatment (e.g. insulin).
The frequency of testing is determined by type of diabetes
(Type 1 or 2) and medication prescribed.
Most blood glucose meters are similar in terms of
technical specifications and the primary determinants of
meter choice in patients who need to test should be
ability/willingness to use the meter and test strip cost.
Blood glucose meters are not prescribeable on the NHS
but most models are provided free of charge to GPs and
diabetes clinics. Patients may also purchase meters from
community pharmacies or online.
Blood glucose test strips cost in the region of £10 – 17 for
50 test strips with most products costing between £14-15.
GlucoRx Nexus test strips cost £9.95 for 50. The product
has been trialled in local patients and most feedback was
very positive.
The GlucoRx Nexus meter is supplied with a lancing
device. The GlucoRx lancets to fit the device are more
cost effective than other lancets on market. 200 lancets =
£5.50Patients are free to use whatever lancing device
they choose with the GlucoRx Nexus meter but as noted,
the GlucoRx Nexus lancets (to fit the lancing device
supplied with the meter) are more cost effective than all
other lancing devices currently on the market.
Review
All patients should be reviewed to see if they are testing in
Medicines Management
NHS Kirklees
29th June 2011
line with the local blood glucose testing guidelines.
Where patients are not testing appropriately (over/under
testing) patients should be offered education and advice
on appropriate testing.
Item to be
switched
Search
1. Blood Glucose Test Strips
2. Lancets
Search for all patients prescribed Blood Glucose Test
Strips on repeat prescription.
Exclusions
Patients groups
where extra
caution should
be exercised

Patients on insulin pumps. The blood glucose
testing meter is integrated with the insulin pump so
the appropriate test strip needs to be prescribed.
These patients may be identified as they will have
Type1 diabetes and will only be prescribed rapid
acting analogue insulins in vial format (e.g.
Humalog or NovoRapid)

Patients using Clever Check system. This provides
an aural result rather than visual result for people
who have visual impairment.
Patients in these groups will need careful individual
assessment to check if a switch of meter would be
appropriate for them:

Type 1 diabetes adults. It is important that any change
in glucose testing equipment does not disrupt pattern
of blood glucose testing

Paediatric patients – A change in testing equipment
may interfere with overall management of diabetes. Do
not switch without prior discussion with specialist
team:
o North Kirklees:
 > 14 years: Dr Alagoa 01924 816131
 < 14 years: Dr Mackay 01924 816158
o Huddersfield:
 Dr Terrett: 01484 342361

Patients using Optium Exceed Meter which tests for
both blood glucose and blood ketones. [Optium Test
Strips].
o Check whether patients are using the blood
Medicines Management
NHS Kirklees
29th June 2011
ketone testing system.
o If the blood ketone testing is being used and
patients wish to continue using the meter for
blood glucose testing do not switch the meter.
New Product

Patients who have dexterity issues – it should be
checked that the patient can use the meter prior to
prescribing. They may sometimes be identified by the
lancing device/meter used.

Multiclix Lancet Device. This has two main uses:
o Patients with dexterity problems
o Children of school age to prevent issues around
sharps in schools.
Where used in adults investigate further the rationale
for using the device if considering switching
meter/lancing device.

.
Patients with learning difficulties or memory problems
Provide a GlucoRx Nexus Meter and prescribe:
1. GlucoRx Nexus strips.
2. GlucoRx Lancets
Caution: “GlucoRx Nexus Strips” must be prescribed
with the new meter as “GlucoRx Strips” are not
compatible with the GlucoRx Nexus meter.
Communication
to Patients
Face to Face (preferred)/Letter to patient (Appendix 1)
/Telephone call as agreed with practice
It is important that patients understand how to use the
blood glucose testing equipment and lancing device.
This education may be provided in the following ways:
 One to one support
 Group training sessions by practice/provided by
GlucoRx
 Internet demonstrations of the GlucoRx device are
available here:
http://www.glucorx.co.uk/nexus/index-n.html
Further
information
Ordering of GlucoRx Nexus Meters:
 Telephone 01483 715008
 Email: info@glucorx.co.uk
Medicines Management
NHS Kirklees
29th June 2011
Customer Care Line (for Patients)
 01483 755 133
GP signature: …………………………….
Date:
Practice Pharmacist signature: ………………………
Date:
Medicines Management
NHS Kirklees
29th June 2011
Appendix 1 – Sample Patient Letter
Dear Title Surname,
RE: Blood Glucose Testing Devices
NHS Kirklees has recently reviewed blood glucose testing devices used within
the area. Following this review it has been decided to recommend that most
people who are required to carry out blood glucose testing should use a single
device (GlucoRx Nexus).
The GlucoRx Nexus meter was chosen as it was found to be easy to use,
significantly more cost effective than most existing alternatives and meets the
technical specifications reviewed in the evaluation.
The practice would like to discuss changing you to the new meter device.
Please make an appointment/come to the practice/ etc.
If you need further details you can contact XXXXX at the practice.
Yours sincerely
____________________
Practice Pharmacist
On behalf of GPs
Medicines Management
NHS Kirklees
29th June 2011