Pharmacy First Pathway Editor

Shingles (Pharmacy First)

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0>=1yesno>=1NONOYESNOYESNOYESNONOYESYESNOYESNOYES>=1noyes0
Question

Is the patient suitable for aciclovir (5x daily dosing)?

aciclovir_suitability decision select
Outcome

Offer aciclovir (subject to inclusion/exclusion criteria in PGD) plus self care. Aciclovir 800mg five times daily (4-hourly during waking hours) for 7 days. Or if unsuitable: offer valaciclovir (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_aciclovir_copy_1773594193570_1 info
Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

outcome_no_treatment_copy_1773593960782_0 info
Question

Does the patient have shingles up to one week after rash onset?

timing_7d decision select
Question

Does the patient have shingles up to one week after rash onset?

timing_7d_copy_1773702411125_0 select
Question

Does the patient meet any of the following criteria? Select ANY that apply

criteria_7d_copy_1773702411386_1 select_multiple
Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

outcome_no_treatment_copy_1773702411492_2 info
Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

outcome_no_treatment_copy_1773593960782_0_copy_1773702411697_4 info
Outcome

Offer valaciclovir 1g three times daily for 7 days plus self care. Preferred for: • Immunosuppressed patients • Adherence risk: already taking 8 or more medicines a day or is assisted in taking their medicines

outcome_valaciclovir_copy_1773594193739_2_copy_1773702411800_5 info
Outcome

Offer aciclovir (subject to inclusion/exclusion criteria in PGD) plus self care. Aciclovir 800mg five times daily (4-hourly during waking hours) for 7 days. Or if unsuitable: offer valaciclovir (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_aciclovir_copy_1773594193570_1_copy_1773702411905_6 info
Question

Is the patient suitable for aciclovir (5x daily dosing)?

aciclovir_suitability_copy_1773594193484_0_copy_1773702411593_3 select
Question

Consider the risk of deterioration or serious illness. Select ANY that apply.

emergency_screen decision select_multiple
Question

Does the patient meet any of the following criteria? Select ANY that apply.

criteria_72h checklist select_multiple
Question

Is the patient eligible for the Shingles pathway? Select ANY that apply.

eligibility checklist select_multiple
Referral

Patient is not eligible for this pathway. Refer to GP or appropriate service.

outcome_not_eligible referral info
Referral

Urgent: call 999 or signpost patient to A&E immediately. Consider calculating NEWS2 Score ahead of signposting patient to A&E or calling 999 in a life-threatening emergency.

outcome_emergency referral info
Question

Does the patient have shingles within 72 hours of rash onset?

timing_72h decision select
Outcome

Shingles less likely. Consider alternative diagnosis and proceed appropriately.

outcome_not_shingles outcome info
Outcome

Patient does not meet treatment criteria. Share self-care and safety-netting advice.

outcome_no_treatment outcome info
Info

Shingles (Herpes Zoster) For adults aged 18 years and over. Exclude: pregnant individuals.

intro_guidance info_panel info
Outcome

Offer aciclovir (subject to inclusion/exclusion criteria in PGD) plus self care. Aciclovir 800mg five times daily (4-hourly during waking hours) for 7 days. Or if unsuitable: offer valaciclovir (subject to inclusion/exclusion criteria in PGD) plus self care.

outcome_aciclovir outcome info
Outcome

Offer valaciclovir 1g three times daily for 7 days plus self care. Preferred for: • Immunosuppressed patients • Adherence risk: already taking 8 or more medicines a day or is assisted in taking their medicines

outcome_valaciclovir outcome info
Outcome

Offer valaciclovir 1g three times daily for 7 days plus self care. Preferred for: • Immunosuppressed patients • Adherence risk: already taking 8 or more medicines a day or is assisted in taking their medicines

outcome_valaciclovir_copy_1773594193739_2 info
Question

Is the patient suitable for aciclovir (5x daily dosing)?

aciclovir_suitability_copy_1773594193484_0 select
Question

Does the patient follow typical progression of shingles clinical features? (Click on info button for guide)

clinical_presentation decision select
Question

Does the patient meet any of the following criteria? Select ANY that apply

criteria_7d checklist select_multiple

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