Fluticasone furoate

Context

This codelist was developed in the context of Pharmacy First Evaluation to identify prescriptions of fluticasone furoate 27.5 micrograms/dose nasal spray recorded in GP records. It includes the generic virtual medicinal product (VMP) and actual medicinal products (AMPs), including branded and manufacturer-specific versions such as Avamys and equivalent generic products. The codelist is intended for studies requiring identification of exposure to intranasal fluticasone furoate, including analyses of prescribing patterns, medication utilisation, treatment pathways, and outcomes associated with intranasal corticosteroid use. It may also be used more broadly in routine healthcare database studies where accurate identification of fluticasone furoate nasal spray exposure is required.

Inclusion/exclusion criteria

The codelist includes SNOMED CT medication concepts representing fluticasone furoate 27.5 micrograms/dose nasal spray. Included concepts cover the generic VMP as well as AMP entries corresponding to branded and manufacturer-specific products, including Avamys, Coryen, Flutikaz, and Relioz. Products were included where they contained the same active ingredient (fluticasone furoate), strength (27.5 micrograms per dose), and route of administration (nasal spray). Products containing other corticosteroids, different strengths, alternative formulations, combination products without fluticasone furoate as the active ingredient, or non-nasal preparations were excluded.

Borderline cases

No major borderline cases were identified. Manufacturer-specific AMP concepts were reviewed and included because differences between suppliers represent the same medicinal product exposure and may reflect variations in prescribing system recording practices. Generic and branded products were considered equivalent for the purpose of identifying exposure to fluticasone furoate nasal spray. Other fluticasone-containing products were excluded where they represented different active ingredients (for example, fluticasone propionate), formulations, or routes of administration, as these may represent different clinical exposures.

Sensitivity vs specificity

The aim of this codelist is to maximise specificity by identifying only prescriptions for fluticasone furoate 27.5 micrograms/dose nasal spray. The codelist does not attempt to capture all intranasal corticosteroid treatments or all medications used for similar indications. This approach reduces the risk of misclassification and is appropriate when the research question requires a precise definition of exposure to fluticasone furoate nasal spray.

Additional information

This codelist includes both VMP and AMP concepts to improve capture of medication records across different prescribing and recording systems. Manufacturer-specific products were retained because electronic health records may record prescriptions using either generic or branded medication concepts. The codelist identifies medication exposure only and does not provide information on the clinical indication for treatment, such as allergic rhinitis or nasal inflammation. The codelist should be reviewed periodically to ensure continued completeness as new equivalent products become available.