The burden of musculoskeletal conditions
Abstract: Musculoskeletal conditions (MsC) are a major burden to the individual, society and the health service; 15–20% of all GP consultations involve patients with MsC. Incident cases of osteoarthritis are ten times more common than rheumatoid arthritis (RA). The prevalence of MsC is higher in women, rises with age and is likely to continue to rise as life expectancy increases. The costs of MsC include those to healthcare services, to society and indirect costs. MsC are among the most commonly reported causes of work-related ill health. Rheumatoid arthritis alone costs the UK economy between £3.8 and 4.8 billion a year. The average cost of a major hip procedure is £7800 and of a major knee procedure £6000. Risk factors for MsC include age and gender. The prevalence of certain MsC varies depending on ethnicity, lifestyle factors and genetic predisposition. The main consequences of MsC are chronic pain and disability. The burden of MsC is high and the impact of these conditions on the health service and society will continue to rise alongside increasing life expectancy.
Abstract: The introduction of biological therapies has resulted in improved outcomes in patients with rheumatoid arthritis (RA), although there are concerns about the long-term safety of these drugs specifically relating to lymphoma and serious infection. Biologics registers have been established worldwide to investigate long-term safety as well as effectiveness of biologic drugs in inflammatory conditions such as RA.
To date, publications from biologics registers have focused mainly on anti-tumour necrosis factor therapy (anti-TNF agents). The reports show that anti-TNF agents are effective in the treatment of RA. However, they are also associated with higher rates of serious infection. Lymphoma risk does not appear to increase, although findings are limited by mean follow-up periods of less than 5 years.
Moving forward, biologics registers will continue to capture long-term follow-up of anti-TNF drugs in RA, as well as incorporating new classes of biologics and other musculoskeletal diseases. This will further extend our knowledge of the long-term safety and effectiveness of biologic drugs, when used in ‘real life’ situations, and across conditions.
Elsevier in Medicine
Full text article available to order through our inter-library loan scheme.
Being green – East Cheshire Trust has begun work with the Salford-based company ENER-G to substantially reduce its energy costs. Both Congleton War Memorial and Macclesfield District General hospitals will take part in this scheme which they hope will achieve major energy efficiency improvements. Some of the proposed changes involve the replacement of some 3,250 light fittings with high efficiency LED lighting, together with boiler efficiency improvements.
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An interesting article in last week’s Health Services Journal on Blogging: patient led therapy in a digital world – it appears that blogging can be good for you!
Read some inspiring stories by clicking the link above.
“Blogging as a therapy can be life changing. Reading these stories is an education, an emotional experience, a journey. There are some very practical insights, some philosophical points and some clear messages for developing a great and relevant future healthcare system.” Roz Davies
Whether you manage several teams or just a couple of individuals, did you know that NHS Employers regularly produce the NHS Managers Bulletins which provide tools, information and advice on people management. Everything from sickness/absence to making the appraisal process more satisfying.
Here are some links to the latest ones:
This month in Eyes on Evidence
Acid-suppressive drugs and oesophageal adenocarcinoma in Barrett’s oesophagus
A systematic review and meta-analysis indicates that proton pump inhibitors reduce the risk of oesophageal adenocarcinoma and high-grade dysplasia in people with Barrett’s oesophagus.
Prescriptions for anxiolytics and hypnotics and risk of death
A population-based cohort study in UK primary care suggests that people who are prescribed anxiolytic and hypnotic drugs have a significantly increased risk of death from any cause over a 7-year period.
Assessment and treatment of dementia in older adults
A systematic review finds that brief cognitive assessment tools can adequately detect early dementia, but whether interventions for mild cognitive impairment or early dementia have a clinically significant effect is unclear.
Bedtime schedules and children’s cognition and behaviour
Two analyses of 7-year-olds in the UK Millennium Cohort Study suggest that not having a regular bedtime is associated with impaired cognition in girls and behavioural difficulties in both girls and boys.
Trained glycaemia alert dogs for people with type 1 diabetes
A small UK intervention study suggests that trained glycaemia alert dogs may be able to notify people with type 1 diabetes during blood glucose variations.
NICE opens consultation on the NICE Accreditation Process Manual Update
NICE is inviting comments on its proposals to update the NICE Accreditation Process Manual.
NICE has recently published Evidence Updates on:
- Physical activity and the environment
- Autism in adults
- Opioids in palliative care