Eyes on Evidence: Issue 61; May 2014

Here are the latest topics for this month from NICE – Eyes on Evidence.

Adenotonsillectomy in children with obstructive sleep apnoea
A randomised controlled trial in the USA finds that adenotonsillectomy does not improve cognitive function in children with obstructive sleep apnoea syndrome, although it does have a beneficial effect on symptoms of sleep apnoea.

Ibuprofen compared with indometacin for patent ductus arteriosus
A Cochrane review reports that ibuprofen is as effective as indometacin for closure of patent ductus arteriosus in preterm or low-birthweight babies, and is associated with a lower risk of necrotising enterocolitis, reduced time on assisted ventilation and a lower risk of negative effects on renal function.

Gallbladder removal with or without bile duct imaging
A retrospective cohort study of US data raises caution about interpreting the benefits of using bile duct imaging during gallbladder removal.

Collaborative care for depression
A cluster randomised controlled trial in English general practices suggests that collaborative care delivered by mental health workers acting as care managers is more effective at reducing depression than usual care.

End-of-life preferences of people with terminal illness who live alone
An Australian cohort study finds that around half of people with terminal illness who live alone would prefer to die at home, but only a small proportion manage to do so.

Evidence Updates
NICE has recently published Evidence Updates on:

• Venous thromboembolic diseases -Interventions to reduce substance misuse among vulnerable young people

Eyes on Evidence helps contextualise important new evidence, highlighting areas that could signal a change in clinical practice. It does not constitute formal NICE guidance. The commentaries
included are the opinions of contributors and do not necessarily reflect the views of NICE.

 

What makes a good consultation?

When you only have 10 minutes with a patient, where do you start and how do you finish?  This BMJ Learning module will look at the key elements of a consultation and ensure nothing of importance is forgotten.

• Communication skills: tips for the 10 minute consultation

Here are 3 other modules you may find useful:

• Depression in adults: in association with NICE
• Generalised anxiety disorder: a guide to diagnosis and management
• Depression in adults with a chronic health problem: in association with NICE

BMJ Learning modules – June

As the pollen season is reaching its peak there tends to be an increase in patients wanting information on allergic rhinitis.

Questions may include: which antihistamines are the least sedating? Will antihistamines help nasal congestion? What are the side effects of intranasal corticosteroids? 

To get the answers and to learn more about this topic, then click on the link to complete this module today.  Allergic rhinitis: an update on treatment

Additional modules on mood disorders – see below.

• Depression in adults: in association with NICE
• Anxiety disorders in adults: in association with NICE
• Depression in adults with a chronic health problem: in association with NICE
• Bipolar disorder: management in primary care – in association with NICE
• Using cognitive behavioural therapy techniques in general practice

Health Technology Assessment bulletin – May 2013

Effectiveness of biofeedback for managing stress incontinence in women

A new study funded by the HTA Programme will find out whether the use of biofeedback can help to improve the results of teaching pelvic floor exercises for women with stress or mixed urinary incontinence. [more…]

SMILE to help those with poorly controlled epilepsy

A new study funded by the HTA Programme will look at how effective a programme called Self-Management education for adults with poorly controlled epilepsy (SMILE) is in helping those with poorly controlled seizures to become ‘experts’ in dealing with their epilepsy. [more…]

Exercise ineffective against depression in care home residents finds HTA research published in The Lancet

Exercise is not effective in reducing rates of depression among elderly care home residents, according to the findings of an HTA Programme study. [more…]

Medicines Healthcare products Regulating Authority: SSRI

Calling all doctors, pharmacists and nurses  involved in the care of patients with depression. Also valuable for clinicians starting out in  psychiatry.

(Selective serotonin reuptake inhibitor) SSRI learning module

The MHRA have just launched a learning module on selective serotonin reuptake inhibitors (SSRI) antidepressants for clinical practitioners.  This self-directed learning package outlines the key risks of this important class of medicines. For each adverse effect, the package outlines:

• the main features of the adverse effect
• factors that increase the risk
• how the risk can be reduced
• specific treatment for the adverse effect.

A self-assessment exercise, together with full feedback, complements the learning material. SSRI learning module