Eyes on Evidence: Issue 38, June 2012

 People who are admitted to hospital with a psychotic disorder may have their illness misclassified. Diagnosis should be reassessed periodically to ensure that the most appropriate interventions are being used.

There may be differences in mortality risk between individual antipsychotic agents used to treat people with dementia. Patients should be monitored for adverse events in the acute treatment period, and periodic attempts to discontinue medication should be made.

Caution is urged over the long-term use of antiplatelets in people with chronic kidney disease. Treating 1000 patients with oral antiplatelet therapy for a year may prevent nine heart attacks, but this needs to be balanced against an increased risk of bleeding.
Pregnant women may experience some benefit from using relaxation techniques during labour, in relation to reduced pain, increased satisfaction and improved clinical outcomes. However, the available evidence is insufficient to make clinical recommendations.

Antimuscarinic drugs for urinary incontinence in women 

There is no strong evidence of a clinically important difference in efficacy between antimuscarinic drugs. The choice of antimuscarinic drug for an individual woman is likely to depend on tolerability, patient preference, and cost.

Details of a new resource available via NHS Evidence search.

Cochrane quality and productivity topics

Potential disinvestment opportunities highlighted this month are:
  • Aminosalicylates for induction of remission or response in Crohn’s disease.
  • Oral budesonide for induction of remission in ulcerative colitis.

Evidence Updates

This month NHS Evidence has published three Evidence Updates.
  • Improving outcomes in head and neck cancers.
  • Familial breast cancer.
  • Sedation in children and young people.