Eyes on Evidence – October 2013

 

 This month in Eyes on Evidence
A Cochrane review notes that training in patient-centred approaches for healthcare professionals may have positive effects on patients’ experiences of consultation processes.
A Danish case-control study finds that use of glucocorticoids is associated with an increased risk of venous thromboembolism.
A cohort study shows that women who gain large amounts of weight during pregnancy are at increased risk of needing operative delivery.
A prospective population study suggests that, compared with bag-valve-mask ventilation, advanced airway management is associated with lower rates of favourable neurological outcomes after out-of hospital cardiac arrest.
A study suggests that British Pakistani girls may be less active than British white girls during school break times.
We would like your examples of how health and social care staff are helping to improve quality and productivity.
NICE has recently published Evidence Updates on:
  • Obsessive-compulsive disorder
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This month’s Eyes on Evidence

Surveillance data from Australia suggests a reduced incidence of genital warts following the introduction of vaccination against human papillomavirus for girls and young women.
A meta-analysis shows that, compared with placebo, pramipexole, ropinirole, rotigotine, gabapentin enacarbil and pregabalin improve symptoms in people with long-term moderate to severe primary restless legs syndrome.
A longitudinal study finds that social isolation and loneliness in older people may be associated with increased all-cause mortality.
An observational study suggests that the risk of thromboembolism after in vitro fertilisation is low but persists into the first trimester of pregnancy.
A meta-analysis notes that COX-2 inhibitors and diclofenac are associated with increased incidence of major vascular events.
A randomised controlled trial suggests that acupuncture for seasonal allergic rhinitis may improve disease-specific quality of life and reduce use of antihistamines.
We highlight a new example from the QIPP collection demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality.

Well worth a look in QIPP

“The Quality, Innovation, Productivity and Prevention (QIPPcollection is intended to be a resource for everyone in the NHS, public health and social care for making decisions about patient care or the use of resources.”

As part of NICE Evidence (National Institute for Clinical Excellence), this site is well worth exploring and encourages submissions from others. Here are some sample topics which give a flavour of the collection:

  • Giving intravenous iron in patients’ homes and community hospitals

    The rural geography of Cornwall means that many patients needed to travel for up to 1 hour to receive a dose of intravenous iron. This journey time increased during the summer because of the extra traffic caused by seasonal …

    QIPP, 22 August 2013 – Publisher: Royal Cornwall Hospitals Trust – Publication type: Quality and productivity collection examples

    read summary

  • Diabetes inpatient care: ThinkGlucose programme

    ThinkGlucose is designed to improve the care of people with diabetes when they are admitted to hospital. Patients with a secondary diagnosis of diabetes who receive the right care for their diabetes are able to return home fitter, more safely and ….

    QIPP, 20 June 2013 – Publisher: NHS Institute for Innovation and Improvement – Publication type: Quality and productivity collection examples

    read summary

  • Safety Express: a national pilot to deliver harm free care

    The QIPP Safe Care workstream launched its pilot, ‘Safety Express’, in January 2011. Over 1000 frontline staff in England worked collaboratively with a shared aim to deliver ‘harm-free’ care, defined as the absence of pressure ulcers, falls, …

    QIPP, 20 June 2013 – Publisher: QIPP Safe Care Programme, Salford Royal NHS Foundation Trust and University of Central Lancashire – Publication type: Quality and productivity collection examples

    read summary

  • Self management for chronic knee pain: using group physiotherapy to teach exercises and coping strategies

    Chronic peripheral joint pain (usually labelled osteoarthritis) is a major cause of suffering, physical disability, psychosocial distress, and direct and indirect healthcare and socioeconomic costs. Pain induced limitation of mobility and

    QIPP, 09 April 2013 – Publisher: Sevenoaks District General Hospital – Publication type: Quality and productivity collection examples

    read summary

  • Wireless working in hospitals: Improving efficiency and safety of out-of hours

    Coordination and communication between hospital wards and team members has been a major issue locally and nationally. Standard pager and landline telephone systems are prone to delays. When pagers are answered, tasks must be interrupted to …

    QIPP, 09 April 2013 – Publisher: Nottingham University Hospitals NHS Trust – Publication type: Quality and productivity collection examples

    read summary

Latest news from Eyes on Evidence

 Issue 51 – July 2013
This month in Eyes on Evidence
General health checks in adults

A Cochrane review suggests that general health checks are not associated with reductions in mortality or morbidity.

Hand eczema in healthcare workers 

A randomised controlled trial indicates that accurate diagnosis of hand eczema and a preventive education intervention in healthcare workers may improve symptoms and quality of life.
A systematic review suggests a lack of clear evidence for a relationship between negative mood and the premenstrual phase in the general population.
Adherence to a warfarin dosing algorithm by clinicians treating people with atrial fibrillation may be associated with improved coagulation control and clinical outcomes.
A retrospective observational study indicates that although short-term trends indicate a decline, longer-term data for 1971 to 2011 show a small increase in new medicine launches.
We highlight 2 new examples from the QIPP collection demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality.
NICE has recently published Evidence Updates on:
  • Depression in children and young people
  • Surgical site infection

Eyes on Evidence

Latest news roundup from Eyes on Evidence

A cohort study reports that rates of death from both natural and external causes are higher in people who self-harm than would be expected in the general population.
Probiotics in antibiotic-associated diarrhoea
A systematic review suggests that probiotics can reduce antibiotic-associated diarrhoea.

‘Anti-fat’ bias among doctors
Results of a web-based survey, designed to assess attitudes towards weight, reveal implicit and explicit ‘anti-fat’ bias among doctors.

Domestic violence presenting in primary care
A survey examines knowledge, attitudes and clinical skills related to domestic violence in selected UK general practices.
Small benefits of Z drugs over placebo for insomnia
A meta-analysis has found that Z drugs reduce the time taken to fall asleep by 22 minutes compared with placebo. However, this result may not be clinically significant and any benefit of Z drugs must be balanced against their well-documented risks.
Hormone replacement therapy (HRT): cardiovascular outcomes after recent menopause
Data from long-term follow-up of an open-label randomised controlled trial suggest that HRT reduces cardiovascular endpoints in women if started early after menopause. However, limitations of the analysis make interpretation of the results difficult.
Case studies from the Quality, Improvement, Productivity, and Prevention (QIPP) collection
We highlight 2 new examples from the QIPP collection, demonstrating how NHS organisations have implemented new local practices that have both cut costs and improved quality.

Evidence Updates
NICE has recently published Evidence Updates on:

  • Self-harm: longer term management
  • Autism diagnosis in children and young people

Eyes on Evidence update: Issue 48 – April 2013

Changes at NICE

Since you last received Eyes on Evidence our name has changed to the National Institute for Health and Care Excellence, to reflect our new role and responsibilities. NICE’s role is to improve outcomes for people using the NHS and other public health and social care services.

Infectious diseases among homeless populations

The prevalence of infectious diseases, such as tuberculosis, HIV and hepatitis C, in homeless populations is significantly higher than in the general population. However, figures show much local variation raising questions about the need for a more locally-based response.

Risk of abuse in disabled children A systematic review of studies from across the world suggests that more than a quarter of children with disabilities will experience abuse within their lifetimes and that children with disabilities are 3 to 4 times more likely to be victims of abuse than their peers without disabilities.

Rheumatoid factor and risk of future rheumatoid arthritis A cohort study reports that raised levels of rheumatoid factor are associated with an increased risk of developing rheumatoid arthritis. Although treating pre-rheumatoid is currently of unproven value, this study suggests it might be possible in the future.

Heart failure: effects of aldosterone antagonists and renin-angiotensin antagonists on mortality An observational study in people admitted to hospital with heart failure (HF) with reduced ejection fraction finds that aldosterone antagonists reduce readmissions for HF but have no effect on mortality and increase the risk of admission with hyperkalaemia. Another observational study in people with HF with preserved ejection fraction finds that angiotensin converting enzyme inhibitors or angiotensin receptor blockers reduced all-cause mortality.

Grapefruit–drug interactions A review article details the evidence for a pharmacokinetic interaction between grapefruit and certain drugs, and the potential clinical consequences of this.

Case studies from the Quality Improvement Productivity and Prevention (QIPP) Collection

The QIPP Collection highlights examples of local best practice, demonstrating how NHS organisations have implemented new practices that have both cut costs and improved quality. We highlight 2 new examples:

Evidence Updates
NICE has recently published Evidence Updates on:

  • Diabetic foot problems
  • Hip fracture
  • Caesarean section
  • Anaphylaxis

 

Eyes on Evidence for March

This month’s topics in NHS Eyes on Evidence:

Analysis of data from a large randomised controlled trial suggests that intensive glucose control in critically ill patients is associated with moderate to severe hypoglycaemia, and a higher risk of death.

A large scale trial examines the benefits and effectiveness of telehealth and telecare services in helping patients avoid the need for emergency hospital care.
 
A cross-sectional study investigating a possible link between harsh physical punishment and mental health disorders reports that reducing physical punishment may help to reduce the prevalence of mental health disorders in the general population. It suggests giving parents information about alternative discipline strategies, such as positive reinforcement.
The QIPP Collection highlights examples of local best practice, demonstrating how NHS organisations have implemented new practices that have both cut costs and improved quality. We highlight a new example:
Chair of the British HIV Association Guidelines Subcommittee, Martin Fisher, talks about the organisation’s experience of the NICE accreditation process.
Accreditation news  
At its January meeting the NICE Accreditation Advisory Committee accredited 2 guidance programmes.

Evidence Updates 
NICE recently published Evidence Updates on:

  • Strategies to prevent unintentional injuries among children and young people aged under 15
  • Hyperglycaemia in acute coronary syndromes
  • Common mental health disorders
  • Hypertension.