Evidence based practice updates - 11 October 2012

New guidelines, research and other tools and updates on evidence based techniques and processes from across the UK. For more information about this theme see Quality and Safety e-Bulletin: evidence based practice.

Some of the resources linked to are in PDF format - see how to access PDF files.

BMC Health Services Research: A qualitative study into the use of formal services for dementia by carers from culturally and linguistically diverse (CALD) communities. “People with dementia and their family carers need to be able to access formal services in the community to help maintain their wellbeing and independence. While knowing about and navigating one's way through service systems is difficult for most people, it is particularly difficult for people from culturally and linguistically diverse (CALD) communities. This study addresses a lack of literature on the use of formal services for dementia by people from CALD backgrounds by examining the experiences and perceptions of dementia caregiving within four CALD communities - Italian, Chinese, Spanish and Arabic-speaking - in south western Sydney, Australia.”

DH: NICE to help drive standards in social care. From April 2013, the role of the National Institute for Health and Clinical Excellence (NICE) will expand to include social care. The Department of Health has agreed an initial list of joint NHS/social care quality standard topics for NICE to start working on.
NICE: First set of health and social care quality standards referred to NICE. 

Guardian: GlaxoSmithKline opens door on data in bid to aid discovery of medicines. British drugs company releases findings of clinical trials and announces new effort to find tropical disease cures.

NHS Choices: Widely used sleeping pill ‘increases dementia’ risk. Sleeping pills taken by millions are linked to dementia, according to The Daily Telegraph. This stems from the results of a French cohort study published in the British Medical Journal that followed just over a thousand elderly adults for 15 years. The participants were initially free from dementia but those who started taking benzodiazepines after the first three years of the study were 60% more likely to develop dementia than those who did not use the drugs.

NHS Evidence Update: Generalised anxiety disorder in adults: Evidence Update September 2012 (PDF 376KB). A summary of selected new evidence relevant to NICE clinical guideline 113 ‘Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults: management in primary, secondary and community care’ (2011).

NHS Evidence Update: Management of stable angina (PDF 369KB). A summary of selected new evidence relevant to NICE clinical guideline 126 ‘Management of stable angina’ (2011).

NICE: NICE should consider multimorbidity in guidelines. NICE guidelines should take into account multimorbidity to help doctors provide better care for people with more than one chronic illness, say researchers writing in the BMJ. "The research team - made up of members from the Universities of Dundee, Glasgow and Manchester and NICE - believe that existing guidelines which concentrate on individual diseases are not best serving clinicians or patients where a number of chronic conditions have to be treated".
BMJ: Adapting clinical guidelines to take account of multimorbidity.

NICE: NICE Pathways – the fast and easy way to access NICE guidance and products. Feature on NICE Pathways and how they can help. 

NICE clinical guideline: Crohn’s Disease (CG152). NICE has published guidance on the role of new and established treatments for the management of Crohn's disease in adults and children. It is aimed at all healthcare professionals involved in the management of Crohn's disease. Recommendations include: offer monotherapy with a conventional glucocorticosteroid (prednisolone, methylprednisolone or intravenous hydrocortisone) to induce remission in people with a first presentation or a single inflammatory exacerbation of Crohn's disease in a 12 month period; discuss with people with Crohn's disease, and/or their carer if appropriate, options for managing their disease when they are in remission, including both no treatment and treatment; offer azathioprine or mercaptopurine as monotherapy to maintain remission when previously used with a conventional glucocorticosteroid or budesonide to induce remission; and consider surgery as an alternative to medical treatment early in the course of the disease for people whose disease is limited to the distal ileum (small intestine).

NICE Medicines and Prescribing: Evidence summaries – new medicines. These are quality-assured summaries of the best available evidence for selected new medicines, or existing medicines with new indications or a new formulation, that are considered to be of significance to the NHS. The topics selected are medicines that have recently gone into the UK market, or medicines that may be marketed in the UK in the next 6-12 months. Summaries that are coming soon are highlighted.

National Institute for Health Research (NIHR) Health Technology Assessment Programme: Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation: a systematic review and economic evaluation. This systematic review finds that dietary change to ensure weight loss, coupled with physical activity, is clinically effective and cost-effective in reducing progression to diabetes in people with impaired glucose tolerance.

RCN: Starting injectable treatment in adults with Type 2 diabetes: RCN guidance (PDF 723.1 KB). More than 90 per cent of people with diabetes have Type 2 diabetes and the introduction of GLP 1 therapies in recent years has further increased the challenge of identifying the appropriate injectable therapy for patients, and how to explain that decision to the individual with diabetes. This new edition provides information relating to GLP 1 therapy action, including the implications for use and the aspects of education that need to be addressed with users. This guidance is intended for nurses new to insulin therapy, and includes an overview of the underlying principles for starting insulin along with practical tips on education, adjustment of doses, and dealing with difficult situations.

RCN: Nominations open for RCN elections. RCN members are being encouraged to put themselves forward to become board members, or join the Students, Health Practitioners (for health care assistants and assistant practitioners) or UK Representatives committees. These are all key roles and are excellent opportunities for personal development, offering successful candidates a chance to shape the direction of the RCN.

Systematic Reviews: Overview of systematic reviews of the effectiveness of reminders in improving healthcare professional behaviour. The purpose of this study, published in Systematic Reviews, was to conduct an overview of existing systematic reviews to evaluate the effectiveness of reminders in changing professional behaviour in clinical settings. The results support that modest improvements can occur with the use of reminders.