Evidence based practice updates - 29 November 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.

Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program: Breathing exercises and/or retraining techniques in the treatment of asthma: comparative effectiveness. This evidence based review finds that complementary breathing retraining methods such as hyperventilation reduction breathing, when compared with other breathing techniques, may reduce asthma symptoms and decrease the use of quick-relief medications.

AHRQ Effective Health Care Program: Physical therapy interventions for knee pain secondary to osteoarthritis. This review found that aerobic and aquatic exercise improved disability measures; aerobic and strengthening exercise reduced pain and improved function. But no single therapy improved all outcomes. 

BBC Health: Concern at outsourced clinical trials in developing world. "Few drug companies have robust measures to ensure outsourced clinical trials in developing countries are safe and ethical, an independent report says."

BBC Health: ADHD treatment 'may reduce risk of criminal behaviour'. A Swedish study has shown that "people with attention-deficit hyperactivity disorder who are involved in crime are less likely to reoffend when on treatment than not."
New England Journal of Medicine (NEJM): Medication for Attention Deficit–Hyperactivity Disorder and Criminality. Summary of article available.

BMC Health Services Research: "More bang for the buck": exploring optimal approaches for guideline implementation through interviews with international developers. “Population based studies show that guidelines are underused. Surveys of international guideline developers found that many do not implement their guidelines. The purpose of this research was to interview guideline developers about implementation approaches and resources.” 

BMC Health Services Research: Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies. This study concludes that "Available evidence showed that case management in community aged care can improve client psychological health or well-being and unmet service needs. Future studies should investigate what specific components of case management are crucial in improving clients and their carers' outcomes."

BMC Nursing: BMC Nursing: Australian nurses in general practice, enabling the provision of cervical screening and well women's health care services: a qualitative study. This study sought to investigate enablers for nurse led care in cervical screening and well womens health care. 

Cochrane Collaboration: PDQ Evidence – Pretty Darn Quick Evidence. PDQ–Evidence offers quick access to the best evidence for decisions about health systems. The website offers direct links between systematic reviews, overviews of reviews, and the studies these reviews examine making it easy to find pertinent information. PDQ–Evidence only includes primary studies that have been referenced in a systematic review.

Economic & Social Research Council (ESRC): ReStore. Research methods web resources. Funded by the Economic and Social Research Council, the ReStore project aims to preserve, sustain and actively maintain selected research methods resources beyond their funding periods.

Guidelines and Audit Implementation Network (GAIN): Guidelines for the oral healthcare of older people living in nursing and residential homes in Northern Ireland (PDF 212.5KB). This guideline addresses the changing context in which more residents in homes now have their own teeth and also reports of poor oral health for residents in care homes. It sets out a best practice model.  

Implementation Science: Strategies for monitoring and updating clinical practice guidelines: a systematic review. This systematic review published in Implementation Science identifies and assesses strategies for monitoring and updating clinical practice guidelines (CPGs). The authors find there is limited evidence concerning optimal CPG updating strategies.

King’s College, Florence Nightingale School of Nursing and Midwifery: Pioneering new diabetes partnership. The Florence Nightingale School of Nursing and Midwifery has announced plans for a new clinical academic centre for diabetes nursing, in partnership with King’s College Hospital NHS Foundation Trust and the Foundation of European Nurses in Diabetes (FEND). The centre will develop and expand vital research into caring for and supporting people with diabetes, within a Europe-wide network. The three year funding programme will begin in 2013.

National Institute for Health Research (NIHR): Focus on Diabetes. This online resource features interviews with NIHR-funded researchers, case-studies on activity taking place in NIHR-supported facilities, a list of studies funded by the NIHR in this area, and information for patients on how to get involved in diabetes clinical research.

NHS Evidence updates. All recent updates are arranged by topic. New updates are:
Lung cancer: Evidence update November 2012. A summary of selected new evidence relevant to NICE clinical guideline 121 ‘The diagnosis and treatment of lung cancer’ (2011) (under cancer heading).
Peritoneal dialysis: Evidence update November 2012.  A summary of selected new evidence relevant to NICE clinical guideline 125 ‘Peritoneal dialysis in the treatment of stage 5 chronic kidney disease’ (2011) (under urogenital heading).

NHS Evidence: Eyes on Evidence November 2012. This month’s issue includes  articles on a study about long-term outcomes after prenatal exposure to chemotherapy; a randomised controlled trial on a multidisciplinary approach to treating tinnitus; a meta-analysis showing that self-monitoring of warfarin reduces the risks of thromboembolic events compared to usual care.

Medicines and Healthcare products Regulatory Agency (MHRA): Better guidance and support for NHS surgeons on vaginal tape and mesh implants. The Department of Health, the NHS Commissioning Board, NHS surgeons (urologists and gynaecologists), and the Medicines and Healthcare products Regulatory Agency (MHRA) are taking action to help reduce the side effects after surgery using vaginal tape for stress incontinence and vaginal meshes for pelvic organ prolapse.

NICE Diagnostics Guidance: Depth of anaesthesia monitors (E-Entropy, BIS and Narcotrend) (DG6). NICE has assessed 3 electroencephalography (EEG)-based depth of anaesthesia monitors - Bispectral Index (BIS), E-Entropy and Narcotrend-Compact M - to help the NHS decide whether to use these products. These monitors are used alongside clinical monitoring to assess a patient's response to anaesthetic drugs during surgery. The aim is to help the anaesthetist tailor the dose of anaesthetic used to the individual patient.

NICE Public health guidance:Obesity - working with local communities (PH42). This guidance aims to support effective, sustainable and community-wide action to prevent obesity. It sets out how local communities, with support from local organisations and networks, can achieve this.
News: Tackle obesity through a 'community-wide' approach.

NICE Quality Standard: Drug use disorders (QS23). This quality standard covers the treatment of adults (18 years or over) who misuse opioids, cannabis, stimulants or other drugs in all settings in which care is received, in particular inpatient and specialist residential and community-based treatment settings. This includes related organisations such as prison services and the interface with other services, for example those provided by the voluntary sector.

NICE: Minimum pricing for alcohol 'will protect young people'. Setting a minimum price per unit of alcohol, as recommended by NICE, will protect young people from the dangers of excessive drinking, according to a new report. The report jointly produced by Alcohol Concern and Balance to coincide with Alcohol Awareness Week, states that cheap alcohol encourages young people to drink to excess, making them susceptible to alcohol-related harm.
Alcohol Concern and Balance North East: Binge - drinking to get drunk: influences on young adult drinking behaviours.

NICE: Patients with psychosis should be offered therapy. Clinical Commissioning Groups should commission services for people with schizophrenia and psychosis in line with NICE guidelines, including the use of cognitive behavioural therapy (CBT) for psychosis, say experts. Currently, just one in ten people who could benefit from the therapy have access to it, despite being approved by NICE.

NICE: Providing help for those who self harm. NICE feature looking at how to provide help to those who self harm.

NICE: Walking and cycling should become the norm for short journeys. More people should be encouraged to keep fit by incorporating walking and cycling into their everyday lives, in an attempt to tackle declining rates of physical activity in England, NICE says. Regular physical activity is key to achieving and maintaining a healthy lifestyle, and can help reduce the risk of heart disease, stroke, and type 2 diabetes, as well as being important for good mental health.

NICE: NICE approves drug for treatment of chronic heart failure. GPs with a specialist interest in heart failure and other healthcare professionals can now use ivabradine (Procoralan) as an option for the treatment of people with chronic heart failure, following latest guidance from NICE.

PLoS: PRISMA-Equity 2012 Extension: Reporting Guidelines for Systematic Reviews with a Focus on Health Equity. Very few systematic reviews report effects of a health intervention on health equity. This study from PLOS One develops consensus-based guidelines for systematic reviews to help reviewers identify evidence on equity. Use of guidelines will improve the reporting of effects on inequities in both health outcomes and healthcare use.

Scottish Government: New medicines review. A review is underway to assess the current systems for making new medicines available across NHS Scotland to ensure consistency of approach to their introduction. The Health Secretary has instructed work to be undertaken to look at every aspect of the introduction of new medicines from national advice to local decision-making to establish whether any further improvements can be made.

Scottish Intercollegiate Guidelines Network: Managing bacterial urinary-tract infections. The Scottish Intercollegiate Guidelines Network has published a patient booklet entitled 'Managing bacterial urinary-tract infections in adults'. Based on SIGN guidelines, these patient booklets explain the recommendations in the clinical guideline and help to make patients aware of the tests and treatments they should expect to receive from the NHS. They are a lay translation of the clinical guidelines. They are not intended to be general information leaflets.