NHS Evidence - Eyes on Evidence - June 2012

. . . providing easy access to a comprehensive evidence base for everyone in health and social care who takes decisions about treatments or the use of resources. A monthly bulletin is produced, Eyes on Evidence; the issue for June 2012 includes:

Diagnosis and treatment of first-episode psychosis. 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.
Mortality risk of antipsychotic treatment in people with dementia. 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.
Effects of antiplatelet therapy in people with chronic kidney disease. 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.
Relaxation techniques for pain management in labour. 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.
Cochrane quality and productivity topics. Potential disinvestment opportunities highlighted this month are aminosalicylates for induction of remission or response in Crohn's disease; and oral budesonide for induction of remission in ulcerative colitis.
Evidence Updates. This month NHS Evidence has published three Evidence Updates on improving outcomes in head and neck cancers; familial breast cancer; and sedation in children and young people.