NICE Eyes on Evidence - Issue 74 July 2015

This month in Eyes on Evidence...

Symptom remission and quality of life in schizophrenia
A retrospective study identified a link between symptom remission and improved quality of life in adults with schizophrenia who were on antipsychotic medication, with paid employment, social activity and drug adherence also positively influencing quality of life.

Enhanced care and support at hospital discharge for older patients
Two randomised controlled trials in Canada and the USA reported that enhanced care and support at discharge in addition to usual care did not reduce visits to the emergency department, hospital readmissions or deaths among older people compared with usual care.

Using information on quality to make decisions about services
A systematic review reported that people with long-term conditions or disabilities and their families sought information on the quality of health and social care services from multiple sources, in particular social networks. These groups tended to use general or subjective information rather than formal quality indicators to make decisions about providers.

Long working hours and alcohol use
A meta-analysis of cross-sectional and prospective data found that people who worked more than 40 hours a week were more likely to show risky alcohol use than people who worked fewer hours, although the increase was small. People who worked 55 hours a week or more were more likely to increase their alcohol use to levels that posed a health risk, but only 2 prospective published studies were available for this analysis.

Risk of neuropsychiatric adverse events with varenicline
A meta-analysis found no increase in the risk of suicide or attempted suicide, suicidal ideation or depression with varenicline compared with placebo. However, prescribers should be aware that the warnings on neuropsychiatric adverse events remain in place within the summary of product characteristics for varenicline.

Evidence summaries from NICE’s Medicines and Prescribing Programme
NICE has recently published Medicines evidence commentaries on:

• Osteoarthritis and low back pain: evidence reviews raise further questions about the efficacy and safety of paracetamol
• Medicines optimisation: discontinuing statin therapy in palliative care
• Chronic obstructive pulmonary disease (COPD): indacaterol/glycopyrronium combination inhaler compared with tiotropium and formoterol in a randomised, non-inferiority study