NICE News May 2016

New guidance and standards Treating jaundice in newborn babies NICE has updated guidelines on diagnosing and treating neonatal jaundice. Jaundice affects approximately 60% of term and 80% of preterm babies in their first week of life. While early and prolonged jaundice is usually harmless, sometimes it is an indication of serious liver disease. New recommendations cover measuring and monitoring bilirubin levels, and the type of phototherapy to use.

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NICE recommends three treatments for type 2 diabetes Tens of thousands of people with type 2 diabetes will be eligible for new treatments under new guidance from NICE. The drugs will help to control blood sugar in those patients who cannot take more commonly prescribed medicines meaning their condition remains stable for longer. An estimated 31,000 people may be eligible for the three recommended treatments: canagliflozin (Invokana), dapagliflozin (Forxiga) and empagliflozin (Jardiance).

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News Antimicrobial resistance: A call to action Antibiotic resistance could kill ten million people a year by 2050, a stark government report has warned. Lord Jim O’Neill, former chairman of Goldman Sachs has set out his final report on the global challenge of resistance to commonly used drugs. NICE guidance on antimicrobial stewardship highlights the importance for healthcare professionals to only prescribe antibiotics when they are needed. Doctors need to give the right antibiotic, at the right dose to the right patient.

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In the bag - improving the move between hospitals and care homes The introduction of a 'red bag' Hospital Transfer Pathway has helped to improve and speed up the transfer between hospital and care home settings. Sutton Homes of Care Vanguard Programme developed the simple and novel approach to follow NICE guidance on the transition between hospital and care home settings.

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Action is needed to address inequalities in end of life care Failure to recognise individuals’ needs means patients are receiving poor quality end of life care, a highly critical report by the Care Quality Commission has found. NICE guidance on end of life care highlights the need for healthcare professionals to recognise when a person is entering their final days of life. The recommendations aim to support medical and social care staff so that they can provide their patients with care that is tailored to their needs and desires.

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Features Catch up on our dual diagnosis Twitter chat Earlier this month mental health expert Professor Alan Maryon-Davis, took over the NICE Twitter account to discuss our draft recommendation on severe mental illness and substance misuse. Have a look at the conversation.

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Have your say Comment on our children's attachment quality standard Comment on our draft quality standard on children’s attachment. The quality standard will cover the identification, assessment and treatment of attachment difficulties in children and young people up to age 18 who are: adopted from care in special guardianship looked after by local authorities in foster homes (including kinship foster care) in residential units and other accommodation or on the edge of care. Please submit any comments to QSconsultations@nice.org.uk by Tuesday 21 June.

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Get involved  Expert advisers needed to help us develop clinical guidelines We’re looking for topic experts to help us develop our clinical guidelines. In particular, we’re seeking to recruit: medical microbiologist (with responsibilities around infection control) infection control clinician registered paramedic nursing professionals and practice leads with an interest in infection control in primary, community and tertiary care vascular specialist podiatrist. The closing date for applications is 5pm on Friday 17 June 2016.

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Lay members required to help develop dementia guidelines We’re looking for lay members to join the social care subgroup for the dementia guidelines committee. In particular we’re seeking people with an understanding of social care for people with dementia and the issues important to people using services and their unpaid carers. The closing date for applications is 11.59 pm on Sunday 12 June 2016.

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Into practice  Using telehealth to improve care Patients with atrial fibrillation and heart valve disease who self-monitored their coagulation status has led to reduced time attending clinics and cost savings. By giving patients self-monitoring coagulation meters, County Durham and Darlington NHS Foundation Trust used telehealth to address capacity issues across the trust.

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Giving every child the best start to life - Public Health Matters Public Health England has produced guidance to increase the proportion of children ready to learn at 2 and ready for school at 5. The guidance includes a number of recommendations from NICE on topics such as immunisation, domestic violence, and postnatal depression.

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No time for Cochrane Reviews Cochrane Clinical Answers now make it easier to use Cochrane Reviews to inform healthcare decisions. Funded by NICE, and provided by Cochrane Library, this new service for healthcare practitioners, including junior doctors and senior consultants, provides practical evidence designed to inform decision making at the point of care. Based on the high-quality evidence of Cochrance systematic reviews, Cochrane Clinical Answers covers 32 clinical specialties. Each Cochrane Clinical Answer is displayed in a user friendly question and answer format. There are outcome-focused presentations of the impact of interventions on the patient and the ability to ‘drill down’ to the evidence from the Cochrane Review. Go to Cochrane Clinical Answers or search other high quality specialist resources via NICE Evidence Resources.

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Looking for resources for Revalidation?

Click here to view the Library's reading list of Revalidation resources available to borrow from the RSCH Library.

NICE Eyes on Evidence - Issue 84 May 2016

This month's Eyes on Evidence includes:

Surgery versus medical therapy in ulcerative colitis
A retrospective cohort study using US data found that elective colectomy was associated with better survival than long-term medical therapy in people with advanced ulcerative colitis, in particular in people aged 50 years or older.

Self-monitoring for people on vitamin K anatagonist anticoagulant therapy
A meta-analysis found that for people receiving long-term vitamin K antagonist therapy, self-monitoring of anticoagulation status with point-of-care devices was at least as safe as monitoring by healthcare professionals.

Shared decision-making: antibiotic use for acute respiratory infections
A Cochrane review found moderate quality evidence that interventions to facilitate shared decision-making reduced antibiotic prescribing for acute respiratory infections in primary care in the short term.

Previous pregnancies in young women having an abortion
A retrospective cohort study of data from England and Wales found that nearly 1 in 4 women aged less than 20 years who underwent an abortion had already had at least 1 previous birth or abortion. Post-abortion contraceptive counselling should take a ‘woman-centred’ approach that focuses on women’s contraceptive preferences.

Mental health of carers after bereavement
A case–control study in Northern Ireland found that people who had cared for someone with a long-term condition who died subsequently had poor mental health after bereavement, but mental health was similarly poor in carers who had not been bereaved.

Evidence summaries from NICE's Medicines and Prescribing Programme
NICE has recently published summaries on:

• Chronic wounds: advanced wound dressings and antimicrobial dressings
• Moderate to severe acute post-operative pain: sufentanil sublingual tablet system
• Attention deficit hyperactivity disorder in children and young people: guanfacine prolonged-release
• Adverse events associated with off-label medicine use in adults
• Myocardial infarction: risks and benefits of extended dual antiplatelet therapy