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