The British Medical Journal has published the results of a study that aimed to assess whether the provision of single lens distance glasses to older wearers of multifocal glasses reduces falls. The results have been reported in the general media (BBC).
The study was conducted in New South Wales, Australia and recruited 606 participants who were regular wearers of multifocal glasses with a mean age of 80 years old. Inclusion criteria included an increased risk of falling and regular use of multifocal glasses while outdoors. Follow up was planned after 13 months with 90% of the intervention group being provided with their new glasses within 2 months.
Participants were randomly assigned to usual care or an intervention group who were provided with single lens distance glasses and advised to use them when walking and undertaking outdoor activities. Assessors were blinded to group allocation.
Use of single lens distance glasses was associated with an 8% reduction in falls (non-significant) in the study population. In a pre-specified sub-analysis, a significant reduction in all falls was identified in participants who undertook higher levels of outdoor activities. This reduction was also observed for outdoor falls and injurious falls. However, there was an increase in the number of outdoor falls among participants who had lower levels of outdoor activity.
The authors conclude that, "provision of single lens glasses for older wearers of multifocal glasses who take part in regular outdoor activities is an effective falls prevention strategy".
Action: Clinicians should be aware of this study. Patients who wear varifocal glasses and who also undertake regular outdoor activities may benefit from obtaining single vision glasses for use outdoors as an intervention to reduce the risk of falls.
The Scottish Medicines Consortium (SMC) has issued its monthly advice on new medicines.
Telmisartan (Micardis®) has been rejected for use in cardiovascular prevention and in type 2 diabetes with documented target organ damage. The manufacturer failed to make a submission.
Sitagliption / Metformin (Janumet®) has been accepted for restricted use as an adjunct to diet and exercise to improve glycaemic control in patients with type 2 diabetes mellitus. It is restricted to use in patients for whom a combination of sitagliptin and metformin is an appropriate choice of therapy and only when the addition of sulphonylureas to metformin monotherapy is not appropriate.
Extended release nicotinic acid / laropiprant (Tredaptive®) has bee accepted for restricted use in the treatment of dyslipidaemia, particularly in patients with combined mixed dyslipidaemia and in patients with primary hypercholesterolaemia as monotherapy in patients in whom HMG-CoA reductase inhibitors [statins] are considered inappropriate or not tolerated.
Action: Clinicians should be aware of the recommendations of the SMC. Routine use of rejected and restricted medicines should be avoided.
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