The National Institute of Health and Clinical Excellence has published new guidance for the month of October.
There are two guidance documents that have an impact in primary care. A technology appraisal recommends (QRG) that prasugrel (Efient®) is an option in combination with aspirin for patients who are treated by percutaneous coronary intervention following an acute coronary syndrome. This applies only when they have had a ST-segment-elevation myocardial infarction (STEMI), have had a blocked stent while on treatment with clopidogrel or have diabetes. The Summary of Product Characteristics recommends treatment continues for up to 12 months unless discontinuation is clinically indicated at an earlier time, perhaps due to side effects.
There is also a clinical guideline that covers the treatment and management of depression in adults (QRG). This is an update of an existing guideline and is published along with a summary guideline that contains information relevant to general hospital settings. A stepped approach is recommended with higher intensity therapies recommended for more severe cases.
Action: Clinicians who are involved in the treatment of adults with depression or who provide continuing care for patients after an acute coronary syndrome should consider these guidelines to be required reading.