The National Institute of Health and Clinical Excellence (NICE) has published new guidance for the month of May 2012. This month there is one technology appraisal and one clinical guideline that impact upon primary care.
Rivaroxaban has been assessed for the prevention of stroke and systemic embolism in people with atrial fibrillation. The treatment is recommended as an option in patients with non-valvular atrial fibrillation and at least one of the following:
- congestive heart failure
- age 75 years or older
- diabetes mellitus
- previous stroke or transient ischaemic attack
The Opioids in palliative care clinical guideline offers evidence-based advice on safe and effective prescribing of strong opioids for pain relief in adults with advanced and progressive disease. Oral sustained-release morphine is recommended as the first line option in patients who are suitable for oral treatment. Where the oral route is not suitable, patches are recommended where pain relief requirements are stable and subcutaneous delivery is recommended where pain relief requirements are unstable. The guideline also offers advice about the management of constipation, nausea and drowsiness.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.