The National Institute of Health and Clinical Excellence (NICE) has published new guidance for the month of November 2012. This month is one technology appraisal and two public health guidelines that impact upon primary care.
The Chronic heart failure - ivabradine technology appraisal recommends ivabradine as a possible treatment for people with chronic heart failure provided the following conditions are met.
- New York Heart Association (NYHA) class II to IV stable chronic heart failure with systolic dysfunction and
- who are in sinus rhythm with a heart rate of 75 beats per minute or more and
- who are given ivabradine in combination with standard therapy including beta-blocker therapy, angiotensin-converting enzyme (ACE) inhibitors and aldosterone antagonists, or when beta-blocker therapy is contraindicated or not tolerated and
- with a left ventricular ejection fraction of 35% or less
It is also recommended that ivabradine is initiated by a specialist after a 4 week period of stabilisation on a combination of ACE inhibitors, beta-blockers and aldosterone antagonists.
The Walking and cycling public health guideline aims to encourage people to increase the amount they walk or cycle for travel or recreation purposes. It is hoped this would help meet public health goals as well as impacting on other areas such as traffic congestion, air pollution and greenhouse gas emissions.
The Obesity - working with local communities public health guideline aims to support effective, sustainable and community-wide action to prevent obesity. The recommendations cover 14 areas from strategic leadership and integrated commissioning to planning and implementing monitoring and evaluation.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
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