The National Institute of Health and Care Excellence (NICE) has published new guidance for the month of March 2015. This month there are four guidelines and two technology appraisals that impact upon primary care.
The Medicines optimisation guideline offers best practice advice on the care of all people who are using medicines and also those who are receiving suboptimal benefit from medicines. The recommendations include topic areas such as medication review, medicines reconciliation and patient decision aids.
The Excess winter deaths and morbidity guideline makes recommendations on how to reduce the risk of death and ill health associated with living in a cold home. Clinicians may find this guideline useful when consulting vulnerable people.
The Maintaining a healthy weight guideline makes recommendations on behaviours that may help people maintain a healthy weight or prevent excess weight gain. The recommendations aim to:
- encourage people to make changes in line with existing advice
- encourage people to develop physical activity and dietary habits that will help them maintain a healthy weight and prevent excess weight gain
- encourage people to monitor their own weight and associated behaviours
- promote the clear communication of benefits of maintaining a healthy weight and making gradual changes to physical activity and diet
- ensure messages are tailored to specific groups
- ensure activities are integrated with the local strategic approach to obesity
The Depression in children and young people guideline has been updated in sections 1.5 and 1.6 where new recommendations on psychological therapies and antidepressants have been added.
The Empagliflozin technology appraisal recommends this treatment for type 2 diabetes, in combination with metformin, only if the person cannot take a sulfonylurea or is at significant risk of hypoglycaemia or its consequences. It can also be used in triple therapy in addition to metformin and a sulphonylurea or a glitazone, and finally use in combination with insulin, with or without other antidiabetic drugs is also allowed.
The Rivaroxaban technology appraisal recommends this treatment as an option within its marketing authorisation, in combination with aspirin plus clopidogrel or aspirin alone, for preventing atherothrombotic events in people who have had an acute coronary syndrome with elevated cardiac biomarkers. The risk of bleeding needs to be assessed before treatment is started and a decision on continuation of treatment should be taken no later than 12 months after starting treatment.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.