The National Institute for Health and Care Excellence (NICE) have published new or updated guidance for the month of July 2023. This month there is one technology appraisal and one clinical guideline that impact upon primary care.
The Semaglutide for managing overweight and obesity in young people aged 12 to 17 years technology appraisal has been terminated. At this time, NICE is unable to make a recommendation about the use in the NHS of semaglutide for managing overweight and obesity in young people aged 12 to 17 years. The manufacturer has confirmed that it does not intend to make an evidence submission for the appraisal. In the absence of any recommendation this drug should not be used for this indication in the specified age group.
The Obesity: identification, assessment and management guideline has been updated. It covers identifying, assessing and managing obesity in children (aged 2 years and over), young people and adults. The update has reviewed the evidence on bariatric surgery and updated the recommendations made for when to refer adults for assessment for bariatric surgery.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
The Medicines and Healthcare products Regulatory Agency (MHRA) has published Drug Safety Update for July 2023 (PDF).
This issue warns clinicians of the risk of anticholinergic side effects, including hyperthermia, noted during use of hyoscine hydrobromide patches. There have been a small number of reports of serious and life-threatening anticholinergic side effects associated with use of these patches, especially when used outside of the licensed indication (prevention of travel sickness symptoms). It is recommended that patients, parents and carers are counselled to monitor for side effects including a high temperature, inability to urinate, confusion, disorientation, seeing or hearing things that are not there, fits or convulsions, reduced consciousness and breathing difficulties. Should any of these symptoms occur they should seek medical help and remove the patch immediately.
This issue also raises awareness of a public consultation on the proposal to reclassify codeine linctus to a prescription-only medicine. Responses are invited through the consultation process. Codeine linctus is currently available for purchase via pharmacies to treat dry or non-productive coughs but recent drug safety reports indicate it is being used recreationally for its opioid effects.
Lastly in this issue is a summary of letters to healthcare professionals in June. These generally related to supply issues and recalls.
Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.
During June 2023 Clinical Knowledge Summaries were published or updated in the following areas.
The topics have all been reviewed and updated with minor structural and layout changes. The Autism in children topic has had a section on the management of behaviour that challenges replaced with a link made to the CKS topic on Learning disabilities. The Feverish children - risk assessment and management topic has been merged with the Feverish children - management topic. The Smoking cessation topic has been updated with a lower threshold for referral after women have completed a carbon monoxide breath test.
Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.
