Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

CKS Updates - May 2019

During May 2019 Clinical Knowledge Summaries were published or updated in the following areas.

The majority of topics have undergone reviews and minor restructures. The Hypercholesterolaemia - familial topic has been updated in line with current NICE guidance. The Ulcerative colitis topic has been significantly restructured with recommendations on the diagnosis and management amended in line with current evidence and the sections on specialist investigations and management have been updated and expanded.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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NICE Guidance - May 2019

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of May 2019. This month there are five guidelines and one diagnostic guideline that impact upon primary care.

The Suspected neurological conditions: recognition and referral guideline has been published. It covers the initial assessment of symptoms and signs that might indicate a neurological condition. It helps non-specialist healthcare professionals to identify people who should be offered referral for specialist investigation.

The Stroke and transient ischaemic attack in over 16s: diagnosis and initial management guideline has been published and it replaces previous guidance from July 2008. It covers interventions in the acute stage of a stroke or transient ischaemic attack (TIA). It offers the best clinical advice on the diagnosis and acute management of stroke and TIA in the 48 hours after onset of symptoms.

The Crohn’s disease: management guideline has been published and it replaces previous guidance from October 2012. It covers the management of Crohn’s disease in children, young people and adults. It aims to reduce people’s symptoms and maintain or improve their quality of life.

The Ulcerative colitis: management guideline has been published and it replaced previous guidance from June 2013. It covers the management of ulcerative colitis in children, young people and adults. It aims to help professionals to provide consistent high-quality care and it highlights the importance of advice and support for people with ulcerative colitis.

The Prostate cancer: diagnosis and management guideline has been published and it replaces previous guidance from January 2014 and June 2015. It covers the diagnosis and management of prostate cancer in secondary care, including information on the best way to diagnose and identify different stages of the disease, and how to manage adverse effects of treatment. It also includes recommendations on follow-up in primary care for people diagnosed with prostate cancer.

The Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care diagnostics guidance has been published. It recommends that there is not enough evidence to recommend the routine adoption of lead-I electrocardiogram (ECG) devices to detect atrial fibrillation in primary care. Further research is recommended and centres already using these devices are encouraged to take part in research and data collection.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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CKS Updates - April 2019

During April 2019 Clinical Knowledge Summaries were published or updated in the following areas.

The majority of topics have undergone reviews and minor restructures. The CVD risk assessment and management topic now recommends using the QRISK3 risk prediction tool. The Chronic kidney disease topic has had an Assessment section added, more information on the management of people with diabetes mellitus and chronic kidney disease is provided and the prescribing information section has been updated.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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NICE Guidance - April 2019

The National Institute of Health and Care Excellence (NICE) have published new or updated guidance for the month of April 2019. This month there are three guidelines that impact upon primary care.

The Urinary incontinence and pelvic organ prolapse in women guideline has been published. It covers assessing and managing urinary incontinence and pelvic organ prolapse in women aged 18 and over. It also covers complications associated with mesh surgery for these conditions. It updates and replaces four previous guidance documents.

The Surgical site infections: prevention and treatment guideline has been published. It covers preventing and treating surgical site infections in adults, young people and children who are having a surgical procedure involving a cut through the skin. It focuses on methods used before, during and after surgery to minimise the risk of infection.

The Ectopic pregnancy and miscarriage: diagnosis and initial management guideline has been published. It covers diagnosing and managing ectopic pregnancy and miscarriage in women with complications, such as pain and bleeding, in early pregnancy (that is, up to 13 completed weeks of pregnancy). It aims to improve how early pregnancy loss is diagnosed, and the support women are given, to limit the psychological impact of their loss.

Action: Clinicians should be aware of this month's new guidance and implement any necessary changes to practice.

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CKS Updates - March 2019

During March 2019 Clinical Knowledge Summaries were published or updated in the following areas.

All of these topics have undergone reviews and minor restructures. No major changes have been made.

Action: Clinicians who see patients with any of these conditions may find the new and updated information useful when reviewing current clinical practice.

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