P.D.P UPDATE Osteoporisis




Case finding for COPD could help to reduce the disease burden
Dr Raj Nair highlights the importance of ensuring that people with chronic obstructive pulmonary disease have access to smoking cessation services and pulmonary rehabilitation

Chronic obstructive pulmonary disease (COPD) is well recognised as a multisystem condition. It is currently the fourth leading cause of death from chronic disease worldwide1 and is predicted to be the third leading cause of death, behind ischaemic heart disease and cerebrovascular disease by 2030.2 Chronic obstructive pulmonary disease affects over 3 million people in England alone3 and accounts for 27,500 deaths annually; this equates to three people dying every hour.4,5 This preventable disease has a significant health and economic impact—nearly £500 million is spent annually in the NHS on direct costs as a result of COPD.6
NICE Clinical Guideline (CG) 101 on the Management of chronic obstructive pulmonary disease in adults in primary and secondary care, 7 which was published in 2010, was a partial update of the original guidance published in 2004 (CG12).8 It covers diagnosis, spirometry, assessment of disease severity, and management.7
This article explores the impact of the NICE guideline for COPD on primary care, its limitations, areas of deficiency, and the potential for future development.

NICE recommendations
It is recommended that a diagnosis of COPD is made on the basis of the presence of characteristic symptoms and signs and demonstration of airflow obstruction using spirometry.7 Assessment of the severity of airway obstruction is based on predicted forced expiratory volume in 1 second (FEV1); this will also help to guide pharmacological inhaler therapy (see Figure 1). The reclassification of disease severity (based on predicted FEV1) is a significant change from the previous version of the guideline, and was made so that the NICE advice was in line with other international guidelines on COPD.9,10 Disease severity should be assessed using the Medical Research Council (MRC) dyspnoea score.11
Both the NICE guideline and the Primary Care Respiratory Society UK have highlighted smoking cessation and pulmonary rehabilitation as key interventions for people with COPD (see Figure 2).7,12 Pulmonary rehabilitation is a personalised multidisciplinary approach that not only assists patients with their mobility, breathing, and confidence, but also helps them gain more of an understanding of their disease as well as independence from their breathlessness. Statistically significant and clinically meaningful improvements in exercise capacity and quality of life have been demonstrated in a meta-analysis of pulmonary rehabilitation.13 Pulmonary rehabilitation should be offered to all individuals with symptomatic COPD (i.e. functionally breathless, MRC dyspnoea score ≥3).7
Since publication of the updated NICE guideline on COPD, newer pharmacological interventions (both inhalers and oral phosphodiesterase-4 [PDE4] inhibitors) have been licensed, with further products in development. The exact impact of these drugs on disease trajectory and FEV1 has yet to be fully determined by NICE within a guideline or technology appraisal.

www.eguidelines.co.uk


Simply 4 Doctors
Helping healthcare professionals stay up to date with the latest medicines and services from AstraZeneca
Register now for simply4doctors to access a wealth of patient resources and medical tools that include instructional videos, symptom checklists, health monitoring, therapy area calculators, and risk indicators. In addition, healthcare professionals will find information about all of AstraZeneca's promoted medicines.
By accessing simply4doctors healthcare professionals can also stay up to date with:
- the latest news and developments in healthcare
- upcoming events and conferences organised by AstraZeneca and the wider medical community
- clinical trial results and upcoming trials at AstraZeneca.

simply4doctors is created exclusively for healthcare and NHS professionals in the UK offering a comprehensive resource in the following therapy areas:
- arthritis
- cardiovascular
- mental health
- oncology
- respiratory.

Click here to visit
www.simply4doctors.co.uk
Other healthcare professionals may wish to visit the parallel sites—simply4nurses and simply4pharmacists.




Restore the Man Your Clinical Update on Men’s Health
Thursday 21st June 2012 Nottingham Belfry Hotel

Click to Open
PDF File





DRUG & THERAPEUTICS UPDATE
02 Dec 2011
Don’t miss out on important information!
Keep up to date with the latest announcements from official health organisations, such as NICE the EMA or the MHRA.

Have a look at some of this week’s updates and Register for a full review

Dear Viewers,
National Institute for Health and Clinical Excellence
NICE has issued final guidance on ranibizumab (Lucentis, Novartis) for the treatment of diabetic macular oedema. It has concluded that the drug does not represent an effective use of NHS resources and has therefore not recommended its use for this condition.
To read more on this article click here >>

NICE has published final draft guidance recommending the use of apixaban (Eliquis, Bristol-Myers Squibb and Pfizer) as an option for the prevention of venous thromboembolism in adults who have undergone planned total hip replacement or total knee replacement surgery.
To read more on this article click here >>

Medicines and Healthcare products Regulatory Agency
The MHRA has warned that the blood glucose analyser Glucose 201+, manufactured by HemoCue AB, may miss hyperglycaemia if used with outdated software (version 106 or lower). This is of particular concern in neonates.
To read more on this article click here >>

The MHRA has launched a learning module on selective serotonin reuptake inhibitors (SSRI) antidepressants for doctors, pharmacists and nurses involved in the care of patients with depression. This self-directed learning package outlines the key risks of this important class of medicines.
To read more on this article click here >>

Department of Health
November GP and Practice Team Bulletin published
To read more on this article click here >>



Dear Prodigy User

The following PRODIGY topics have been updated to include new evidence and recommendations published by National Institute for Health and Clinical Excellence (NICE), the Driver and Vehicle Licensing Agency (DVLA), and the Medicines and Healthcare products Regulatory Agency (MHRA).
- Alcohol -
problem drinking has been revised to reflect recommendations in the clinical guideline Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence from NICE (2011).
The prescriptions in Asthma and Chronic obstructive pulmonary disease have been amended to reflect the removal of the black triangle from Serevent Evohaler® (salmeterol cfc-free inhaler).
Bowel screening has been updated to include information on NHS bowel cancer screening programmes in Northern Ireland, Scotland, and Wales.
Breast screening has been updated to include the extension to the age range for women eligible for routine breast screening through the NHS Breast Screening programme in England. The Easy Read patient information leaflet on breast screening has also been updated to reflect these changes.
- Diabetes -
type 1 and Insulin therapy in type 1 diabetes have been updated to include the information on fitness to drive from the DVLA's guidance for medical practitioners, At a glance guide to the current medical standards of fitness to drive (2011).
- Influenza –
seasonal has been revised with the updated doses of oseltamivir in renal impairment in line with the British National Formulary (BNF).

The main changes in Insulin therapy in type 2 diabetes include:
The addition of information on fitness to drive from the DVLA's guidance for medical practitioners, At a glance guide to the current medical standards of fitness to drive (2011).
The removal of Optiset®, Opticlick® and Optipen® devices from the topic as Sanofi are to phase these out by December 2011.
Lipid Modificationhas been updated to include the MHRA warning on the interaction between systemic fusidic acid and statins.
Opioid dependence has been updated to incorporate the relevant recommendations from the NICE guideline Needle and syringe programmes: providing people who inject drugs with injecting equipment (2009) into the topic.
A literature search was conducted in October 2011 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the following topics:
- Pubic Lice - the literature search identified the United Kingdom National Guideline in the Management of Phthirus pubis infestation (2007) produced by the British Association of Sexual Health and HIV. Recommendations within this guideline are consistent with the current PRODIGY topic therefore no changes to recommendations have been made.
- Roundworm - no changes to clinical recommendations have been made.
- Scabies - the literature search identified the United Kingdom National Guideline on the Management of Scabies infestation (2007) produced by the British Association of Sexual Health and HIV. Recommendations within this guideline are consistent with the current PRODIGY topic therefore no changes to recommendations have been made.

- Threadworm - no changes to clinical recommendations have been made.
Kind Regards
The PRODIGY Team




Round-Up of Clinical Guidance issued during October 2011
Click to Open




Update on Polycystic Ovary Syndrome
www.pcos.i8.com
Click to Open
Power Point Slides




P.D.P UPDATE Osteoporisis
Click to Open
Power Point Slides


Click to Download








     
 
 
 

advertisement

  

 
 
HOME | Meetings & conferences | News review | General Practice Guideline | Investment & Pention | Commissioning /Consortium | Travel Guide | Useful Links | Our Aim | Our Team | P.D.P Update | About Us | Contact Us
 
 
Designed and Developed by VisionMatic.co.uk