Stop smoking intervention
This is a new guideline from NICE on stop smoking interventions. If you do nothing else, I would strongly encourage you to do the National Centre for Smoking Cessation and Training NCSCT e-learning mo...
Louise Hudman is a GP locum and regularly summarises clinical guidelines.
Heavy menstrual bleeding (menorrhagia)
NICE published an update to its guideline on heavy menstrual bleeding (menorrhagia) in March 2018. There are a couple of changes:Hysteroscopy is now the first line investigation for most women who n...
Nice Attention Deficit Hyperactivity Disorder ADHD guideline
This is a guideline from NICE on Attention Deficit Hyperactivity Disorder ADHD. It was written in 2008, then updated in March 2018. The changes are relatively subtle, so I shall outline the changes, t...
Kyleena – a new intrauterine system for contraception
This is a statement from Jan 18 from FSRH giving information about Kyleena, which is a new levonorgestrel (LNG) containing intrauterine system (IUS). What is Kyleena? An IUS. It contains levonorgestre...
Otitis Media – when to use antibiotics
This is a new guideline from NICE on when to use antibiotics for otitis media (March 2018). It doesn't change common practice, but I found some of the statistics really helpful for explaining why we p...
Peristeen transanal irrigation system for managing bowel dysfunction
This is a new guideline from NICE on the use of the Peristeen transanal irrigation system for managing bowel dysfunction. Peristeen is otherwise known as Coloplast; patients use it every other day. It...
Pancreatic cancer in adults (when to offer surveillance)
This is a new guideline from NICE on pancreatic cancer. Most of this is aimed at specialists, but there was a useful bit on when to consider surveillance in people who are at higher risk. Hopefully mo...
Faltering growth in children
This is a recent guideline from NICE, which gives advice on managing faltering growth in children. A lot of this is common sense, but as it is a new guideline, I will summarise the bits relevant to us...
Sore throat – when to use antibiotics
This is a new guideline from NICE which advises on when to use antibiotics in patients with tonsillitis or sore throat. If you already use a scoring system to help you decide when to prescribe it does...
Diagnosing and managing cystic fibrosis
This is a new guideline from NICE on diagnosing and managing cystic fibrosis. Most of this guideline will be much more relevant to secondary care, so I'm just covering the list of possible presentatio...
Multiple Sclerosis – Cladribine tablets (Mavenclad)
This is a new guideline from NICE on a new treatment for MS. Obviously we won't be prescribing this, but I thought it worth mentioning as we may see patients starting to use it. It is an oral medicati...
Sinusitis treatment down to five days
This is a NICE guideline from a couple of months ago in the use of antibiotics in sinusitis. I must say that this has changed my practice significantly, so well worth a read, especially the background...
Latest endometriosis NG73 guidelines from NICE
![By richie graham (originally posted to Flickr as jensute) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons](https://www.nasgp.org.uk/wp-content/uploads/2017/11/Endometriosis.jpg)
This is a new guideline from NICE on managing endometriosis. I'll do a general summary of this as it is a new guideline. However I don't think it changes very much that we do. There is a good algorith...
Eating Disorders
This is a new guideline from NICE on managing eating disorders. It is really targeted around anorexia nervosa and bulimia. Much of this is not new, but as we don't see patients with these disorders to...
Post pregnancy contraception
This is a new guideline from the FSRH on contraception after pregnancy. There is nothing particularly new about specific methods, but there are a few new interesting points (including a reminder that ...
Nice | Who should we be testing for cirrhosis?
This is a new guideline from NICE on cirrhosis. The most important bit for us is knowing who should be tested as we may need to be referring these patients on. Higher risk patientsHepatitis B Hepati...
Nice | Non-alcoholic fatty liver disease NAFLD
This is a new guideline from NICE on non alcoholic fatty liver disease (NAFLD) in children, young people and adults. To be honest, I don't think this guideline is terribly helpful. I've done a brief s...
Evolocumab and Alirocumab for treating dyslipidaemia
There are two new guidelines from NICE on the use of Evolocumab and Alirocumab for treating primary hypercholesterolaemia (both familial and non-familial) and mixed dyslipidaemia. What are these drugs...
FSRH | UKMEC update (risks of various contraceptive use)
The UKMEC criteria from the FSRH have been updated. These criteria tell you what conditions or criteria may make the use of different contraceptives inappropriate. If you are not familiar with it, it ...
Greenlight XPS (laser treatment) for treating benign prostatic hyperplasia
This is a new guideline on using the Greenlight XPS system for treating BPH. This has been widely reported in the media. It is as effective as TURP in low-risk patients and has the big advantage of be...
Nice | Non-alcoholic fatty liver disease NAFLD
This is a new guideline from NICE on non alcoholic fatty liver disease (NAFLD) in children, young people and adults. To be honest, I don't think this guideline is terribly helpful. I've done a brief s...
Nice | Detection and management of sepsis
This is a new guideline from NICE on the detection and management of sepsis. None of this is likely to be new, but it is worth looking through. I think the main reason is, sadly, from a medico-legal p...
FSRH | COC – risks of different oestrogen and progesterone
This is a statement from the FSRH on a study recently published on risks with COC use. This study looks at how the different dose of oestrogen and how the different progesterone affect the risk of PE,...
GP-Update | Normal variants of lower limb conditions in children
How often have you encountered an anxious parent with their child with bow legs or in-toeing and wondered ‘is this normal or not?’. If you don’t feel 100% confident in knowing which child needs simple...
Type 2 diabetes – canagliflozin, dapaglifozin and empaglifozin as monotherapies
This is new guidance from NICE advising that canagliflozin, dapagliflozin and empagliflozin can all be used as monotherapies in treating Type 2 Diabetes. Previously they have only been advised as add-...
New tests for pre-eclampsia (PlGF-based testing)
This is a new guideline from NICE on using two new tests which will help in the diagnosis of pre-eclampsia. Although we are unlikely to be using these tests ourselves, we may start seeing patients who...
Migraine – transcutaneous electrical stimulation of the supraorbital nerve
Another guideline from NICE on a new treatment for migraine (transcutaneous electrical stimulation of the supraorbital nerve). They have advised that this treatment can be used as it raises no safety ...
Nice | Alzheimer’s drugs
This is a guideline update from NICE on the use of donepezil, galantamine, rivastigmine and memantine in Alzheimer's disease. Donepezil, galantamine and rivastigmine (the acetylcholinesterase - AChE ...
Sacubitril valsartan for chronic heart failure
This is a new guideline from NICE on when sacubitril valsartan should be used. Sacubitril valsartan is a combination drug. It includes the angiotensin 2 receptor blocker (ARB), valsartan. It also incl...
Routine pre-operative tests and blood pressure
These are two guidelines, but both on the topic of pre-operative testing, so they fit nicely together. I am just pulling out the points useful for us GPs. Pre-operative tests This is a new guideline f...
Nice | Pumps for diabetes that have integrated blood glucose sensors
This is a new guideline from NICE that advises that two new diabetes pumps can be used. These both have integrated interstitial glucose sensors. This means that the pump can measure glucose levels. Th...
Nice | New treatments for migraines and sinusitis
These are 2 new guidelines from NICE. I thought it was interesting to know that they are out there, but we don't need to know much about them at this stage. Transcutaneous stimulation of the cervical ...
RCOG | Endometrial hyperplasia
This is a new guideline from RCOG on diagnosing and managing endometrial hyperplasia. This is a very common condition, so highly relevant for us and I had no idea on some of the management options. I ...
RCOG | Ovarian Hyperstimulation Syndrome
This is a new guideline from the RCOG on managing ovarian hyperstimulation syndrome (OHS). Most patients will ultimately be managed in secondary care, but we need to be aware of it, as most women appa...
Testicular cancer
Aimee Lettis from GP Update on how the management of testicular cancer has come a long way in the last 50 years.Testicular cancer survival has been one of the real success stories in cancer tre...
Nice | Repetative transcranial magnetic stimulation for depression
This is a new guideline from NICE advising that repetitive transcranial magnetic stimulation (rTMS) can be used in the treatment of depression. rTMS is only normally considered for patients who have n...
Nice | Percutaneous treatment of intervertebral discs for back pain
There are three new guidelines from NICE about using various percutaneous treatments for intervertebral disc problems. Percutaneous coblation of the intervertebral disc for low back pain and sciatica....
Nice | Sacral nerve stimulation for non obstructive urinary retention
This is a new guideline from Nice advising that sacral nerve stimulation can be used to treat non obstructive idiopathic urinary retention. It may be useful for people with neurological disorders for ...
FSRH | Daylette and Eloine – a new pill containing drospirenone
This is a guideline from the FSRH about a new pill, Eloine, which contains 20mcg ethinylestradiol and 3mg drospirenone. There is a cheaper generic equivalent, called Daylette. In the USA it is known a...
Nice | Nalmefene for reducing alcohol consumption
This is a guideline on Nalmefene from NICE; they originally advised that Nalmefene could be used in Nov 14. This lays out how. It is an opioid receptor modulator and can help to reduce alcohol consump...