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 ...
Louise Hudman is a GP locum and regularly summarises clinical guidelines.
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 patients
Hepatitis 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. A recent SIGN guideline gave very similar advice.
Sacubitril valsartan is a combination drug. It includes the angiotensin...
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...
Nice | Morton’s neuroma – radiofrequency ablation
This is a new guideline from NICE on treating symptomatic Morton's neuroma with radiofrequency ablation (RFA). They also list current advised management, which I have added at the bottom, as I felt a ...
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 | Tuberculosis (TB)
This is an updated guideline from NICE on managing tuberculosis. I guess the relevance will be largely related to where you work. There isn't any really big change here, but there are lots of things t...
Nice | Idelalisib for treating chronic lymphocytic leukaemia
This is a new guideline from NICE on idelalisib use in chronic lymphocytic leukaemia. Idelalisib is likely to be secondary care prescribed, but I felt it was worthwhile knowing about as it is a new ty...
Nice | Tolvaptan for treating autosomal polycystic kidney disease
This is a new guideline from NICE advising that tolvaptan can be used for treating autosomal polycystic kidney disease. It is a selective vasopressin antagonist which can reduce cell proliferation, cy...
Nice | Type 2 diabetes in adults
This is an update of the last Nice guideline on type 2 diabetes in adults, which was published in 2009. I am just summarising things that have changed since the last update. If you don't want to read ...
Nice | Edoxaban for preventing stroke and VTE in non valvular AF
This is a new guideline from NICE which advises that Edoxaban can be used for preventing stroke and VTE in patients with non-valvular AF who have one or more other risk factors such as:
Heart failure...
Nice | End of Life care
This is a new guideline from NICE on end of life care. You may have heard it widely reported in the news, given all the attention over the Liverpool Care Pathway. What was reported as being different ...
Nice | Managing discharge from hospital
This is a new guideline from NICE giving advice about managing discharge from hospital safely. Most of this we already do. There are a couple of points worth noting:
Patients felt to be at risk of re...
Nice | Managing the menopause
This is a new guideline from Nice on managing the menopause, both in women undergoing premature ovarian failure and in women going through it at a more normal age.
There isn't much earth shattering in...
Nice | Older people with social needs and multiple long-term conditions
This is a new guideline from NICE on caring for people with both social needs and long term conditions. It really needs to be read after their other recent publication on home care (or see my post for...
Home care for older people
This is a new guideline from NICE on homecare for older people. Most of this isn't new, or is aimed at other health professionals, but there are a couple of points of note for us.
Care Coordinator.
Ni...
Nice | Attachment in children in care or at risk of going into care
This is a new guideline from NICE on trying to avoid and manage attachment problems in children in all sorts of care scenarios.
Most of this will hopefully be implemented by social workers, but we may...
Nice | Dementia – advice for those in ‘mid-life’
This is a new guideline from NICE advising that the following advice should be given to people in 'mid-life' to reduce the risk of dementia in later life:
stop smoking (strong evidence for an increas...