Evidence
Alert

Early warning scores used in hospitals must be based on sound science

Early warning scores have been used in UK hospitals since the late 1990s to minimise harm to patients. They are designed to highlight deterioration of a patient’s health using measurements of temperature, heart rate, blood pressure and other easily-measured signs.  Research has shown that changes in these signs could mean patients are at increased risk ...

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High rates of delirium, persistent fatigue and post-traumatic stress disorder were common after severe infection in previous coronavirus outbreaks

Little is known about the mental health consequences of severe COVID-19 illness because it is caused by a new coronavirus. Previous outbreaks caused by other coronaviruses (severe acute respiratory syndrome, SARS, and Middle East respiratory syndrome, MERS) may provide insights into ongoing problems after recovery from severe illness.  Researchers looked at reports of psychiatric problems ...

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Fluoxetine does not improve outcomes after stroke

Many people experience disability after a stroke, such as weakness in the arm or leg, or problems with language and communication. The antidepressant drug fluoxetine has been used to reduce disability following a stroke but it is unclear how effective it is. The first of three large-scale trials into the impact of fluoxetine in stroke ...

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Cycling to work lowers risk of illness and death compared to driving

People who cycle to work are at lower risk of cardiovascular disease, cancer and death than those who drive. This is seen across all occupational groups and suggests that cycling to work could benefit people from all economic backgrounds. The UK government has advised against using public transport during the coronavirus pandemic. This could result ...

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New tool for assessing the severity of type 2 diabetes could help personalise treatment and improve outcomes

A new severity scoring system for type 2 diabetes may be better at identifying patients at risk of declining health than the current commonly used blood test. The Diabetes Severity Score (DISSCO) is a computer algorithm that combines information routinely collected in primary care. Researchers found that a higher DISSCO score was linked to an ...

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Lung health checks in supermarket car parks reach older smokers in deprived communities

Tests carried out on mobile units parked in supermarket car parks were a popular and effective way to check the lungs of at-risk current and former smokers in a study in Manchester.     Simple tests of lung function in these mobile units found more than a third of those screened had evidence of airflow obstruction. This ...

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Bespoke shoes and insoles could prevent foot ulcers in people with diabetes

Shoes and insoles which are custom-made to relieve pressure on the foot could prevent ulcers in people with diabetes. Foot ulcers are a serious complication of the disease and can lead to amputation if they are not managed appropriately. Even a mild injury can cause a foot ulcer. Researchers wanted to identify design features of ...

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Damage to kidneys and eyes may start before people are diagnosed with diabetes

One in two people diagnosed with type 2 diabetes already have damage to their eyes, kidneys or heart. That damage is more likely if they had problems with blood sugar control before being diagnosed. Diabetes causes damage to blood vessels, because of poorly-controlled levels of sugar in the blood. These damaged blood vessels can lead ...

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Most people caring for relatives with dementia experience loneliness

Around two-thirds of family carers of people with dementia experience loneliness. Almost half are moderately lonely and a fifth are severely lonely, reports one of the first large scale studies to look at this issue. Carers who felt lonely tended to have lower wellbeing, smaller social networks, and more stress associated with caregiving. A poor-quality ...

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Loneliness in people with dementia is linked to social isolation and depression

One-third of people with mild-to-moderate dementia experience loneliness. 30% are moderately lonely and 5% are severely lonely, reports one of the first major studies to look at the issue. These figures are comparable to the general population of older people. People with dementia who live alone, and who experience social isolation, depression and lower quality ...

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Most patients leaving hospital in India are given inadequate medical information

A lack of medical information could make it more difficult for patients to recover after they are discharged from hospital. Patients with long term conditions such as cancer or diabetes, called chronic non-communicable diseases (NCDs), need repeated visits to doctors. Surveys in India included hundreds of patients with NCDs and showed that only half receive ...

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Drug users who lack access to clean water use dangerous alternatives to prepare injections

Strategies to reduce the harm to homeless people who inject drugs rarely focus on their lack of access to clean water. This matters because injecting drugs prepared with unclean water or alternatives to water can lead to serious infections and illness. A study explored how people who inject drugs typically prepare injections, including when they ...

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Asthma patients with a history of opioid use have worse outcomes

A new study of asthma patients with and without a history of drug misuse found that rates of attendance at an annual asthma review were poor across the whole group. Rates of flu vaccination, which is recommended for people with asthma, were also generally low. However, patients with a history of opioid use disorders (OUD) ...

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Most patients undergoing planned surgery do not need compression stockings

Compression stockings might be unnecessary for patients at moderate or high risk of blood clots who are undergoing planned surgery. A study called GAPS suggests that anti-clotting medicine alone is just as effective as using it in combination with compression stockings.  Researchers involved in the large randomised controlled study recommend that guidelines for preventing blood ...

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Some antidepressants can help people quit smoking, but other medications may offer greater benefits

Some anti-smoking medicines are designed specifically to reduce cravings for the nicotine in cigarettes. They include the drug varenicline and nicotine replacement therapy (NRT), such as patches and gum. But medicines designed to treat depression may also help people to stop smoking. One antidepressant, called bupropion, can be prescribed as an anti-smoking medicine in the ...

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Combined drug and psychological therapies may be most effective for depression

The most effective treatment for adults with moderate depression is likely to be a combination of antidepressant drugs and psychological interventions. A new summary provides the strongest evidence to date that the combination of treatments work better than either alone. The most recent advice from National Institute for Health and Care Excellence (NICE) comes in ...

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New research supports the move to raise the blood pressure target for frail older people

Frail older people may not benefit from the same tight blood pressure control that has been shown to benefit relatively younger, healthier groups in existing trials. The medical records of more than 400,000 patients in primary care were reviewed. The researchers found that lower than normal blood pressures were associated with a higher death rate ...

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Ambulance staff who respond to suicides need more support

UK ambulance staff report lasting and troubling memories of being called to suicides. But in a small qualitative study, they said there was little acknowledgment in the workplace that such events are traumatic. This is important since someone exposed to suicide is known to be themselves at greater risk of suicide. Each worker interviewed had ...

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Interactive dashboard identifies patients at risk of unsafe prescribing in a flexible and sustainable way

The Salford Medication Safety Dashboard (SMASH) was successfully used in general practices with the help of on-site pharmacists. SMASH is a web application that flags up a list of patients who are potentially at risk from medicines they have been prescribed.  There was an initial period of increased workload when SMASH was used to review ...

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Public health messages on alcohol need to consider how and why people drink, not just how much

Public health messages about alcohol could be more effective if they reflect how and why patients drink, rather than simply focusing on how much alcohol is being consumed. There may be a need for more relevant public health campaigns to raise awareness of the long-term consequences of heavy drinking.   GPs can help patients reduce their ...

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GPs who make the most urgent referrals for cancer see the fewest cancer deaths among their patients

GP practices across England vary in how frequently they make urgent referrals for suspected cancer. Patients from general practices which make the most urgent referrals are more likely to have their cancer diagnosed at an early stage. A new study found that they are about 4% less likely to die within 5 years. This is ...

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Decision aids quickly and accurately rule out heart attack for almost half of all patients tested

Decision aids provided immediate reassurance to almost half of all patients arriving at emergency departments with a suspected heart attack. Use of the aids, which are based on a single blood test, accurately ruled out heart attacks in patients with relevant symptoms. Aids could provide early reassurance for worried patients and families and avoid many ...

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Therapists and patients have good quality interactions during telephone sessions

The quality of interactions between therapists and their patients is as good by telephone as in face-to-face sessions. A review of the evidence found little difference in the interaction regardless of how therapy was delivered. Telephone sessions were shorter but measures such as empathy and attentiveness, as well as patients’ readiness to disclose information, was ...

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A simple test may predict the risk of hospitalisation for flare-up in patients with COPD, a common lung disease

The sit-to-stand test, which requires only a chair and a stopwatch, could identify patients with a common lung disease who are at high risk of being admitted to hospital. Researchers found that the test, which takes less than five minutes to perform, also predicted the length of their hospital stay. The study looked at patients ...

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Patients are often unsatisfied with the explanation they receive when something goes wrong

Patients have a legal right to know when something goes wrong with their care. But previous research has shown that they do not always get a satisfactory explanation. Researchers in Leeds and Bradford explored the expectations and challenges faced by both patients and healthcare professionals in talking about clinical errors. They found patients and professionals ...

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High-intensity interval training rapidly improves fitness in patients awaiting surgery for urological cancer

High-intensity interval training (HIIT) significantly improved men’s fitness in the short timeframe before cancer surgery. A small study found that HIIT improved the heart and lung (cardiorespiratory) function of men with urological cancers such as of the prostate, bladder or kidney. The authors hope their findings will lead to the development of effective exercise regimes ...

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Apps to help patients take medication on time need to be evaluated in a consistent way

Patients who used apps to remind them to take their medication were more likely to say they took it as prescribed. A review found that patients were twice as likely to say they followed the information given by their prescriber (adhered to their medication) if they used an app. Taking medication as prescribed is important ...

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People with late-stage Parkinson’s need personalised, flexible, home-based care

People with late-stage Parkinson’s disease have complex, unmet needs, but their voices are often not heard, say researchers. One-on-one interviews revealed that people in this group need more flexible, personalised care at home and in the community to help them manage their symptoms and maintain control over their condition. The research also highlights the need ...

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Loneliness, but not social isolation, predicts development of dementia in older people

Older people who feel lonely and have few close relationships may have an increased chance of developing dementia. Perhaps surprisingly, being socially isolated with few or infrequent social contacts does not seem to predict dementia risk, researchers found. This study was carried out before the coronavirus pandemic but the findings are relevant now, when the ...

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Largest ever trial into a rare cancer of the urinary system shows clear benefits of chemotherapy after surgery

A rare cancer of the urinary system can be effectively treated with chemotherapy after surgery. The largest trial ever conducted into the disease found that giving chemotherapy halves the risk of the cancer coming back after surgery. The results provide clear evidence for this approach to become the new standard of care for patients whose ...

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