Implied parental expectation of antibiotic prescription does not appear to affect clinician prescribing for childhood respiratory tract infection in primary care. Parents typically accept clinicians’ treatment recommendations based on symptoms and signs, with a minority seeking further home care advice. This NIHR-funded analysis of 56 videoed primary care consultations is the first such study to ...

In My Signals, health and social care staff and service users tell us what research is important to them and why they feel others need to know about it. In this collection, we asked seven occupational therapists to tell us which Signals have interested them most and explain why they feel the findings are worth ...

In adults after major surgery, high-flow nasal oxygen decreases by about two-thirds the need for reintubation compared with conventional oxygen therapy. In this study, only about four in every 100 patients needed reintubation with high-flow nasal oxygen, compared with about 11 in every 100 patients receiving conventional oxygen therapy. This review evaluated seven randomised and ...

Use of a rapid C-reactive protein (CRP) blood test in general practice for people with a flare-up of COPD reduces the proportion who take antibiotics over the next month by about 20 percentage points compared with usual care alone. The reduction in antibiotic use does not lead to worse health, more visits to the doctor ...

Surgery for adults who have a deviation, or bend, in the wall running through the centre of their nose improves quality of life more than non-surgical alternatives. The benefit was maintained for at least two years. The surgery, a septoplasty, also improves airflow through the nose. The trial compared septoplasty to non-surgical alternatives, such as just ...

Care bundles for COPD are difficult to implement, and their introduction in NHS hospitals does not reduce repeat admissions, deaths or use of resources when used on or after admission. Care bundles are packages of interventions which, in other situations, can improve care. COPD care bundles include: checking inhaler technique and medication use providing a ...

People with chronic obstructive pulmonary disease (COPD) have a slightly reduced risk of having a flare-up of symptoms if they take mucolytic drugs. The number of days on which they are too ill to perform their normal activities is also slightly reduced, from 1.57 days to 1.14 days per month. A review of placebo-controlled trials, ...

Pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) improves psychological symptoms modestly, compared with no intervention. Depression improves by about 2.5 points, and anxiety by 2.2 points on the Hospital Anxiety and Depression Scale (range 0 to 21). This review of 10 trials is the first to show that pulmonary rehabilitation – already known to ...

A 12% reduction in GP antibiotic prescriptions for respiratory conditions was achieved through the use of electronic decision and training tools. This reduction did not increase the risk of serious infections compared to usual care. The low-cost intervention in this large NIHR-funded trial included a short training webinar for GPs and feedback on their practice’s ...

Vitamin D supplements halve the number of exacerbations of chronic obstructive pulmonary disease (COPD) in people with low levels of the vitamin, from two per year to one per year. The supplements do not affect exacerbations of COPD in people who are not deficient. This NIHR-funded review is the first to pool individual-level data from ...