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Care commissioning process is too laborious, report concludes
Source: BMJ, Nuffield Trust Area: News BMJ News features a story on a report by the Nuffield Trust which highlights the findings of an in-depth study of commissioning for people with long-term conditions. The study was funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme. The Nuffield Trust carried out a 15 month (November 2010 to January 2012) study of commissioning practice in three high-performing primary care trust (PCT) areas (Calderdale, Somerset and the Wirral). The authors carried out detailed observation around what the trusts actually did around co...
Source: NeLM - News - March 1, 2013 Category: Drugs & Pharmacology Source Type: news

Online training and brochure for stroke care teams launched
Source: Wessex HIEC Partnership Area: News Wessex HIEC in collaboration with the University of Central Lancashire has launched an online training package for professionals involved in stroke care. The clinical leads forum has also developed a brochure for patients and their families to understand more about the condition and information specific to their own care.   Please see link for details.
Source: NeLM - News - February 19, 2013 Category: Drugs & Pharmacology Source Type: news

Cohort study: Long term calcium intake and rates of all cause and cardiovascular mortality
Source: BMJ Area: News Supplementation with calcium has become increasingly common but recent analyses of trials have suggested a higher risk of both ischemic heart disease and stroke with calcium supplements in women. To investigate the association between long term dietary and supplemental intake of calcium with all cause mortality as well as with cardiovascular mortality, researchers conducted a prospective longitudinal cohort study in Swedish women.   The Swedish mammography cohort, established in 1987-90, provided the data for the purposes of this study. Women were born between 1914 and 1948 and followed-up ...
Source: NeLM - News - February 13, 2013 Category: Drugs & Pharmacology Source Type: news

RCT: Clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention (WOEST)
Source: Lancet Area: News If percutaneous coronary intervention (PCI) is required in patients taking oral anticoagulants, double antiplatelet therapy with aspirin and clopidogrel is indicated. However, such triple therapy increases the risk of serious bleeding and this treatment strategy has not been tested prospectively.   Omission of oral anticoagulants could lead to an increased risk of thrombotic stroke, whereas clopidogrel is essential to prevent stent thrombosis. The exclusion of aspirin might, therefore, be useful to reduce the bleeding risk in patients with coronary artery disease.   The open-lab...
Source: NeLM - News - February 13, 2013 Category: Drugs & Pharmacology Source Type: news

RCT: Endovascular treatment for acute ischaemic stroke
Source: NEJM Area: News A study, published in New England Journal of Medicine, compares the clinical efficacy of endovascular treatment with systemic intravenous thrombolytic therapy in patients with ischaemic stroke.   The study randomly assigned 362 patients with acute ischemic stroke, within 4.5 hours after onset, to endovascular therapy (intra-arterial thrombolysis with recombinant tissue plasminogen activator [t-PA], mechanical clot disruption or retrieval, or a combination of these approaches) (181 patients) or intravenous t-PA (181 patients). Treatments were to be given as soon as possible after randomisat...
Source: NeLM - News - February 8, 2013 Category: Drugs & Pharmacology Source Type: news

RCT: Endovascular therapy after intravenous t-PA versus t-PA alone for stroke
Source: NEJM Area: News A study, published early online in the New England Journal of Medicine, assessed the effectiveness of using endovascular therapy after the administration of intravenous tissue plasminogen activator (t-PA) by comparing this approach with the use of intravenous t-PA alone.   Patients who had received intravenous t-PA within 3 hours were randomly assigned in a 2:1 ratio to receive additional endovascular therapy or no additional therapy. The primary outcome measure was a modified Rankin scale score of 2 or less (indicating functional independence) at 90 days (scores range from 0 to 6, with hi...
Source: NeLM - News - February 8, 2013 Category: Drugs & Pharmacology Source Type: news

FDA approves alogliptin for type 2 diabetes as three separate preparations
Source: FDA Area: News The FDA has approved alogliptin for the treatment of type 2 diabetes as three separate preparations: alogliptin monotherapy; alogliptin in combination with metformin; and alogliptin in combination with pioglitazone.   Alogliptin stimulates insulin release following meals and was shown to be safe and effective as monotherapy in 14 clinical trials involving approximately 8,500 patients with type 2 diabetes.  Alogliptin monotherapy reduced glycosylated haemoglobin (HBA1c) by 0.4 to 0.6% compared to placebo following 26 weeks of treatment.   The FDA has requested additional data ...
Source: NeLM - News - January 28, 2013 Category: Drugs & Pharmacology Source Type: news

RCTs: Peginesatide in patients with anaemia and chronic kidney disease
Source: N Engl J Med Area: News In the New England Journal of Medicine, researchers report the results of four event-driven, randomised, controlled, open-label trials that compared the efficacy and safety of standard erythropoiesis-stimulating agent (ESA) therapy with peginesatide (Omontys), a peptide based ESA approved in the US in March 2012 for the treatment of anaemia caused by chronic kidney disease in adults who are undergoing dialysis.   The EMERALD 1 and EMERALD 2 studies involved patients undergoing haemodialysis. Cardiovascular safety was evaluated by analysis of an adjudicated composite safety end poin...
Source: NeLM - News - January 24, 2013 Category: Drugs & Pharmacology Source Type: news

Systematic review and meta-analysis of statin therapy and outcome after ischaemic stroke
Source: Stroke Area: News Data are conflicting regarding the relationship between acute statin therapy and outcome after ischaemic stroke. Some authors have reported improved survival and functional outcome associated with statin treatment, but these findings have not been consistently replicated. Some authors have also reported worse outcomes in patients treated with the combination of acute statins and IV thrombolysis, though these results have not been consistently reproduced. Large randomised trials of acute statin therapy after stroke may resolve these issues, but are expensive and require several years to conduct. M...
Source: NeLM - News - January 10, 2013 Category: Drugs & Pharmacology Source Type: news

NICE consults on potential new QOF indicators for 2014/15
Source: NICE Area: News NICE is inviting comment from stakeholders on 14 potential new indicators for consideration for the 2014/15 Quality and Outcomes Framework (QOF), covering the following topics:   . Hypertension . Dementia . Coronary heart disease . Diabetes (including tightly linked measures) . Peripheral arterial disease . Stroke and TIA   The consultation will close at 5pm on 4th February 2013.
Source: NeLM - News - January 7, 2013 Category: Drugs & Pharmacology Source Type: news

NHS Improvement publishes Spotlight on Stroke
Source: NHS Improvement Area: News NHS Improvement has published a new set of stroke publications which include resources for:   . Continuing health care in stroke . Early supported discharge . Patient and public engagement and experience . Psychological care . Rapid response to acute stroke . Six month reviews . Seven day therapy services . Transient Ischaemic Attack
Source: NeLM - News - January 3, 2013 Category: Drugs & Pharmacology Source Type: news