Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes NICE guideline [NG5]

NICE | January 2019 | Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes NICE guideline [NG5]

NICE is holding a consultation on Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes 

The consultation closes on 5 February 2019.

Full details from NICE 

 

Emergency caesareans put new mothers at higher risk of developing postnatal depression, according to new research

University of York | January 2019 | Emergency caesareans put new mothers at higher risk of developing postnatal depression, according to new research

Researchers at the University of York have found that women who have an unplanned caesarean are at a higher risk of experiencing postnatal depression. The study found new evidence that emergency C-sections put new mothers at greater risk of experiencing mental health problems after giving birth.

Out of the 165,000 births in England each year, there are currently around 25,000 unplanned caesarean deliveries.

Author of the study, Dr Valentina Tonei from the Department of Economics at the University of York, said: “The findings of this study are striking because they provide evidence of a causal relationship between emergency C-sections and postnatal depression.

“This has important implications for public health policy, with new mothers who give birth this way in need of increased support.

Although earlier studies have frequently looked at small samples at individual hospitals; this research used a representative sample (n=5000) first-time mothers from the UK Millennium Cohort Study.

This research isolated the effects of emergency C-section on mothers’ psychological well-being in the nine months following delivery by taking other factors, such as differences in the resource and staffing levels in hospitals and the mental health history of the mothers, into account.

In selecting only first-time mothers, the research team eliminated the effects of previous birthing experiences (Source: University of York).

Read the press release in full University of York Emergency caesareans put new mothers at higher risk of developing postnatal depression, according to new research

See also: Science Daily Emergency caesareans put new mothers at higher risk of developing postnatal depression

This study has now been published in the Journal of Health Economics 

Highlights

We study the effect of unplanned caesarean deliveries on mothers’ mental health.

We address endogeneity by using hospital fixed-effects and instrumental variables.

We find that unplanned caesarean section increases the risk of postnatal depression.

Results show the importance of psychological support for mothers after the delivery.

Abstract

The dramatic increase in the utilization of caesarean section has raised concerns on its impact on public expenditure and health. While the financial costs associated with this surgical procedure are well recognized, less is known on the intangible health costs borne by mothers and their families. We contribute to the debate by investigating the effect of unplanned caesarean deliveries on mothers’ mental health in the first nine months after the delivery. Differently from previous studies, we account for the unobserved heterogeneity due to the fact that mothers who give birth through an unplanned caesarean delivery may be different than mothers who give birth with a natural delivery. Identification is achieved exploiting exogenous variation in the position of the baby in the womb at the time of delivery while controlling for hospital unobserved factors. We find that mothers having an unplanned caesarean section are at higher risk of developing postnatal depression and this result is robust to alternative specifications.

Full reference: Tonei, V. |2019|Mother’s mental health after childbirth: Does the delivery method matter? Journal of health economics|63| P. 182-196.

This article is available to Rotherham NHS staff  and can be requested here 

NICE Guidance: Platelet-rich plasma injections for knee osteoarthritis Interventional procedures guidance [IPG637]

 NICE |  January 2019 | Platelet-rich plasma injections for knee osteoarthritis Interventional procedures guidance [IPG637]

 

Evidence-based recommendations on platelet-rich plasma injections for knee osteoarthritis in adults. This involves taking plasma from a small amount of the person’s own blood and injecting it into the knee.

See NICE for details

Suicide prevention: fourth annual report

Department of Health and Social Care | January 2019 | Suicide prevention: fourth annual report

The fourth progress report of the suicide prevention strategy for England details what has been done to reduce deaths by suicide since the third progress report, published in January 2017. 

Alongside this, the government has published the first suicide prevention: cross-government workplan, which sets out the actions being taken up to 2020 to carry out the suicide prevention strategy for England (Source: Department of Health and Social Care ).

 

Community health services explained

The King’s Fund | January 2019 | Community health services explained

Every year community services have around 100 million patient contacts, accounting for £10 billion of the NHS budget and 20 per cent of the total NHS workforce.  Community services are a diverse sector;  as they cover a range of services  from those targeted at people living with complex health and care needs – such as district nursing and palliative care – to health promotion services – such as school nursing and health visiting. Community services play a key role in keeping people well, treating and managing acute illness and long-term conditions, and supporting people to live independently in their own homes. 

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Despite their vital contribution, community services are poorly understood compared to other parts of the NHS. In this explainer, The King’s Fund set out what these services are, the challenges they are facing and how they are changing (Source: The King’s Fund).

Every 3 seconds a person in the UK could be having a life-threatening asthma attack, finds Asthma UK

Asthma UK | January 2019 | Every three seconds someone in the UK could be having a life-threatening asthma attack- new figures

Asthma UK has launched new guidance for people with asthma in the UK, figures released by the charity suggest that the incidence of asthma attacks in the UK could be 10 million, a figure much higher than previously indicated by research.

The charity suggests that this number could be reduced if people with the respiratory condition were able to recognise the warning signs of an attack.

Asthma UK advises that if people need to use their reliever inhaler three or more times a week, are waking up at night because of their asthma and have symptoms such as wheezing or a cough that is worsening or interfering with their work or day-to-day activities, they should contact their GP for advice.

asthma

The clinical lead at Asthma UK, Dr Andy Whittamore says:

“It is shocking to think that every three seconds in the UK someone could be having an asthma attack, a terrifying experience than can cause distress and in some cases prove fatal. Asthma attacks do not come out of the blue and if people recognise the tell-tale signs that an attack is about to strike they can get the help that could save their life.

“We’re urging everyone with asthma to visit our health advice pages so they can understand what to do if an asthma attack is impending or strikes and get medical advice (Source: Asthma UK).

Find out more at www.asthma.org.uk/asthmaattacks

Asthma UK Every three seconds someone in the UK could be having a life-threatening asthma attack

In the news:

OnMedica Total number of UK asthma attacks could top 10 million, says charity

National Clinical Audit of Seizures and Epilepsies for Children and Young People (2018)

Health Quality Improvement Programme & Royal College of Paediatrics & Child Health | January 2019 | National Clinical Audit of Seizures and Epilepsies for Children and Young People (2018)

Health Quality Improvement Programme have published The National Clinical Audit of Seizures and Epilepsies in Children and Young People, also known as Epilepsy12, shows incremental improvements in some areas of paediatric epilepsy service provision alongside a considerable need for improvement in others. 

hqip
Image source: hqip.org.uk

The report shows incremental improvement in  some areas of paediatric epilepsy
service provision, including:
• overall numbers of epilepsy nurse specialists
• overall numbers of paediatricians with expertise and
• the number of specific clinics for children and young people with epilepsies

It also includes a number of recommendations, such as:

  • sufficient provision of defined general paediatricians with expertise in epilepsies to correctly
  • diagnose epilepsy and provide appropriate ongoing management for all children with epilepsy
  • sufficient provision of epilepsy specialist nurses to ensure ongoing input to all children with epilepsies
  • ensuring rescue medication training
  • ensuring epilepsy clinic capacity
  • fulfilling Best Practice Criteria
  • defining paediatric neurology referral pathways
  • facilitating local access to vagus nerve stimulation
  • co-locating mental health provision
  • improving ‘service contactability’  (Source: HQIP)

National Clinical Audit of Seizures and Epilepsies for Children and Young People (2018)