NICE | September 2019 | Community pharmacies: promoting health and wellbeing | In development [GID-QS10115]
NICE is consulting on community pharmacies’ roles in promoting health and welbeing, NICE wants to hear about the 5 key areas for quality improvement which you consider as having the greatest potential to improve the quality of care in this area.
Closing date for comments: Wednesday 2 October 2019 at 5pm
Public Health England | September 2019 | Hepatitis C in England and the UK
Public Health England (PHE) has released its latest PHE hepatitis C virus (HCV) reports and supporting documents, for England and the UK. The report estimates that around two-thirds of people living with hepatitis C may not realise they have the virus, with PHE urging those at risk to get tested. The latest releases are also accompanied by slidesets and infographics.
The ‘make do and mend’ health service: solving the NHS capital crisis | Institute for Public Policy Research
This report explores the levels of capital investment in the NHS and indicates that there is still £55 billion of debt outstanding from Private Finance Initiatives. This report recommends a new settlement to fund capital and support transformation totalling £5.6 billion per year and indicates that the PFI legacy must be urgently addressed, through a ‘right to enfranchisement’ for the NHS, which would bring those that represent bad deals back into public ownership.
This review looks in detail at the mental healthcare provided to young people from the unique perspective of the overlap between physical and mental healthcare, the quality of physical and mental healthcare provided and how patients with mental health conditions use healthcare services. The overarching aim of this study was to identify areas of care that can be improved for all patients aged between 11 and 25 years.
The review is divided into three reports and can be downloaded here
The Cancer Survival in High-Income Countries (SURVMARK-2), isa longitudinal, population-based study which aims to provide a comprehensive overview of cancer survival across seven high-income countries and a comparative assessment of corresponding incidence and mortality trends.
While the study’s evaluation indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, international disparities persist. The UK was behind Australia, New Zealand, Noway, Canada, Denmark and Norway. Some of the lowest rates of 1-year survival was observed for stomach, colon, rectal, and lung cancer in the UK (Source: Arnold, et al, 2019).
Population-based cancer survival estimates provide valuable insights into the effectiveness of cancer services and can reflect the prospects of cure. As part of the second phase of the International Cancer Benchmarking Partnership (ICBP), the Cancer Survival in High-Income Countries (SURVMARK-2) project aims to provide a comprehensive overview of cancer survival across seven high-income countries and a comparative assessment of corresponding incidence and mortality trends.
In this longitudinal, population-based study, we collected patient-level data on 3·9 million patients with cancer from population-based cancer registries in 21 jurisdictions in seven countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway, and the UK) for seven sites of cancer (oesophagus, stomach, colon, rectum, pancreas, lung, and ovary) diagnosed between 1995 and 2014, and followed up until Dec 31, 2015. We calculated age-standardised net survival at 1 year and 5 years after diagnosis by site, age group, and period of diagnosis. We mapped changes in incidence and mortality to changes in survival to assess progress in cancer control.
In 19 eligible jurisdictions, 3 764 543 cases of cancer were eligible for inclusion in the study. In the 19 included jurisdictions, over 1995–2014, 1-year and 5-year net survival increased in each country across almost all cancer types, with, for example, 5-year rectal cancer survival increasing more than 13 percentage points in Denmark, Ireland, and the UK. For 2010–14, survival was generally higher in Australia, Canada, and Norway than in New Zealand, Denmark, Ireland, and the UK. Over the study period, larger survival improvements were observed for patients younger than 75 years at diagnosis than those aged 75 years and older, and notably for cancers with a poor prognosis (ie, oesophagus, stomach, pancreas, and lung). Progress in cancer control (ie, increased survival, decreased mortality and incidence) over the study period was evident for stomach, colon, lung (in males), and ovarian cancer.
The joint evaluation of trends in incidence, mortality, and survival indicated progress in four of the seven studied cancers. Cancer survival continues to increase across high-income countries; however, international disparities persist. While truly valid comparisons require differences in registration practice, classification, and coding to be minimal, stage of disease at diagnosis, timely access to effective treatment, and the extent of comorbidity are likely the main determinants of patient outcomes. Future studies are needed to assess the impact of these factors to further our understanding of international disparities in cancer survival.
Researchers employed a systematic approach to review trends in the incidence of diabetes, using a systematic review (SR) of literature using studies from the middle of the 1960s to 2014. The SR of 47 studies indicates that the incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. The study’s authors attribut this to preventive strategies and public health education and awareness campaigns could have contributed to the fall in diabetes incidence in recent years.
Objective To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes.
Design Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines.
Data sources Medline, Embase, CINAHL, and reference lists of relevant publications.
Eligibility criteria Studies of open population based cohorts, diabetes registries, and administrative and health insurance databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year.
Results Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends, and 9% (2/22) had decreasing trends. In 1990-2005, diabetes incidence increased in 66% (33/50) of populations, was stable in 32% (16/50), and decreased in 2% (1/50). In 2006-14, increasing trends were reported in only 33% (11/33) of populations, whereas 30% (10/33) and 36% (12/33) had stable or declining incidence, respectively.
Conclusions The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different.
Häusler N, et al. | 2019| Association of napping with incident cardiovascular events in a prospective cohort study |Heart |Published Online First| doi: 10.1136/heartjnl-2019-314999
Swiss researchers report that people in studies who had a nap once or twice a week have a lower incidence of cardiovascular incidents than those who did not nap. Nap frequency may help explain the discrepant findings regarding the association between napping and CVD events.
Objective There is controversy regarding the effect of napping on cardiovascular disease (CVD), with most studies failing to consider napping frequency. We aimed to assess the relationship of napping frequency and average nap duration with fatal and non-fatal CVD events.
Methods 3462 subjects of a Swiss population based cohort with no previous history of CVD reported their nap frequency and daily nap duration over a week, and were followed over 5.3 years. Fatal and non-fatal CVD events were adjudicated. Cox regressions were performed to obtain HRs adjusted for major cardiovascular risk factors and excessive daytime sleepiness or obstructive sleep apnoea.
Results 155 fatal and non-fatal events occurred. We observed a significantly lower risk for subjects napping 1–2 times weekly for developing a CVD event compared with non-napping subjects, in unadjusted as well as adjusted models. The increased HR for subjects napping 6–7 times weekly disappeared in adjusted models. Neither obstructive sleep apnoea nor excessive daytime sleepiness modified this lower risk. No association was found between nap duration and CVD events.
Conclusion Subjects who nap once or twice per week have a lower risk of incident CVD events, while no association was found for more frequent napping or napping duration. Nap frequency may help explain the discrepant findings regarding the association between napping and CVD events.