This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Any review of this sort is only as good as the studies fed into it. While the studies were judged to be of a good quality, the reviews' authors warn that there were "relatively few" studies included; seven in total. But the main conclusions were based on just three studies which mainly involved adults with mild or moderate asthma. This means the results may not apply to people with severe asthma, or to children.
Unfortunately, the review can't tell us whether everyone with asthma would benefit from taking vitamin D, or only people whose vitamin D levels are low. Also, it doesn't give us a recommended dose.
The review notes, for example, that for every 10,000 people who take standard-dose statin therapy for five years, only five would experience muscle weakness as a result.
Comparatively, between 500 and 1,000 cases of heart attack or stroke would have been avoided by the same number of people.
The authors also note that many side effects reported in placebo-controlled trials of statins may not in fact have been directly caused by the drugs.
Often, people who claimed statins were causing side effects continued to have the same side effects when given a dummy treatment.
Ironically, many of the media sources talking about side effects being "dangerously exaggerated" are the same ones exaggerating them in the first place – as we discussed in more detail in June 2016.
Dr Maureen Baker of the Royal College of General Practitioners (RCGP) said: "We hope this research reassures patients that in the majority of cases statins are safe and effective drugs – but in most cases where adverse side effects are seen, these are reversible by stopping taking statins."
Cognitive–behavioural therapy (CBT) is one of the most promising treatments for chronic fatigue syndrome (CFS). It is unclear whether CBT is effective for Black and minority ethnic (BME) groups.
Aims: To assess the effectiveness of CBT in BME patients compared with White British patients presenting to a specialist CFS service. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
A real world controlled effectiveness study carried out in unselected patients from UK general practices provides a better way of evaluating drug treatments for use in routine clinical care than standard randomised controlled trials, say the authors of a study in chronic obstructive pulmonary disease (COPD). To read the full article, log in using your NHS OpenAthens details
Asthma guidelines aim to guide health practitioners to optimise treatment for patients so as to minimise symptoms, improve or maintain good lung function, and prevent acute exacerbations or flare-ups. The principle of asthma guidelines is based on a step-up or step-down regimen of asthma medications to maximise good health outcomes using minimum medications. Asthma maintenance therapies reduce airway inflammation that is usually eosinophilic. Tailoring asthma medications in accordance with airway eosinophilic levels may improve asthma outcomes such as indices of control or reduce exacerbations or both. Fractional exhaled nitric oxide (FeNO) is a marker of eosinophilic inflammation, and as it is easy to measure, has an advantage over other measurements of eosinophilic inflammation (for example sputum eosinophils).
Background: Several clinical trials of vitamin D to prevent asthma exacerbation and improve asthma control have been conducted in children and adults, but a meta-analysis restricted to double-blind, randomised, placebo-controlled trials of this intervention is lacking.
Objectives: To evaluate the efficacy of administration of vitamin D and its hydroxylated metabolites in reducing the risk of severe asthma exacerbations (defined as those requiring treatment with systemic corticosteroids) and improving asthma symptom control.
Objectives To ascertain the stakeholders' views and devise recommendations for further stages of the Wearable Sensing and Smart Cloud Computing for Integrated Care to Chronic Obstructive Pulmonary Disease (COPD) Patients with Co-morbidities (WELCOME) system development. This system aims to create a wearable vest to monitor physiological signals for patients concerned incorporating an inhaler adherence monitoring, weight, temperature, blood pressure and glucose metres, and a mobile health application for communication with healthcare professionals (HCPs). Open Access Article
A Cochrane Review finds that self-monitoring or self-management can improve the quality of oral anticoagulation therapy and reduce thromboembolic events.
The Community Treatment Team (CTT), a NELFT NHS Foundation Trust initiative, is made up of nurses (many are independent nurse prescribers), geriatricians, occupational therapists, physiotherapists, social workers, support workers and administrators.
BBC News reports a "third [of people] given wrong initial heart attack diagnosis", while The Sun makes the totally unsupported claim that "Doctors miss heart attacks in women 'because they expect victims to be fat, middle-aged men'."
These headlines are based on a study that analysed a database containing information about nearly 600,000 people in the UK who had been diagnosed with a heart attack over a nine-year period.
The Nuffield Trust’s report, Digital requirements for new primary care models, highlights how technology can help to enable primary care to meet the historic demands and pressures it faces. With 85 per cent of asthma patients managed exclusively in primary care, it’s essential that asthma is placed at the heart of new technologies.
The increasing prevalence and associated cost of treating Chronic Obstructive Pulmonary Disease (COPD) is unsustainable, and focus is needed on self-management and prevention of hospital admissions. Telehealth monitoring of patients’ vital signs allows clinicians to prioritise their workload and enables patients to take more responsibility for their health. This paper reports the results of a qualitative study embedded within a feasibility and pilot Randomised Controlled Trial (RCT) of Telehealth-supported care within a community-based COPD supported-discharge service. The aim of the study was to qualitatively explore the experiences of patients with COPD who had received either a Telehealth-supported or a specialist nursing intervention following their discharge from hospital after an admission for a COPD exacerbation.
"Heart disease deaths now lower than cancer – but obesity crisis means this may not last," the Daily Mirror reports. A major review of European trends in cardiovascular disease deaths found that UK cancer deaths overtook cardiovascular deaths in 2014.
"Calcium supplements could dramatically raise the risk of dementia in women who suffer a stroke, a new study found," the Mail Online reports. However, the sample size (98) of women taking supplements was small, which casts doubts on the reliability of the claims.