Tag Archives: NICE guidance

Yet, not all today’s physicians are keeping step with this new world. All too often adopting new ways of talking to patients or prescribing new technologies and medicines is left by the wayside in favour of keeping to tried and tested habits. Treating a common heart disorder Take the case with atrial fibrillation (AF), which affects around 800,000 people in the UK. Anticoagulation to reduce the risk of stroke is an essential part of AF management but according to the Department of Health many patients are not always appropriately anticoagulated.1 Since 2012, the National Institute for Health and Care Excellence (NICE) has approved a number

NICE draft guidance on acute heart failure published The draft acute heart failure clinical guideline from the National Institute of Health and Care Excellence (NICE) is now out for consultation with stakeholders. Guideline recommendations, available on http://www.nice.org.uk, include advice that people with suspected acute heart failure should be seen by a specialist team with a heart failure service at hospital. Currently practice is not standardised across hospitals and many patients are not treated by a dedicated service. …and also on ICDs and CRT   Draft technology appraisal guidance on the most clinically and cost-effective impla

NICE updates A new ‘Evidence Update’ has been produced by the National Institute for Health and Clinical Excellence (NICE), which summarises selected new evidence relevant to the NICE guideline on the management of chronic heart failure (CHF) in adults in primary and secondary care (clinical guideline 108).NICE says “Whilst Evidence Updates do not replace current accredited guidance, they do highlight new evidence that might generate a future changes in practice.”  It says it will welcome feedback from societies and individuals in developing this service. The update is available from www.evidence.nhs.uk/evidence-update-2. New guides

Key new recommendations include the following: Diagnosis of primary hypertension should be confirmed using 24–hour ambulatory blood pressure monitoring, or home blood pressure monitoring, rather than be based solely on measurements of blood pressure taken in the clinic. This is to reduce the occurrence of white coat hypertension, which recent studies have suggested is causing the misdiagnosis of hypertension in up to a quarter of the 12 million patients currently labeled with the condition. For the treatment of hypertension, the guideline now recommends that calcium channel blockers (CCBs) should be the first choice of agent used in patien

Navigating the changing landscape of cardiovascular commissioning A clear majority (58%) of GPs with a special interest in cardiology (GPSIs) feel unprepared to fulfill a commissioning role in the new NHS landscape, despite almost half of GPs being currently involved in commissioning, according to results from the REACCT (REAssessing Cardiology Commissioning and Treatment) report announced at the meeting. The report also reveals that a majority of cardiologists (57%) feel unprepared to take on new commissioning roles around the management of cardiovascular disease (CVD). The report (available from: www.pccs.org.uk/report) was written by the P

When the dentist said: “Be still your beating heart!” Dear Sirs, We all often encounter a patient history and apparent presenting complaint that we can not precisely and cleverly explain. Our patient, Mr BW, a fit and active 53-year-old man, attended a routine appointment as an outpatient. He had done this many times previously as he was experiencing difficuties with heart rate control and troubling symptoms secondary to atrial fibrillation (AF). Coincidentally, he had also had amalgam dental fillings drilled some 18 months previously. Since then, his cardiac problems had escalated. There appeared no clear causality between the fillings a

The position now So where does the current guidance leave us? First, it provides interventional cardiologists enough freedom to be able to treat most of our patients in what we consider to be an evidence-based manner. This desire to provide optimal care for our patients has been, incidentally, repeatedly and insidiously questioned over the last 12 months – but I will return to that issue later. In fact, I know that I am not alone in feeling that the guidance should have included diabetes as an indication for DES independent of the 3.0 mm/15 mm parameters. Are there any large observational or randomised series of stent activity that do not