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NIHR Signal Text message reminders increase attendance at NHS health checks
Sending text messages reminding people to book their NHS health check following their invitation letter increases attendance. There is little evidence to support pre-notification text messages telling people an invitation would soon be sent. NHS health checks are offered to adults aged 40 to 74 years. Identification and management of cardiovascular risk factors has been shown to save lives. Yet only half of adults attend a check when it is offered. This trial conducted across general practices ...
NIHR Signal Diet and physical activity interventions targeting children and youth have different, yet small, effects on preventing obesity
Obesity prevention interventions which include both diet and physical activity may reduce the risk of obesity in pre-school children. Once at school, physical activity appears to be more effective for weight loss than diet alone. Resulting weight loss form any intervention, if any, has been very small with unclear benefits to the individual or population. This NIHR-supported Cochrane systematic review pooled the results of 153 global randomised-control trials (sevenfrom the UK) aiming to preven...
NIHR Signal Transcatheter aortic valve implantation may be an option for patients with aortic stenosis at lower surgical risk
Transcatheter aortic valve implantation (TAVI), the less-invasive procedure, may be associated with a reduced risk of death and stroke for up to two years when compared with surgical aortic valve replacement for adults with severe narrowing of the aortic valve, irrespective of the level of surgical risk. TAVI is already an established procedure for those unsuitable for surgery or at high risk. This meta-analysis evaluated seven trials comparing 8,020 adults treated with one of these procedures ...
NIHR Signal A lower drink-drive limit in Scotland is not linked to reduced road traffic accidents as expected
Lowering the drink-drive blood alcohol limit in Scotland was not followed by reduced road traffic accidents, perhaps because of a lack of enforcement. While there was a 0.7% reduction in alcohol bought in pubs and restaurants after the new legislation (on-trade sales), there was no significant change in sales of alcohol from shops or supermarkets (off-trade), where most purchases are made. Drink-drive accidents account for around 13% of all road deaths in Britain. In an attempt to improve this ...
NIHR Signal A temporary clot-catching filter inserted after major trauma does not prevent lung clots
In adults after major trauma who cannot safely be given anti-clotting drugs, placing a removable metal filter in a major vein to the heart (the inferior vena cava) within 3 days of admission does not reduce their chances of having a clot in their lungs (pulmonary embolus) within 90 days, compared with having no filter. The filters do not affect the risk of bleeding. The filter aims to catch clots that might develop in the legs and travel to the lungs, until anti-clotting drugs can be safely sta...
NIHR Signal Exercise training improves physical capacity after lung cancer surgery
People who receive exercise training following surgery for lung cancer can walk about 57 metres further in six minutes than controls who did not exercise. After surgery like thisto remove all or part of a lung, people typically manage about 500 metres in six minutes on the test, and anything above 20 metres is considered a worthwhile improvement. Exercise also increases leg strength and quality of life. A decline in physical fitness is a common and debilitating effect of lung resection. Exerci...
NIHR Signal Length of steroid course for childhood nephrotic syndrome makes little difference to later recurrences
For children with a first presentation of nephrotic syndrome, an extended sixteen-week treatment regimen with prednisolone does not reduce the risk of relapse compared with the standard eight-week course. Most children will experience a relapse with either regimen, but the longer course may delay it by a month or so which may, in turn, reduce the resource use, such as emergency department visits, shorter admissions and less need to see the GP. This can also make the longer course cheaper overall...
NIHR Signal Four-drug treatment for HIV offers no benefit over standard three-drug treatment
Quadruple drug therapy for people starting HIV treatment offers no benefit over the currently recommended triple therapy. Antiretroviral (anti-HIV) therapy is highly effective, with almost all treated individuals in the UK surviving as long as non-infected people. The courses now available mean those treated are usually unable to pass on the virus. There are several classes of treatment and individual drugs which can be used in various combinations. The British HIV Association currently recomme...
NIHR Signal Surgery for a deviated nasal septum improves quality of life more than non-surgical approaches
Surgery for adults who have a deviation, or bend, in the wall running through the centre of their nose improves quality of life more than non-surgical alternatives. The benefit was maintained for at least two years. The surgery, a septoplasty, also improvesairflow through the nose. The trial compared septoplasty to non-surgical alternatives, such as just monitoring the patient or giving treatments such as corticosteroid nasal sprays. There has been a lack of good-quality evidence in managing t...
NIHR Signal Closer links between police and health services can improve experiences for people in mental health crisis
Tighter working partnerships between health professionals and police services are likely to improve the care of people who come into contact with police during mental health crises. People experiencing severe mental health episodes can present with extreme and unpredictable behaviour posing a danger to themselves and members of the public. Police are often the first to respond in these challenging situations. New models are emerging of mental health staff working with police. This NIHR-funded ...
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