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NIHR Signal Additional therapy helps social recovery from first episode psychosis
Social recovery therapy increases structured activity, such as work, education or sport, by eight hours per week for people with severe social withdrawal following a first episode of psychosis. This cognitive behavioural type of treatment was added to other early interventions and might be particularly useful for those lacking motivation or living with other conditions that prevent them engaging with mental health services. This NIHR-funded trial included 154 young adults with first episode of ...
NIHR Signal Free entry for leisure centres may increase physical activity across all social groups
Removing access fees from gyms and leisure centres with a strong marketing campaign and five extra community health trainers gave 26,400 more physical activity “swim and gym” visits per quarter in a borough of 150,000 people. Re:fresh, a subsidised access scheme implemented in a socially disadvantaged local authority in England, Blackburn and Darwen, also found increases in monthly gym and swim activity from 3 to 15%, and overall levels of participation were more pronounced in disad...
NIHR Signal Introducing a primary care risk prediction tool did not reduce emergency admissions
Predicting emergency admissions paradoxically increased hospital admissions from primary care across all risk groups by about 3% overall. The Predictive Risk Stratification Model (PRISM) was evaluated in a trial in general practices in Wales, and there is little evidence it benefits patients by reducing deaths or improving quality of life either. The number of people living to older age with chronic health conditions is growing. Various risk stratification tools have been introduced across the...
NIHR Signal A frailty checklist was completed in only a quarter of older people at hospital admission
Frailsafe is a simple safety checklist offering the opportunity to improve safety and quality of care for frail older people while in hospital. It aims to increase key clinical assessments or practices on things like risk of falls, mobility and delirium, and to facilitate communication between staff. However, the relatively low completion rate highlights the need to understand how this approach can be better embedded in the complex care that is typical of services provided for older people. Com...
NIHR Signal Gout medication may slow progression of chronic kidney disease
In people with existing kidney disease, one in four will have worse disease within six to 12 months. Uric acid-lowering drugs such as allopurinol halve the risk of disease progression over this period. They also reduce heart attack or stroke by 60%. Uric acid, the cause of gout, is produced when proteins are broken down by the body. It is excreted by the kidneys and often builds up in people with chronic kidney disease. It is not certain whether increased uric acid causes progression of kidney ...
NIHR Signal Calcium channel blockers are useful in managing Raynaud’s phenomenon
Calcium channel blockers, such as nifedipine, are confirmed as useful in reducing the frequency, duration, severity of attacks, pain and disability associated with Raynaud’s phenomenon. People had two to six fewer attacks per week on average with treatment, and 13 without. Raynaud’s is a disorder which reduces blood flow to the fingers and toes as a result of the blood vessels tightening and going into spasm in the cold. This updated review suggested that calcium channel blockers ma...
NIHR Signal Diabetes drug aids fertility in women with polycystic ovaries
The diabetes drug metformin may help women with polycystic ovarian syndrome who are having problems getting pregnant, but it is unclear whether it works better than an alternative fertility drug that stimulates the ovaries. This study updates a previous review of trials that compare metformin with placebo, no treatment or with the fertility drug clomifene. It summarised results of 48 studies, including 4,451 women. The study found that metformin may work better than placebo or no treatment and ...
NIHR Signal Rivaroxaban plus aspirin may reduce heart attack and strokes in people with peripheral arterial disease, but with an added risk of bleeding
People with peripheral arterial disease who took rivaroxaban plus aspirin daily over an average of 21 months reduced their risk of cardiovascular death, heart attack or stroke from seven to five in every 100 people treated compared with those given aspirin alone. The rivaroxaban plus aspirin group also reduced their risk of major limb problems or amputation but increased their risk of bleeding from one to two for every hundred people treated. Peripheral arterial disease is a condition in which ...
NIHR Signal Takeaways linked to increased cardiovascular risk factors and obesity in children
Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly ever eat them. Their diets were also higher in fat and lower in protein and calcium. This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and ris...
NIHR Signal Type 2 diabetes can be reversed with a low-calorie diet
Nearly half of people given a formula replacement diet of 830 calories per day for three to five months, followed by food reintroduction, went into remission from type 2 diabetes. They were supported to achieve and maintain weight reduction by primary care nurses or dieticians. This trial involved 298 adults who had been diagnosed with type 2 diabetes within six years. Those that stuck with the program were more likely to lose weight (average 10kg was lost) and to go into remission compared to ...
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