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NIHR Signal Peer support may reduce readmissions following mental health crises
People discharged from mental health crisis teams are less likely to re-enter acute services within a year if they receive self-management support. The support in this study was provided by a peer worker, someone with experience of mental illness. The peer worker used a workbook to provide information and talk through recovery goals. The study compared this with those who had received the workbook by post. Participating adults had a range of mental illnesses and had been managed by six crisis r...
NIHR Signal Methylphenidate remains first-choice drug treatment for children and young people with ADHD
The stimulant methylphenidate has the best balance of effectiveness against side effects in children and young people with attention deficit hyperactivity disorder. Amphetamines are more effective, but also more likely to be stopped for a reason other than side effects. This large, NIHR-funded systematic review compared a range of drugs against each other through a network meta-analysis. Effectiveness and tolerability were assessed at about 12 weeks of treatment. Other second-line drug treatmen...
NIHR Signal Guided online interventions can help people recover from depression
Internet-based interventions combined with remote professional support can improve outcomes for people with depression. Those receiving the intervention show better initial response to treatment and higher recovery rates compared with control groups who are either waiting for treatment or receiving less support. This meta-analysis shows people using guided internet therapy are over twice as likely to respond to treatment and achieve remission. This finding reinforces current NICE guidance which...
NIHR Signal Supporting families of those in intensive care improved family satisfaction but didn’t reduce family distress
A multicomponent support intervention for family members of patients in intensive care didn’t reduce their anxiety, depression or distress around the overall experience. However, it increased satisfaction with the quality of staff communication and delivery of care. Family members of critically unwell patients on intensive care often need to be involved in care decisions. Yet they may feel unsupported and bewildered in the process. This intervention, delivered in five US intensive care un...
NIHR Signal Amphetamines probably the best first-choice treatment for adults with ADHD
There is further evidence to support the amphetamines as the most effective group of drugs for treating adults with attention deficit hyperactivity disorder in the short-term. Two of these drugs were shown to provide the most improvement in core symptoms of attention deficit hyperactivity disorder, are tolerated as well as any other drug treatment and are less likely to be stopped. The review did not identify data to determine whether amphetamines should continue to be used for longer than 12 ...
NIHR Signal Virtual reality therapy reduces fear of heights
Virtual reality therapy directed by a virtual therapist substantially reduced fear of heights compared to patients’ own usual care, which was mainly no treatment. One hundred participants had moderate fear of heights or worse. After roughly six sessions of virtual reality treatment, participants’ fear of heights was lessened, and some said that it had improved how they coped with heights in their daily lives. These results show that this intervention is effective and suggests poten...
NIHR Signal Women rate quality and safety of birth experience as important
Most healthy women would like a natural birth if possible, but acknowledge the unpredictability and risks of childbirth. They also appreciate the supportive care environment where healthcare providers are competent, kind and respectful to them, their partners and their baby. In a large review of studies with over 1,800 women’s views on what matters in childbirth, having a healthy baby was important. Avoiding unnecessary medical intervention and retaining a sense of control over their birt...
NIHR Signal People with osteoarthritis can benefit from exercise but may harbour myths about safety
Programmes that show people with osteoarthritis how to exercise safely may slightly improve pain scores, self-belief and social function, but participants also report the myth that discomfort while exercising indicates on-going harm. The review combines evidence from 21 randomised controlled trials evaluating exercise in hip or knee osteoarthritis with 12 studies where people receiving the intervention were interviewed about the impact of exercise on their disease. Participants were men and wom...
NIHR Signal Cognitive behavioural therapy could benefit adults with attention deficit hyperactivity disorder (ADHD)
Cognitive behavioural therapy improves the core symptoms of attention deficit hyperactivity disorder (ADHD) in adults, compared with a range of other treatments. This Cochrane review found a general trend for improvements in inattention, hyperactivity and impulsiveness, especially when therapy was combined with medication. The review included trials that compared cognitive behavioural therapy to other specific interventions or to a range of control conditions, including waiting list and no trea...
NIHR Signal Music can reduce pain and anxiety following surgery
Recorded music played before, during or after surgery in adults reduces self-reported post-operative pain and anxiety, compared with usual care. The average effect is equivalent to a reduction in anxiety of 21 percentage points and a 10 percentage point reduction in pain within a few days of surgery. It is thought that placebo and distraction effects probably play a role, but in this review music still improved pain when used for patients under a general anaesthetic. Nearly two-thirds of patie...
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