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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 Oral steroids do not help hearing for children with glue ear
Oral steroids do not improve hearing, symptoms, or quality of life in children with glue ear. This NIHR-funded trial compared oral steroids with placebo for 389 children with glue ear, also called otitis media with effusion, and found no significant effect on those outcomes. Glue ear is when the middle ear fills with fluid, often following an ear or respiratory infection. The fluid makes hearing more difficult. It usually resolves within three months without treatment, but if it lasts longer, t...
NIHR Signal Abdominal aortic aneurysm screening for women is unlikely to be a fair use of NHS resources
Nearly 4,000 women would need screening to prevent one death, and a third of aneurysms detected wouldn’t have influenced the individual woman's health or lifespan. Aneurysm rupture is a life-threatening emergency with low survival. Men are known to be at higher risk of an aneurysm and are offered screening at age 65 to allow early diagnosis of aneurysms large enough to warrant surgical repair. However, a third of deaths from rupture are in women. This NIHR-funded study is the first t...
NIHR Signal Omega-3 supplements do not prevent heart disease, stroke or death
Omega-3 fatty acid supplements from fish oils or plants have little or no effect on the risk of heart disease, stroke or overall death rates. This finding contradicts a widespread belief that omega-3 supplements are protective. Previous evidence in favour of omega-3 supplements is mainly derived from trials at high risk of bias. The better evidence identified in this review does not demonstrate any health benefit. The review provides robust evidence confirming current guidance that omega-3 supp...
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 Tools for GPs can help reduce unnecessary antibiotic prescribing
Interventions to reduce inappropriate antibiotic prescribing for upper respiratory tract infections are most effective when they provide a negotiation tool to support patient interaction. These interventions are more likely to be rejected if they are perceived as interfering with individual clinical judgment or damaging patient relationships. Upper respiratory tract infections often resolve themselves within a few days, without the need for antibiotics, yet antibiotics are often prescribed. Thi...
NIHR Signal Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetes
Patients with type 2 diabetes who monitor their blood glucose themselves may see small, short-term improvements in blood sugar control. This is not enough to be clinically important or outweigh the costs and personal inconvenience of long-term self-testing. Self-monitoring is a well-established strategy for type 1 diabetes and for people with type 2 who need insulin. The benefit for all people with type 2 is debatable. This review pooled 24 randomised controlled trials comparing self-monitoring...
NIHR Signal Closing five emergency departments not linked with increased hospital admissions, though ambulance call-outs increased
Closure of five small emergency departments in England was not associated with change in the number of hospital admissions, urgent care attendances or deaths among the local populations. However, ambulance call-outs increased by 14% relative to comparison areas, with a four-minute increase in the time to reach a hospital with an emergency department. Emergency departments continue to be under high pressure, while staff shortages increase patient safety concerns. One option is to close smaller s...
NIHR Signal A football programme for overweight men achieves sustained weight loss
A 12-week weight management programme for men, centred on football, achieved 4.9kg weight loss at 12 months. Modest weight loss of 2.9kg was maintained at 3.5 years. Rates of overweight and obesity are higher for men than women in the UK, and there is little evidence that interventions are effective in the longer term. This NIHR-funded study followed 488 of 747 men (65%), average age 47 years, originally allocated to a programme of behavioural advice and football training with a professional co...
NIHR Signal The blood-thinner apixaban is less likely to cause major bleeding than warfarin
People who take apixaban to prevent blood clots are less likely to suffer major bleeding complications than those taking warfarin. Findings are similar in different groups of people, such as those with irregular heart rhythm (atrial fibrillation) and those who have had joint replacement surgery. Warfarin has long been used as an anticoagulant but needs frequent blood test monitoring. The new class of direct-acting oral anticoagulants does not usually need monitoring and is replacing warfarin. ...
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