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NIHR Signal Self-monitoring improves control of high blood pressure compared with GP monitoring alone
Allowing patients who have inadequately controlled high blood pressure to monitor their own blood pressure at home helps their GPs to optimise their management. Patients who self-monitor and visit or talk to their GP when needed for medication adjustments achieve 4mmHg lower systolic blood pressure over 12 months compared with those relying only on the measurements made by a GP without self-monitoring. Effects are similar if patients write down their measurements to send to the GP or do so via ...
NIHR Signal Cartoons are promising for reducing dental anxiety in children
Cartoons delivered on laptops, projectors or 3D goggles with sound can help distract anxious children who fear dental procedures. Dental anxiety can prevent children from attending the dentist for care, and this type of distraction could offer a useful tool to help them. This review looked at a range of audiovisual approaches tested in trials of healthy children receiving dental treatment under local anaesthetic. The children were assessed for physiological measures related to emotional state (...
NIHR Signal Opioid drugs are no better than standard painkillers for long-term back and joint pain
People with long-term back pain, or osteoarthritis of their hips or knees, do not get better pain relief from opioid drugs and are more likely to get side effects than those who take paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen. A US study assigned 240 patients to either opioid or non-opioid pain relief drugs and measured their pain over 12 months. Those who were assigned opioid drugs had less relief of their pain and also were more likely to have si...
NIHR Signal Fish oil supplements are ineffective for treating dry eyes
Omega-3 fatty acids or ‘fish oil’ supplements are no more effective than inactive olive oil capsules for relieving dry eye disease. Some patients take fish oil supplements for this common problem, but this new evidence suggests that they consider alternatives. Dry eye disease is a common long-term inflammatory condition causing discomfort, and disturbances including blurred vision. Treatment of symptoms includes using artificial tears. Although guidelines recognise the lack of exist...
NIHR Signal Group-based diet and exercise programmes can lead to weight loss
The evidence is growing that group-based weight loss programmes can offer effective and acceptable options for overweight people, particularly men. On average, people in group dietary advice and exercise programmes lose 3.5kg more than non-participants by six months – a modest 4% weight loss overall but less than the 5% that is often regarded as clinically important. In this systematic review on the group weight loss approach, participants in the 47 trials were adults from the general pop...
NIHR Signal Prescribing anti-inflammatories for urine infection reduces antibiotic use but increases complication risk
Urinary tract infection symptoms resolved by three days for 80% of women given antibiotics compared with 54% given anti-inflammatories. Anti-inflammatories reduced antibiotic use, but 5% of women developed more severe infection of the kidneys. Urinary infections are the second most common reason for prescribing antibiotics in general practice, after respiratory infection. As such, this use may be contributing to increasing antibiotic resistance. This Swiss trial provided an important head-to-h...
NIHR Signal People maintain increases in physical activity three years after receiving pedometers
Middle-aged to older adults given pedometers and a walking programme as part of two NIHR trials continued to be active three years later. In one trial they were walking around 650 extra steps a day. In both trials, they spent about 30 minutes per week extra in moderate-to-vigorous physical activity compared to controls. Brisk walking is a good way for older adults to achieve physical activity recommendations. This is the long-term follow-up of two large NIHR-funded trials that recruited adults ...
NIHR Signal Vaccination likely to reduce influenza in healthy children
In healthy children aged two to 16, vaccines are likely to reduce laboratory-confirmed cases of influenza and may reduce the risk of influenza-like illness compared to placebo. Seven children need to receive the live vaccine to prevent one case of confirmed influenza. Twenty children need to be vaccinated to prevent one case of influenza-like illness. This updated Cochrane review included 41 trials of either live attenuated (weakened) or inactivated influenza vaccines, with over 200,000 partici...
NIHR Signal Redesigning oral surgery with enhanced primary dental care, electronic referral and triage may save overall costs
An electronic referral system including consultant-led triage and an advanced oral surgery service in primary care results in fewer people requiring oral surgery in hospital. It comes at a lower overall cost than the previous arrangement. About two-thirds of patients could be treated safely in enhanced primary settings rather than hospital. This NIHR-funded study implemented several changes, an electronic referral system which standardised and improved the level of information provided in refer...
NIHR Signal Case managers improve outcomes for people with dementia and their carers
Using a case manager to coordinate health and social care improves the challenging behaviour of people with dementia and reduces the burden on caregivers. Quality of life of caregivers improves the most when case managers have a professional background in nursing. This NIHR-funded review compared the effectiveness of standard community treatment and interventions with case managers overseeing the interventions for people living with dementia. It considered evidence from 14 trials in a number of...
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