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NIHR Signal People take prescribed statins more reliably after discussing their advantages and disadvantages
Patients want to know more about how statins work, the reasons for prescribing them and their possible side effects. Statins lower cholesterol and reduce the risk of recurrent stroke or heart attack. They also help prevent cardiovascular disease developing in people at high risk. At a population, level statins reduce the overall incidence of cardiovascular disease for people at moderate risk, but the benefits for an individual are less clear-cut. This review found that people are happy to take...
NIHR Signal Text messages improve diabetes self-management and blood sugar control
In adults with poorly controlled diabetes, text messages offering advice and support can improve self-management and blood sugar control. This trial included 366 adults with type 1 or type 2 diabetes in New Zealand. An automated system delivered individually tailored text messages to participants over a nine-month period to support self-management of blood sugar. The control group received usual care, comparable to that in the UK. The text message group had a small reduction in blood sugar lev...
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 Factors in men’s choice of active surveillance for low-risk prostate cancer
Many personal, organisational and national factors can help or hinder men from choosing active surveillance over radical treatment when they have low-risk prostate cancer. Men are more likely to adhere to this plan of regular monitoring if they and their families are fully informed and understand that it includes the option of further treatment if necessary. The recent ProtecT trial demonstrated that there was no difference in 10-year survival rates between men with low risk localised prostate ...
NIHR Signal Person-centred care improves quality of life for care home residents with dementia
A person-centred care intervention for people with dementia living in care homes improved their quality of life, reduced agitation and improved interactions with staff. It may also save costs compared with usual care. The WHELD intervention involves training staff in person-centred care, with a focus on improving social interactions and appropriate use of antipsychotic medications. An early study suggested it could halve antipsychotic use. This larger-scale NIHR trial conducted across 69 UK nu...
NIHR Signal Men feel physically and psychologically ill-prepared for prostate cancer surgery
Following prostate cancer surgery men often experience physical changes, such as urinary incontinence and erectile dysfunction, causing negative emotions and distress. This review found that men felt poorly prepared – psychologically and physically – for the changes they might experience after surgery. Surgery was often described as "life-changing", and men described worrying about their future. NICE recommend that men and their partners/carers are fully informed about pro...
NIHR Signal Blood pressure self-monitoring works best when people are well-supported
People with high blood pressure are more likely to have their blood pressure controlled after 12 months if they self-monitor and receive counselling by telephone compared with usual monitoring in the clinic. When people were asked to self-monitor their blood pressure with no additional support, it was no better than getting their blood pressure measured in a clinic. This NIHR-funded review of 25 trials found that self-monitoring with counselling by telephone reduced systolic blood pressure by a...
NIHR Signal Use of public defibrillators linked to out-of-hospital cardiac arrest survival
Providing a shock using a defibrillator to people with out-of-hospital cardiac arrest before the arrival of emergency medical services increases their chance of survival. The UK survival rate is around 8%, which is lower than in other developed countries. This review found that bystander assistance through cardiopulmonary resuscitation and attaching a defibrillator increased it to 32%, compared to 12% for police or firefighters. Survival rates were even higher for people who had a rhythm that c...
NIHR Signal Carers of stroke survivors voice an unmet need for practical and emotional support
The carers of stroke survivors express a need to be recognised by hospital rehabilitation teams as partners in care. Carers emphasised that their deep knowledge can contribute to joint decision making about the care of their spouse or family member. This research suggests that considering carers’ needs for support, information and training into care planning could ease the distress currently reported. This review describes how family, friends and spouses often felt emotionally overwhelmed...
NIHR Signal Parents want more balanced information on risks and benefits in advance of vaccinations
Parents say that insufficient information can lead them to regret their vaccination decision. They often want more information from trusted sources and expect practitioners to discuss both benefits and risks in good time before vaccination. England and Wales are below World Health Organization (WHO) targets for the uptake of several immunisations. This Cochrane review of 38 qualitative studies focused on the views of parents in relation to communications about vaccinations for children under si...
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