My name is Fernando Florido and I am a General Practitioner in the United Kingdom. Welcome to the latest instalment in our monthly series, "NICE News," where we discuss new and updated guidelines published by the National Institute for Health and Care Excellence (NICE), specifically as it relates to primary care.
In this episode, I'll be focusing on the NICE guidance and advice published in May 2023. We'll be reviewing the latest recommendations that are relevant to primary care practitioners, with the goal of keeping you informed and up-to-date on the latest developments. This month we are focusing on cardiovascular risk assessment and digital technologies for anxiety and depression
By way of disclaimer, I am not giving medical advice; this episode is intended for health care professionals, it is only my interpretation of the guidelines and you must use your clinical judgement.
There is a YouTube version of this and other videos that you can access here:
The Full NICE News bulletin for May 2023 can be found at:
· https://www.nice.org.uk/guidance/published?from=2023-05-01&to=2023-05-31
Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release]
Free Download / Stream: https://alplus.io/halfway-through
Transcript
Hello and welcome to another episode of NICE News. My name is Fernando Florido, a GP in the United Kingdom. Today, we'll be discussing the NICE Guidance and advice published in May 2023, specifically for Primary Care.
This month we are focusing on cardiovascular risk assessment and digital technologies for anxiety and depression
Before we begin, I want to remind you that this episode is not medical advice. It is only my interpretation, and you must use your clinical judgement.
Finally, I'd like to remind you that there is a YouTube version of this episode which can be found in the episode description.
Now, with that said, let’s get straight into it.
The first clinical area refers to cardiovascular risk assessment and lipid modification where new/updated recommendations have been made.
And the first one is to offer those 25 to 84 years of age a CVD risk assessment using the QRISK3 tool. This is because evidence suggested that the additional fields included in QRISK3 (such as severe mental illness, regular corticosteroid use and atypical antipsychotic use) enabled the tool to perform better than QRISK2 at predicting CVD events.
If the 10‑year risk of CVD is 10% or more, we will check for secondary causes, give lifestyle advice and consider atorvastatin 20 mg for primary prevention and atorvastatin 80 mg for secondary prevention. If a statin is given, we will check lipids and LFTs at 3 months.
NICE also reinforces their advice against aspirin in primary prevention.
The definition of high intensity statins was also updated to remove simvastatin 80 mg which is rarely used because of the risk of myopathy.
Finally, evidence showed that statins are cost effective for people with 10‑year CVD risk less than 10% so we can use our clinical judgement to give a statin even if the QRISK3 score is less than 10%.
The second clinical area refers to digitally enabled therapies for anxiety and depression. The following can be used as treatment options:
· Beating the Blues for anxiety and depression and
· Space, also for Anxiety or Depression
· iCT‑either PTSD or SAD for post-traumatic stress disorder or social anxiety disorder
· Deprexis for depression
They have risk management systems in place, so it has been concluded that using these digital therapies could increase access to treatment and support, while ensuring patient safety.
And finally NICE also reviewed newer point-of-care tests for UTIs that give faster and more accurate results, sometimes showing which antibiotics the infection will respond to.
The tests are still in the early stages and it is difficult to assess the risks and benefits, so, these rapid point-of-care tests (such as Astrego, and Uriscreen), cannot be recommended for early routine use because further research is recommended.
We have come to the end of this episode. I hope that you have found it useful. Thank you for listening and good-bye
