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Agilio: Diagnosis and Treatment Guidance May 2025 Update    

This update contains 5 significant changes and 42 minor changes.

Significant Changes:

  • Cataracts — reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomised controlled trials published since the last revision of this topic. There have been no major changes to the recommendations.
  • Chronic pain — reviewed. A literature search was conducted in January 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.
  • Bronchiectasis — reviewed and updated. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to the recommendations have been made.
  • Itch in pregnancy — reviewed. A literature search was conducted in March 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The topic has undergone restructuring. No major changes to the recommendations have been made.
  • Pityriasis rosea — reviewed. A literature search was conducted in January 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic.

 

Minor Changes:

  • Asthma — minor update. Revised text in the prescribing section on the use specific types of inhalers to improve the clarity of the recommendations in line with NICE asthma guidance on MART and AIR therapies.
  • Autism in adults — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Autism in children — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Bone and soft tissue sarcoma – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Brain and central nervous system cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Breast cancer – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Candida – skin — minor update. Removed a reference relating to causes and risk factors which was no longer relevant.
  • Cervical cancer and HPV — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Childhood cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Depression — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Depression – antenatal and postnatal — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Epilepsy — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Gastrointestinal tract (lower) cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Gastrointestinal tract (upper) cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Generalized anxiety disorder — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Gynaecological cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Haematological cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Head and neck cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Insomnia — minor update. Update to the text on dosing for the elderly for Lunivia®
  • Insulin therapy in type 2 diabetes — minor update. Removed reference to the NICE key therapeutic topic and updated the link to the RCN guideline Starting injectable treatment in adults with type 2 diabetes.
  • Learning disabilities — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Lung and pleural cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Nausea/vomiting in pregnancy — minor update. Detail about the absolute risk of oral clefting with ondansetron use in the first trimester has been added to the basis for recommendation of the treatment section of this topic as well as RCOG advice that its use should not be discouraged if first line antiemetics are ineffective.
  • Osteoporosis – prevention of fragility fractures — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Ovarian cancer — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative cancer care – pain — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – constipation — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – cough — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – dyspnoea — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – general issues — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – malignant skin ulcer — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – nausea and vomiting — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – oral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Palliative care – secretions — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Platelets – abnormal counts and cancer — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Pre-conception – advice and management— minor update. Recommendations on folic acid supplementation have been clarified.
  • Prostate cancer — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Rheumatoid arthritis — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Skin cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework.
  • Smoking cessation — minor update. The recommendations on vaping in pregnancy have been clarified and detail added to the basis for information section.
  • Urological cancers – recognition and referral — minor update. QOF indicators removed in line with NHS England’s 2025 Quality and Outcomes Framework
  • UTI men — minor update. Removed odiferous and cloudy urine as potential signs of urinary tract infection as these are not considered reliable predictive indicators of UTI.