Skip to main content

Menu

Agilio’s DTG December 2022 Update

This update contains 7 significant changes, 11 minor changes and 1 new topic.

New Topic:

  • Long-term effects of coronavirus (long COVID) — this is a new Agilio topic. A literature search was conducted in October 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials. The recommendations have been made in line with current evidence in the literature.

Significant Changes:

  • Alcohol – problem drinking — reviewed. A literature search was conducted in November 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes have been made to the recommendations.
  • Back pain – low (without radiculopathy) — reviewed. A literature search was conducted in October 2022 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 minor restructuring to improve clarity and navigation. The use of benzodiazepines for the management of muscle spasm associated with acute non-specific low back pain is no longer recommended, in line with the National Institute for Health and Care Excellence (NICE) guidance Low back pain and sciatica in over 16s: assessment and management (NICE 2020), which recommends the clinical and cost-effectiveness of benzodiazepines for the acute management of low back pain as an area for future research.
  • Dyspepsia – proven GORD — reviewed. A literature search was conducted in October 2022 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.
  • Dyspepsia – proven peptic ulcer — reviewed. A literature search was conducted in November 2022 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.
  • Pre-conception – advice and management — reviewed. A literature search was conducted in October 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the topic. No major changes were made to recommendations.
  • Shoulder pain — reviewed. A literature search was conducted in October 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the topic. No major changes to recommendations have been made.
  • Warts – anogenital — reviewed. A literature search was conducted in November 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key RCTs published since the last revision of the topic. Minor updates to structure and updated literature has been incorporated to provide supporting evidence for the guidance. No major changes to the clinical recommendations have been made.

Minor Changes:

  • Anticoagulation – oral — minor update. Added a rare adverse effect of rivaroxaban of eosinophilic pneumonia in line with the manufacturer’s SPC.
  • Antiplatelet treatment — minor update. A new caution has been added when prescribing ticagrelor as the manufacturer advises caution relating to people with sleep apnoea.
  • Attention deficit hyperactivity disorder — minor update. Management in specialist settings updated to include the option of melatonin medication in use for children and young people with insomnia aged 6-17 with ADHD, where sleep hygiene measures have been insufficient.
  • Coronavirus – COVID-19 — minor update. Heavy menstrual bleeding added as a possible adverse effect of booster vaccinations in line with the updated manufacturer’s Summaries of Product Characteristics for Comirnaty and Spikevax vaccines. Recommendations on assessment and management of suspected long COVID have been removed from this topic and links added to the new Agilio topic on Long-term effects of coronavirus (long COVID).
  • Diabetes – type 1 — minor update. Recommendations on continuous blood glucose monitoring have been updated in line with the NICE guidelines Type 1 diabetes in adults: diagnosis and management, and Diabetes (type 1 and type 2) in children and young people: diagnosis and management. The NICE quality standard for children and young people has also been updated.
  • Diabetes – type 2 — minor update. Added delayed gastric emptying as an adverse effect of lixisenatide as per the manufacturer’s updated SPC.
  • Heart failure – chronic — minor update. Added information about concomitant use of losartan and grapefruit juice to be avoided as grapefruit juice decreases the therapeutic effect of losartan.
  • Hypercholesterolaemia – familial — minor update. Information regarding interactions between ticagrelor and rosuvastatin added in line with the manufacturer’s updated SPC.
  • Lipid modification – CVD prevention — minor update. Information regarding interactions between ticagrelor and rosuvastatin added in line with the manufacturer’s updated SPC.
  • Lyme disease — minor update. Information that doxycycline prescribing for children aged 9-12 is an off-label indication added to the prescribing section of this topic.
  • Raynaud’s phenomenon — minor update. Added adverse effects of anxiety reactions, sleep disorders, mood changes, and depression based on an update to the manufacturer’s SPC.