Health technology assessment : HTA
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Health Technol Assess · May 2018
Randomized Controlled TrialContinuous low-dose antibiotic prophylaxis to prevent urinary tract infection in adults who perform clean intermittent self-catheterisation: the AnTIC RCT.
People carrying out clean intermittent self-catheterisation (CISC) to empty their bladder often suffer repeated urinary tract infections (UTIs). Continuous once-daily, low-dose antibiotic treatment (antibiotic prophylaxis) is commonly advised but knowledge of its effectiveness is lacking. ⋯ The results of this large randomised trial, conducted in accordance with best practice, demonstrate clear benefit for antibiotic prophylaxis in terms of reducing the frequency of UTI for people carrying out CISC. Antibiotic prophylaxis use appears safe for individuals over 12 months, but the emergence of resistant urinary pathogens may prejudice longer-term management of recurrent UTI and is a public health concern. Future work includes longer-term studies of antimicrobial resistance and studies of non-antibiotic preventative strategies.
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Health Technol Assess · May 2018
Randomized Controlled TrialEnhanced psychological care in cardiac rehabilitation services for patients with new-onset depression: the CADENCE feasibility study and pilot RCT.
Around 19% of people screened by UK cardiac rehabilitation programmes report having moderate or severe symptoms of depression. These individuals are at an increased risk of cardiac mortality and morbidity, reduced quality of life and increased use of health resources compared with their non-depressed counterparts. Maximising psychological health is a goal of cardiac rehabilitation, but psychological care is patchy. ⋯ Consideration should be given to the delivery of EPC by dedicated mental health practitioners, working closely with cardiac rehabilitation services.
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Health Technol Assess · May 2018
What works to increase attendance for diabetic retinopathy screening? An evidence synthesis and economic analysis.
Diabetic retinopathy screening (DRS) is effective but uptake is suboptimal. ⋯ The National Institute for Health Research Health Technology Assessment programme.
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Health Technol Assess · Apr 2018
Randomized Controlled Trial Multicenter StudySelf-Management education for adults with poorly controlled epILEpsy [SMILE (UK)]: a randomised controlled trial.
Epilepsy is a common neurological condition resulting in recurrent seizures. Research evidence in long-term conditions suggests that patients benefit from self-management education and that this may improve quality of life (QoL). Epilepsy self-management education has yet to be tested in a UK setting. ⋯ More research is needed on self-management courses, with psychological components and integration with routine monitoring.
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Health Technol Assess · Mar 2018
Randomized Controlled Trial Multicenter Study Clinical TrialPositive behaviour support training for staff for treating challenging behaviour in people with intellectual disabilities: a cluster RCT.
Preliminary studies have indicated that training staff in Positive Behaviour Support (PBS) may help to reduce challenging behaviour among people with intellectual disability (ID). ⋯ Findings from the main study and the naturalistic follow-up suggest that staff training in PBS as delivered in this study is insufficient to achieve significant clinical gains beyond TAU in community ID services. Although there is an indication that training in PBS is potentially cost-effective, this is not maintained in the longer term. There is increased scope to develop new approaches to challenging behaviour as well as optimising the delivery of PBS in routine clinical practice.