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Agilio’s DTG September 2022 Update

This update contains 1 new topic, 4 significant changes and 20 minor changes.

New Topic

  • Integrated health and social care for people experiencing homelessness — this is a new Agilio topic. The evidence base has been reviewed in detail, and recommendations are clearly justified and transparently linked to the supporting evidence.

Significant Changes

  • Gonorrhoea — reviewed. A literature search was conducted in July 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 to clinical recommendations have been made.
  • Hypertension — reviewed. A literature search was conducted in July 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 is now fully in line with the National Institute for Health and Care Excellence (NICE) guideline Hypertension in adults: diagnosis and management and includes recommendations for adults with type 2 diabetes. As updates had already occurred to align with the NICE guideline, no major new changes to the recommendations have been made. Minor restructuring changes have been made.
  • Melanoma — reviewed. A literature search was conducted in July 2022 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. Minor structural changes have been made to this topic, recommendations on non-melanoma lesions have been removed and the topic title has been changed to Melanoma. There have been no major changes to the recommendations.
  • Multiple sclerosis — reviewed. Updated to align with NICE [NG220] Multiple sclerosis in adults: management. No major changes to recommendations have been made.

Minor Changes

  • Glaucoma — minor update. Added a link to the NHS England Decision support tool.
  • Urinary tract infection – children — minor update. This topic has been updated with the NICE quality standards covering Urinary tract infection in children and young people.
  • Feverish children – risk assessment — minor update. This topic has been updated with the NICE quality standards covering Fever in under 5s.
  • Feverish children – management — minor update. This topic has been updated with the NICE quality standards covering Fever in under 5s.
  • Impetigo -– minor update. A minor typographical error has been corrected.
  • Immunizations – seasonal influenza — minor update. The management section has been updated to align with the NHS immunisation programme 2022 to 2023.
  • Dupuytren’s disease — minor update. Added NHS England Decision support tool link.
  • Carpal tunnel syndrome — minor update. Added link to the NHS England Decision support tool.
  • Osteoarthritis — minor update. Added link to NHS England Decision support tools.
  • Atrial fibrillation — minor update. Added a link to the NHS England Decision support tool.
  • Cataracts — minor update. Added a link to the NHS England Decision support tool.
  • Macular degeneration – age related — minor update. Added link to NHS England Decision support tool.
  • Bipolar disorder — minor update. Removed prothrombin time as an annual monitoring requirement for sodium valproate.
  • Smoking cessation — minor update. Added information relating to the Allen Carr Easyway seminar programme. Added information about the lack of availability of varenicline until further notice.
  • Post-traumatic stress disorder — minor update. Typographical error corrected.
  • Immunizations – childhood — minor update. UK and international immunisation schedule comparison tool has been added to the ‘unknown immunization history’ sections.
  • Lipid modification – CVD prevention — minor update. A recommendation to consider offering inclisiran has been added in line with the NICE technology appraisal Inclisiran for treating primary hypercholesterolaemia or mixed dyslipidaemia.
  • Hypercholesteraemia – familial — minor update. Recommendations on offering inclisiran and bempedoic acid have been added in line with the NICE technology appraisals Inclisiran for treating primary hypercholesterolaemia or mixed dyslipidemia and Bempedoic acid with ezetimibe for treating primary hypercholesterolaemia or mixed dyslipidaemia.
  • Neuropathic pain – drug treatment — minor update. Information that people taking pregabalin should be monitored for suicidal ideation and discontinuation considered in suspected cases has been added to this topic in line with the updated Summary of Product Characteristics.
  • Diabetes – type 1 — minor update. Recommendations on blood pressure targets have been updated, and recommendations on providing advice about periodontitis have been added in line with the updated NICE guideline Type 1 diabetes in adults: diagnosis and management.