NICE has issued the final guideline in a series of three, relating to the care and support of children and young people with autism.
Recent studies show that there are more than half a million people in the UK with an autism spectrum condition and at least one in 100 children is thought to be affected. The new guideline, aimed at addressing the broader challenges presented by autism, emphasises that many presenting symptoms in children and young people with autism may signify additional medical needs that are in danger of being under-treated where professionals and services have not made necessary adaptations to their practice.
Chair of the Guideline Development Group Professor Gillian Baird, Consultant Paediatrician, Guy’s and St Thomas’ NHS Foundation Trust, said: “Many people who have autism will have other physical, neurodevelopmental or mental health conditions such as intellectual disability, attention deficit hyperactivity disorder, anxiety and sleep problems which are not always recognised.”
The guideline makes a number of recommendations to ensure that healthcare professionals, including GPs, understand the condition and are trained to meet the individual needs of children and young people with autism.
NICE advises that this should include:
- Understanding the nature and course of behaviour in children and young people with autism
- Recognition of common coexisting conditions, including: mental health problems such as anxiety and depression; physical health problems such as epilepsy; sleep problems; other neurodevelopmentalconditions such as ADHD
- Understanding the patient’s experience of autism and its impact on them, and the impact of autism on the family (including siblings) or carers The guideline also places strong emphasis on the need for effective communication between relevant health and social care teams.
NICE has already published recommendations on diagnosing autism in children and diagnosing and managing the condition in adults.
Consultation begins on revised hypertension medicines guideline
The European Medicines Agency (EMA) has invited comments on a draft revision of its"guideline"on the clinical investigation of medicines for the treatment of hypertension, published at the end of July. The consultation will last for 6 months, ending on January 31 2014.
This latest incarnation is the fourth revision of the"guideline. Its main purpose is to augment the guidance given on gathering long-term safety data and to clarify the situations in which outcome studies might be required in order to detect potential long-term effects on mortality and morbidity.
The consultation document can be viewed at: http://www.ema.europa.eu/ docs/en_GB/document_library/Scientic_ guideline/2013/07/WC500146993.pdf.
Comments should be sent no later than 31 January 2014 to"cvswpsecretariat@ ema.europa.eu.
New measure aim to improve psoriasis management
A new set of quality standards, aimed at improving care for people with psoriasis and ironing out national variations in practice, has been published by NICE.
The prevalence of psoriasis is estimated to be around 1.3–2.2% in the UK, with more than 1.3 million people in the UK currently living with the disease. Psoriasis has a significant impact on quality of life, and around 14% of patients have associated joint disease. The majority ofpatients are managed in primary care,with specialist referral being needed at some point in up to 60% of cases.
A recent UK audit in the adult population found wide variations in practice, particularly in relation to access to specialist treatments, appropriate drug monitoring, specialist nurse support and psychological services.
The quality statements outlined by NICE include measures to ensure that:
- The severity of the disease, and its impact on physical, psychological and social wellbeing, is assessed at diagnosis and when response to treatment is
- Patients are referred for assessment by a dermatology specialist if indicated
- Annual checks for psoriatic arthritis are undertaken
- Patients receiving systemic therapy are monitored in accordance with locally agreed protocols.
Headache guidance highlights medication overuse
NICE has published new standards aimed at improving the care and support for young people and adults who suffer headache, including migraine.
More than 10 million people in the UK experience regular or frequent headaches, accounting for an estimated 25 million lost days at work or school each year. The new quality standard, based on the NICE clinical guideline on headaches, is designed to improve the diagnosis and management of headache disorders in people aged 12 years and older.
- Patients diagnosed with primary headache disorder should have their headache type(s) classified as part of the diagnosis, facilitating appropriate treatment and prevention
- In order to minimise the risk of secondary headaches, patients with primary headache disorder should be given information on the risk of medication overuse headache
- People with migraine should be offered combination therapy with a triptan and either an non-steroidal anti-inflammatory drug (NSAID)"or paracetamol