After stroke: the Cinderella of falls prevention research

Key message: There is a lack of evidence on interventions which aim to prevent falls in people after they have had a stroke. This is in contrast to good evidence on some effective  preventive measures for older people living in the community.

It’s Age UK’s annual Falls Awareness Week this week, with an emphasis this year on healthy feet. The excellent review from the Cochrane Bone, Joint and Muscle Trauma Group on preventing falls in older people living in the community, which we blogged about when it was updated last autumn, has useful evidence on a range of strategies to prevent falls, including some relating to feet!

Hot off the press: catch this Cochrane evidence!

New and updated Cochrane reviews are now published daily

If your idea of a present is a new or updated Cochrane review then it’s now Christmas every day with the arrival of Publish When Ready here in Cochraneland. In a huge change to the system for publishing reviews and protocols in the Cochrane Library, new arrivals appear daily, throughout the day, instead of once a month. In the time it takes me to make a cup of tea, a new review may have popped into the Library, ready for my consumption. It’s all rather exciting! It’s also rather alarming, as I have the distinct feeling that with such a rapid flow of  evidence I may miss things and fail to shout about stuff that you might like to know about. It may calm down (or I may speed up!) but with the sudden arrival of a very large amount of new evidence I thought I’d give you a bit of a round-up. So here are my picks of the week on surgery, drugs and rock’n'roll, with some talking treatment thrown in.

New evidence on benefits of formoterol for asthma, but there are still unanswered questions

Key message: The addition of new evidence to this review has shown a significant reduction in asthma-related non-fatal serious adverse events in adults with asthma who are given regular formoterol as well as inhaled steroids.

When asthma is not well controlled by low-dose inhaled corticosteroids (ICS), many asthma guidelines recommend adding another type of medicine, a long-acting beta₂-agonist, such as formoterol. These have been shown to improve lung function, quality of life and asthma symptoms but there are concerns about their safety when used regularly.

Taking antibiotics? Probiotics can cut your risk of diarrhoea

Key message: moderate quality evidence suggests that probiotics are both safe and effective for preventing Clostridium difficile-associated diarrhoea.

It’s no surprise that a new Cochrane review made headline news on the BBC’s health pages last week and was featured in many other health news reports too, as its focus was the use of probiotics to prevent Clostridium difficile-associated diarrhoea (CDAD) in people taking antibiotics.

Medicines help smokers quit long term, finds Cochrane overview of reviews

Key message: Varenicline, nicotine replacement therapy and bupropion all improve smokers’ chances of quitting long term, with a low risk of harms

Today is World No Tobacco Day, which seems a great day for the publication of new Cochrane evidence on medicines to help people quit smoking. Three medicines are licensed for this purpose in Europe and the USA and recommended in many national guidelines: nicotine replacement therapy (NRT), bupropion and varenicline. Cytisine is licensed in Russia and some other countries and other medicines, such as nortriptyline, have been tested. A new overview of reviews from a team at the Cochrane Tobacco Addiction Group has brought together results from Cochrane reviews on the effectiveness of medicines for helping adults to quit smoking for at least six months and on harms associated with them.

Newer nebulisers cut treatment times for people with cystic fibrosis

Key message: Nebulisers don’t all perform the same. Some newer types such as adaptive aerosol delivery and vibrating mesh technology have advantages over conventional systems including significantly shorter treatment time

Nebulisers are devices that allow medicines to be breathed in as a mist. People with cystic fibrosis (CF) are amongst those living with chronic conditions who use them to take medicines which help control their symptoms. Taking medicines this way may take a few minutes or as much as forty minutes each time and nebulised treatment has been found to significantly add to the burden of treatment for people with CF.

Screening for abnormal heart rhythms: can we protect more people from stroke?

It’s Action on Stroke Month here in the UK and the Stroke Association hope to raise awareness of stroke and particularly its emotional impact, through the many events taking place during May. They’ve also produced a really helpful guide to making information accessible for people with aphasia, which you can download from the link here. But what can be done to prevent people from having a stroke in the first place? Screening has moved in and out of favour for various conditions in recent years, but something that might be useful is to look for people with abnormal heart rhythms (atrial fibrilliation) that put them at higher risk of stroke and offer them treatment.