This month, 20 care pathways have been updated with the latest evidence. Highlights include:
The ‘Contraception’ pathway has been accredited by the Royal College of Obstetricians and Gynaecologists (RCOG). Updated information on managing problems and follow-up when using a copper-bearing intrauterine device along with further expert opinion has been added.
The ‘Bladder cancer’ pathway has undergone large structural and content changes to reflect the updated National Institute for Health and Care Excellence (NICE) guidelines on the diagnosis and management of bladder cancer. Non-urgent referral recommendations from NICE on recurrent/persistent unexplained urinary tract infections have been added.
The ‘Abnormal vaginal bleeding’ pathway has under gone significant structural changes in order to separate the management of irregular menstrual bleeding for women using, and not using, hormonal contraception. Further information on management of abnormal vaginal bleeding in premenopausal women and suspected cancer referral has also been added.
The ‘Epilepsy in adults’ pathway has undergone extensive structural and content changes in line with updated guidelines on epilepsy from the Scottish Intercollegiate Guideline Network (SIGN) and Clinical Knowledge Summaries (CKS). Updated information on driving and epilepsy, drug safety updates on anti-epileptic drugs, including in women of childbearing age, recommendations from the Medicines and Healthcare Products Regulatory Agency (MHRA) toolkit on the risks of valproate medicines in female patients, and additional information on the use of contraceptives has been included.
The ‘Type 1 diabetes mellitus in children and adolescents’ pathway has undergone extensive structural and content changes in line with guidelines on Type 1 diabetes in children from the National Institute for Health and Care Excellence (NICE). Further recommendations on diagnosis and management have been added including the safe use of insulin, monitoring for foot disease, driving criteria and the management of diabetes in unwell patients have also been added.
The full list of pathways receiving an update is:
- Abnormal vaginal bleeding
- Abnormal vaginal discharge
- Acute coronary syndrome (ACS)
- Assessment of sexually transmitted infections (STIs)
- Asthma in adults
- Bacterial meningitis in adults
- Bladder cancer
- Chronic kidney disease
- Community acquired pnuemonia
- Diabetes in pregnancy
- Deep vein thrombosis
- Endometrial cancer
- Epilepsy in adults
- Kidney cancer
- Smoking cessation
- Stroke and transient ischaemic attack (TIA)
- Type 1 diabetes mellitus in children and adolescents
Changes in the information landscape can be identified by different sources, including regular searches for national clinical guidelines, recently published quality-appraised secondary literature, and user feedback. The impact of new information is assessed to determine a timeframe for updating the care map. Practice-based knowledge from clinical experts is then added where appropriate.
Download the report for a brief summary of changes for all care maps updated in this publication.