This month, 19 care pathways have been updated with the latest evidence.  Highlights include:

The ‘Chronic obstructive pulmonary disease (COPD)’ pathway has undergone content changes to include new recommendations on the assessment and management of COPD in line with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline on global strategy for the diagnosis, management, and prevention of COPD. Further guidance on the diagnosis of asthma-COPD overlap syndrome and the use of antibiotics in COPD exacerbation have been included.

The ‘Contraception’ pathway has undergone content changes to include further guidance on contraindications for contraceptive use in line with the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC 2016). Recommendations on cautions regarding the risk of intravascular insertion of the progesterone-only implant and brand name prescription of the progestogen intrauterine system have been incorporated.

The ‘Hepatitis C’ pathway has undergone content changes to incorporate updated recommendations on the general management of hepatitis C, hepatitis C screening in men who have sex with other men, and treatment in hepatitis C patients with heart rhythm disorders. New recommendations on antiviral treatment from the National Institute of Health and Care Excellence (NICE) have been included.

The full list of pathways receiving an update is:

  • Acute diarrhoea in children
  • Attention deficit hyperactivity disorder (ADHD)
  • Antenatal care
  • Cardiovascular disease risk management
  • Chronic kidney disease
  • Contraception
  • Chronic obstructive pulmonary disease (COPD)
  • Dementia
  • Diabetes
  • Early childhood assessment
  • Heart failure
  • Hepatitis C
  • Interstitial lung disease
  • Lymphoma
  • Miscarriage
  • Pneumothorax
  • Postnatal care
  • Stable angina
  • Termination of Pregnancy

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 pathway. Practice-based knowledge from clinical experts is then added where appropriate. Based on this, 5 care pathways have been removed pending further update, and 13 care pathways have been deprioritised for permanent removal.

Download the report for a brief summary of changes for all care pathways updated and deprioritised in this publication.