Research Roundup


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Debbie Rigby takes a look at the latest in research news

Advise non-pharmacological therapy as first line treatment for chronic insomnia

Guidelines recommend non-pharmacological approaches, including cognitive behavioural therapy, as first line treatment for chronic insomnia in adults. Yet, sedatives are commonly prescribed to treat insomnia. Sedatives are associated with serious harm, including cognitive deficits, falls, confusion, hip fracture, dependency, and mortality.

BMJ 2021;372:n680.

 

Discontinuation of antiepileptic drugs in adults with epilepsy

Patients with epilepsy who have been free of seizures for at least two years may be able to stop their antiepileptic drugs. The risk of recurrence decreases with every additional year of seizure freedom. Discontinuation may be considered after an individualised harm–benefit assessment and consultation with a neurologist is recommended. Most guidelines encourage slow discontinuation of antiepileptic drugs.

Aust Prescr 2021;44:53-6.

 

Balancing the benefits and harms of oral anticoagulation in non-valvular atrial fibrillation

There is evidence of considerable over- and under-treatment with oral anticoagulants in Australia. The direct oral anticoagulants apixaban, dabigatran and rivaroxaban offer an improved safety profile over warfarin. Patient preferences are important and shared decision-making supports better adherence to treatment.

Aust Prescr 2021;44:49-52.

 

Vitamin D supplementation to prevent acute respiratory infections

A systematic review and meta-analysis of aggregate data from 46 randomised controlled trials (75 541 participants) has shown vitamin D supplementation was safe and overall reduced the risk of acute respiratory infections compared with placebo, although the risk reduction was small. Protection was associated with administration of daily doses of 400–1000 IU for up to 12 months, and age at enrolment of 1·00–15·99 years.

Lancet Diabetes & Endocrinology 2021.

 

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