Debbie Rigby takes a look at the latest in research news
A retrospective cohort study was conducted using pharmacy medication supply data of 553 residents from 16 nursing home facilities around Sydney, Australia. The mean number of symptomatic medications per resident increased from 4.6 medications 1 year before death to 5.1 medications at death, while preventive medication decreased from 2.0 to 1.4 medications. Symptomatic medications were used longer in the last year of life, compared to preventive medications.
Front. Pharmacol, 23 January 2018.
A systematic review and meta-analysis of 36 RCTs (n=4887) has concluded that NSAIDs were equivalent to opioids or paracetamol in the relief of acute renal colic pain at 30 minutes. There was less vomiting and fewer requirements for rescue analgesia with NSAIDs compared with opioids. Patients treated with NSAIDs required less rescue analgesia compared with paracetamol. The authors conclude that NSAIDs should be the preferred analgesic option for patients presenting to the emergency department with renal colic.
European Urology 2017.
This is an updated version of the original Cochrane review. Randomised, double-blind studies that compared a single dose of analgesic plus caffeine with the same dose of the analgesic alone in the treatment of acute pain were evaluated. Most studies used paracetamol or ibuprofen, with 100 mg to 130 mg caffeine, and the most common pain conditions studied were postoperative dental pain, postpartum pain, and headache. The addition of caffeine (≥ 100 mg) to a standard dose of commonly used analgesics provides a small but important increase in the proportion of participants who experience a good level of pain relief.
Cochrane Database of Systematic Reviews
Type 2 diabetes (T2DM) is associated with an increased risk of fracture, particularly of the hip, despite normal or high bone mineral density. Longer duration of disease and poor glycaemic control are both associated with higher fracture risk. Clinical management should focus on falls prevention strategies, avoidance of known risk factors, maintenance of good glycaemic control and bone protective intervention in individuals at high risk of fracture.
Journal of Internal Medicine 2018;283(2):140-153.