Memokath-051 stent for ureteric obstruction [MTG 35]

New: Medical technologies guidance


The case for adopting Memokath‑051 for treating ureteric obstruction is partially supported by the evidence. The evidence is limited but suggests that in selected cases, Memokath‑051 is effective at relieving ureteric obstruction and improving quality of life. When inserted by trained clinicians (see section 4.8) and in appropriate patients (see section 1.2), Memokath‑051 is associated with equivalent success rates and a better patient experience compared with double‑J stents. Using Memokath‑051 may also reduce the number of stent replacements needed compared with using double‑J stents.


The case for adopting Memokath‑051 for treating ureteric obstruction is partially supported by the evidence. The evidence is limited but suggests that in selected cases, Memokath‑051 is effective at relieving ureteric obstruction and improving quality of life. When inserted by trained clinicians (see section 4.8) and in appropriate patients (see section 1.2), Memokath‑051 is associated with equivalent success rates and a better patient experience compared with double‑J stents. Using Memokath‑051 may also reduce the number of stent replacements needed compared with using double‑J stents.

NIHR Signal Hearing aids make communication easier for people with mild hearing loss

Hearing aids for people with mild-to-moderate hearing loss make communication easier and improve listening ability. A range of similar ‘social’ benefits improved on scores designed to measure the quality of life alongside the improvements in hearing. There were no reports of adverse effects for hearing aids.

Hearing loss can have a far-reaching impact on people’s mental and physical health, taking a toll on their quality of life. It can be simply viewed as a natural part of ageing, but this review highlights the positive impact that hearing aids can have on conversation and socialisation before people’s hearing loss becomes severe. Despite hearing loss being common, it can take people ten years to get appropriate treatment.

From the NIHR Dissemination Centre

NIHR Signal Breathing exercises improve asthma and can be learned by DVD

Breathing exercises taught by a physiotherapist in person or on DVD both improved the quality of life of adults with poorly controlled asthma to a small but similar extent. The DVD was the cheapest option, and it could lead to inexpensive internet delivery in the future.

This NIHR-funded trial recruited 655 UK adults with poorly controlled asthma. It showed about 63% of those receiving the breathing exercises had clinically important improvements in their asthma-related quality of life over a year, compared to 56% who improved receiving usual care.
Exercises did not improve formally measured lung function, suggesting the underlying biology of the asthma was unchanged.

The findings imply that breathing exercise programmes – currently recommended in the 2016 British guideline on the management of asthma when delivered by a physiotherapist – may be equally effective, and cheaper when delivered via DVD (or another video).

From the NIHR Dissemination Centre

Protocol for a systematic search and critical review of studies, in effective strategies to maintain quality of life in adult patients with postural orthostatic tachycardia syndrome utilizing an interpretive approach

EP Europace, Volume 19, Issue suppl_1, 1 October 2017, Pages i43

POTS is a rare condition which disproportionately affects young women (5:1). Diagnosis is by tilt table which confirms >30 beat per minute heart rate rise on standing. Symptoms for sufferers are variable, including palpitation, dizzyness, poor concentration, "brain fog", pains, anxiety and gastrointestinal disturbances. Current evidence base is limited. Treatment is salt, fluids, compression stockings, tilt exercises and medication. There is no systematic review published in POTS. Meta-analysis is not possible due to heterogeneity of studies.

UHCW Research: H Eftekhari, F Osman and S Hayat

Quality of life measures predict cardiovascular health and physical performance in chronic renal failure patients

PLoS One; San Francisco12.9 (Sep 2017): e0183926.

Patients with advanced chronic kidney disease (CKD) experience complex functional and structural changes of the cardiopulmonary and musculoskeletal system. This results in reduced exercise tolerance, quality of life and ultimately premature death. We investigated the relationship between subjective measures of health related quality of life and objective, standardised functional measures for cardiovascular and pulmonary health.

In CKD and HTN, objective physical performance has a significant effect on quality of life; particularly self-reported physical health and functioning. Therefore, these quality of life measures are indeed a good reflection of physical health correlating highly with objective physical performance measures.

UHCW Research: A. Rogan, K. McCarthy, C. McGregor, G. Evans, S. Hewins, N. Aldridge, S. Fletcher, N. Krishnan and R. Higgins

New quality of life measure for recovering cancer patients

In a world leading move, quality of life for cancer patients will be tracked as part of ambitious plans by NHS England to radically improve care and support for people once treatment ends.

The new ‘quality of life metric’, which is the first of its kind, will use questionnaires to measure how effective this support is and the data will be made available on My NHS – helping patients, the public, clinicians and health service providers see how well their local after cancer care support is doing.

Developing A Complex Multi-Modal Self-Management Behaviour Change Intervention: Theories, Processes and Materials

BJP ASM Poster Abstracts 2017. First Published May 3, 2017 

 
The Improving the Wellbeing of people with Opioid-Treated CHronic pain (I-WOTCH) study aims to enable those with persistent non-malignant pain to self-manage their pain better, reduce opioid use and improve their quality of life. We report the complex intervention-development approaches, the pilot process evaluation, and the patient-facing material required.

UHCW Research: Shyam Balasubramanian

Age And Utilities: Issues For HTA

This paper from the Office of Health Economics investigates whether and how age affects respondents’ Time Trade-Off (TTO) and Visual Analogue Scale valuations of hypothetical EQ-5D health states using data from the 1993 MVH UK valuation study. 

A key finding is the existence of an inverse U-shaped age-utility pattern, with respondents in their forties tending to provide the highest TTO values, and the oldest respondents valuing health profiles systematically (and significantly) lower than younger age groups. This trend is particularly visible for profiles describing problems in the mobility or the self-care dimensions.

New study to look at improving rehabilitation of older people following discharge from hospital

Researchers funded by the NIHR are conducting a five year national study looking at how rehabilitation can be improved for older people with frailty following discharge from hospital after an acute illness or injury.

The study, known as HERO (Home-based Extended Rehabilitation of Older people), Led by Dr Andrew Clegg (the Academic Unit of Elderly Care and Rehabilitation (AUECR), University of Leeds based at Bradford Teaching Hospitals), will involve 718 older people with frailty admitted to hospital following acute illness or injury. Participants will be recruited across 10 hospitals within Yorkshire and the South West of England over 23 months in total, with recruitment staggered to accommodate an internal pilot. The overall aim is to investigate whether an extended rehabilitation programme using a home-based exercise intervention developed for older people with frailty improves health-related quality of life.

Hope for those stuck in mental health institutions

There is a chink of light that could transform the lives of thousands of people with learning disabilities, needlessly stuck in mental health institutions away from homes, families and communities. On Wednesday, the public affairs committee will hear from Simon Stevens, head of NHS England, and others, on reducing the number of people with learning disabilities in mental health hospitals to improve their quality of life.

Predictors of satisfaction and quality of life following post‐mastectomy breast reconstruction

Psycho-Oncology, March 6, 2017. http://dx.doi.org/10.1002/pon.4397

Objective Breast reconstruction is associated with multiple psychological benefits. However, few studies have identified clinical and psychological factors associated with improved satisfaction and quality of life. This study examined factors, which predict satisfaction with breast appearance, outcome satisfaction and quality of life following post‐mastectomy breast reconstruction.

UHCW Research:  Park, Alan ^, Skillman, Jo and McCarthy, Kate 

Providing physical activity interventions for people with musculoskeletal conditions

The report has been produced by Arthritis UK, in partnership with the Department of Health, Public Health England and NHS England. It's intended for organisations responsible for commissioning and providing local services, as well as musculoskeletal and physical activity organisations who may find it of interest.

The report highlights the importance of providing physical activity interventions for people with musculoskeletal conditions and details the resources that local authorities and commissioners can use to enable and support people with musculoskeletal conditions to be physically active.

Cumbria’s new persistent physical symptom management service – improving value for patients, the population and the NHS

The new persistent physical symptom management service (PPSS) introduced by Cumbria CCG in April 2016, offers GPs a single point of access to a biopsychosocial symptoms management service, whatever the patients’ diagnosis. Early evaluation shows it is improving access; has high patient and GP satisfaction; and there is positive improvement on core measures for Improving Access to Psychological Therapies (IAPT) depression and quality of life outcomes. Early financial indicators, whilst not the key driver, look to show measurable cost savings.

Staying put: developing dementia-friendly care and support for people with a learning disability

Voluntary Organisations Disability Group 
 
This report, written by a partnership of voluntary sector organisations, calls for the needs of people with learning disabilities and dementia to be better addressed. It focuses on how best to support the growing numbers of people with the condition. It is based on recent work with care providers aiming to improve the quality of life of people with a learning disability and dementia, and the challenges to this goal.

• Report
• Voluntary Organisations Disability Group - press release

Long-term oxygen therapy shows no benefit for moderate lung disease

Long-term oxygen therapy for 16 hours per day did not lengthen life or the time until hospital admission for people with stable chronic obstructive pulmonary disease (COPD) who experience a moderate drop in blood oxygen levels with exercise or at rest. Nor did it improve their quality of life, lung function or anxiety and depression scores.

From the NIHR Dissemination Centre

Barrett's oesophagus patients attending hospital: Baseline clinical, patient history and quality of life data from BOSS and AspECT

European Journal of Surgical Oncology, November 2016, Volume 42, Issue 11, Page S223-S224

From 2005 to 2011 two large UK studies recruited 6327 evaluable patients with Barrett's Oesophagus attending hospital clinics. Baseline clinical, patient history and quality of life data was collected prior to randomisation and this rich dataset is the basis for this abstract.

UHCW Research: Jankowski, Janusz

Stoma accessories and quality of life

BJN 24(Sup 17) p. S22. DOI: http://dx.doi.org/10.12968/bjon.2015.24.Sup17.S22

UHCW Research: Abby Barnwell

Supported self-management improves quality of life and self-belief after stroke

Training people to take an active role in managing the consequences of their stroke improves their quality of life.

This Cochrane review pooled data from 14 trials comparing supported self-management with control interventions in people who had experienced a stroke one month to a year previously and lived in the community. Participants varied in their level of disability after stroke.

From the NIHR Dissemination Centre

NHS England reports on first year of the national cancer strategy

The national cancer strategy sets an ambitious task for the NHS: to make significant progress in reducing preventable cancers, increasing cancer survival and improving patient experience and quality of life by 2020.

NHS England’s progress report shows that rapid progress has been made in a number of areas

Flushing your nose with salt water may be moderately useful for symptoms of sinusitis

Nasal irrigation seems moderately effective for symptoms of sinusitis. People using nasal irrigation showed greater improvement in their sinus-related quality of life compared to people who didn’t use irrigation. They were also less likely to use over-the-counter medicines, and to have spent fewer days unwell with symptoms by six months.

From the NIHR Dissemination Centre