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Two weeks in primary care...News Roundup

The fortnightly roundup of key political and clinical news for primary care and community nurses.

Cancer treatment

Breast cancer drug expense 'unjustifiable'

Guidelines published by NICE have said that a treatment for secondary breast cancer, Kadcyla, is too expensive to provide on the NHS.

The drug, also known as trastzumab emtansine, is currently available to breast cancer sufferers via the government's Cancer Drugs Fund. However, when this scheme ends in 2016, the drug will become unavailable on the NHS, due to the £90,000 per patient cost it incurs.

Kadcyla is intended for women with HER2-receptor-positive breast cancer which has spread around the body. It works by seeking out and destroying cancer cells from within, making it unlikely to cause the side effects usually associated with chemotherapy. During trials, the drug extended the lives of patients by 5.8 months on average, according to the manufacturers.

Dr Caitlin Palframan, policy officer at Breakthrough Breast Cancer, said: 'It appears NICE will be forced to reject these cutting-edge treatments, some of which are capable of providing women facing terminal breast cancer diagnoses with extra time with their loved ones, which is the very least they deserve.'

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Multiple sclerosis

MS patients in Northern Ireland 'left behind'

Multiple sclerosis (MS) sufferers in Northern Ireland are being 'left behind' as new treatments are introduced, according to the MS Society.

The charity is launching a new initiative, called 'Treat Me Right', to encourage patients and healthcare professionals to discuss treatment as new options are introduced.

Director of operations at the MS Society, Patricia Gordon, said: 'People with MS face increasingly complex decisions about which treatment is best for them. It is therefore essential that our health service is more responsive, enabling everyone with MS to have more regular reviews with neurologists to ensure they have timely access to the right treatment at the right time.'

Leadership and management

QNI chief executive earns doctorate in education

Crystal Oldman, chief executive of the Queen's Nursing Institute (QNI), has received a doctorate in education (EdD) from The Open University for research into management and leadership in higher education.

Ms Oldman embarked on the study and research for the EdD five years ago before she started her role at the QNI. She said that she was 'relieved and happy' to have completed the doctorate.

Ms Oldman said: 'Working towards the doctorate has given me a depth of understanding of leadership and management that are not context dependent. The research discipline can be applied to evidence-based practice and innovations. The leadership element will help me identify and promote the rising stars of community nursing through QNI schemes. My findings around recruitment of and supporting managers will allow me to strengthen the QNI and its input into community and practice nursing.'

Ms Oldman previously worked in nursing higher education.

Drug guidance

New guidance on domperidone

The Medicines and Healthcare Products Regulatory Agency (MHRA) has issued guidance stating that the drug domperidone should never be prescribed to people with serious heart conditions, following a European review.

The drug, used to treat nausea and vomiting, should no longer be used in the treatment of heartburn or stomach discomfort, and should only be taken for the shortest possible duration in the minimum effective amount. The advice also recommends that adults do not take more than three 10mg tablets a day.

The review also found that taking the drug may contribute to a small increase in the risk of serious ventricular arrhythmias or sudden cardiac death.

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Heart disease

Air pollution and cardiovascular disease

The Committee on the Medical Effects of Air Pollutants (COMEAP) has announced it will review and update its previous work on the links between air pollution and cardiovascular disease.

COMEAP originally published work in 2006 on the relationship between cardiovascular disease and increased air pollution. The findings from this report support the need for further analysis of the effects of air pollutants on hospital admissions for the treatment of cardiovascular disease and reductions in life expectancy.

The announcement follows an increase in the level of air pollution in England's bigger cities.

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