Cochrane review: oxycodone for neuropathic pain

24th August 2016

The previous Cochrane review on oxycodone for neuropathic pain and fibromyalgia has been split into separate reviews and the use of oxycodone for neuropathic pain has been updated. The authors have concluded that there was very limited evidence that oxycodone (as oxycodone m/r) may provide moderate benefit (equivalent to a 30% reduction in pain) to people with painful diabetic neuropathy or postherpetic neuralgia. There was no evidence for other neuropathic pain conditions.

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NICE call for evidence for End of Life Care service delivery

24th August 2016

NICE are requesting information for the guideline they are developing on End of Life Care for adults in the last year of life, specifically, on service delivery models to:

• identify people who may be entering the last year of their life
• support people to stay in their preferred place of care (e.g. out of hours services)
• facilitate smooth transitions between care settings (e.g. discharge planning teams)
• facilitate continuity and coordination of care (e.g. multidisciplinary team working)
• reduce inappropriate/avoidable hospital admissions (e.g. community health services and telehealth)
• facilitate discharge back to the community from other settings (e.g. rapid discharge pathways) 

The deadline for submission is 19 September 2016.

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Cochrane review: codeine versus placebo for cough in children

24th August 2016

In this new review, the authors conclude that codeine and its derivatives should not be used for cough in children <12 years (as recommended in many national guidelines). The rationale for this is:

• there is currently no published RCT and thus no evidence on the efficacy of codeine (or codeine derivatives)-based medications as antitussives in improving clinical outcomes for chronic cough in children
• there are documented risks associated with the use of these medications, and children are particularly at risk
• there is a high degree of variability in codeine-morphine metabolism in children, with the potential undesirable effects of respiratory suppression and opioid-toxicity  
• the underlying aetiology should be defined, rather than the cough empirically treated. 

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