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Summary of guidance relevant to general practice published in October 2010

  • Nocturnal enuresis
  • Liraglutide for type 2 diabetes
  • Denosumab for osteoporotic fractures
  • Omalizumab for asthma
  • Case history to support the implementation of guidance on lower urinary tract symptoms in men

Nocturnal enuresis

GPs should offer support, assessment and treatment to all children and young people under 19 with bedwetting, tailored to their circumstances and needs. Note that children under 7 should not be excluded from the management of bedwetting on the basis of age alone.

Advice on fluid intake and toileting patterns should be offered and GPs should encourage positive rewards for agreed behaviour (for example, using the toilet before going to bed and drinking during the day), either alone or in conjunction with other treatments for bedwetting.

An alarm may be offered to children whose bedwetting has not responded to other treatments, where appropriate.

Desmopressin may be offered if an alarm is inappropriate or undesirable, or if rapid-onset or short-term improvement in bedwetting is a priority. Children that do not respond to desmopresin should be referred.

GPs with experience in managing bedwetting might also consider offering anticholinergics or imipramine.

The guidance 'Nocturnal enuresis: the management of bedwetting in children and young people' is available on the NICE website.

Support tools to help put this guidance into practice.

We have prepared:

  • a slide set which would be useful to promote discussion of this guidance at a practice meeting
  • a baseline assessment tool will help you to assess where current services need to be changed or updated to comply with the guidance
  • audit support identifies audit criteria and a data collection sheet to help plan a practice audit
  • costing statement and costing template to help you to identify the costs and savings of putting this guideline into practice
  • guide to resources relating to this guideline and to the Constipation in children and young people guidance (CG99)

Liraglutide for type 2 diabetes

NICE recommends liraglutide taken at a dose of 1.2 mg once a day as a possible treatment for some people with type 2 diabetes, but does NOT recommend its use at the higher dose of 1.8mg once a day.

The guidance 'Liraglutide for the treatment of type 2 diabetes mellitus' is available on the NICE website.

NICE has prepared a costing template and audit support to help you to implement this guidance

Denosumab for osteoporotic fractures

Postmenopausal women who are at increased risk of osteoporotic fractures may be treated with denosumab if treatment with alendronate and either risedronate or etidronate is unsuitable.

The guidance 'Denosumab for the prevention of osteoporotic fractures in postmenopausal women' is available on the NICE website.

NICE has provided a costing statement and audit support to help you to implement this guidance.

Omalizumab for asthma

NICE does not recommend omalizumab (Xolair) for the treatment of severe persistent allergic asthma in children aged 6-11 years.

Children currently receiving omalizumab should have the opportunity to continue treatment until it is considered appropriate to stop.

The guidance 'Omalizumab for the treatment of severe persistent allergic asthma in children

aged 6 to 11 years' is available on the NICE website.

NICE has provided a costing statement and audit support to help you to implement this guidance.

Case history to support the implementation of guidance on lower urinary tract symptoms in men

An interactive case history, designed to help GPs to implement our guideline on ‘Lower urinary tract symptoms in men', is now available on our website.

View this case history and our other education resources

This page was last updated: 17 February 2011

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.