Associated symptoms of nausea, photophobia and phonophobia, a

\n\nAssociated symptoms of nausea, photophobia and phonophobia, and functional disability were reduced within two hours, and similar numbers of participants experienced adverse events, which were mostly mild and transient.\n\nThere were insufficient data to evaluate other doses of oral diclofenac, or to compare different formulations or different dosing regimens; only one study compared oral diclofenac with an active comparator (oral sumatriptan 100 mg).\n\nAuthors’ conclusions\n\nOral diclofenac potassium 50 mg is an effective

treatment for acute migraine, providing relief from pain and associated symptoms, although only a minority of patients experience pain-free responses. Adverse events are mostly mild and transient and occur at the same rate as with placebo.”
“Objective To determine the extent find more to which computerised decision support can improve concordance of multidisciplinary teams with therapeutic decisions recommended by guidelines.\n\nDesign Multicentre cluster randomised trial.\n\nParticipants Multidisciplinary cardiac rehabilitation teams in Dutch centres and their cardiac rehabilitation

patients.\n\nInterventions Teams received an electronic patient record system with or without additional guideline based decision support.\n\nMain outcome measures Concordance with guideline recommendations assessed for SRT2104 concentration two standard rehabilitation treatments-exercise

and education therapy-and for two new but evidence based rehabilitation treatments-relaxation and lifestyle change therapy; generalised estimating equations were used to account for intra-cluster correlation and were adjusted for patient’s age, sex, and indication for cardiac rehabilitation and for type and volume of centre.\n\nResults Data from 21 centres, see more including 2787 patients, were analysed. Computerised decision support increased concordance with guideline recommended therapeutic decisions for exercise therapy by 7.9% (control 84.7%; adjusted difference 3.5%, 95% confidence 0.1% to 5.2%), for education therapy by 25.7% (control 63.9%; adjusted difference 23.7%, 15.5% to 29.4%), and for relaxation therapy by 25.5% (control 34.1%; adjusted difference 41.6%, 25.2% to 51.3%). The concordance for lifestyle change therapy increased by 3.2% ( control 54.1%; adjusted difference 7.1%, -2.9% to 18.3%). Computerised decision support reduced cases of both overtreatment and undertreatment.\n\nConclusions In a multidisciplinary team motivated to adopt a computerised decision support aid that assists in formulating guideline based care plans, computerised decision support can be effective in improving the team’s concordance with guidelines. Therefore, computerised decision support may also be considered to improve implementation of guidelines in such settings.

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