Clinical Knowledge Summaries (CKS): new topics and updates

 NICE Clinical Knowledge Summaries (CKS) topics are aimed at healthcare professionals working in primary and first contact care in the UK. The 370 topics cover 1000 clinical presentations or patient scenarios and are free to access.

The following CKS topics have been created or updated over the past months:

April: 

• Platelets – abnormal counts and cancer is a new CKS topic. The evidence base has been reviewed in detail, and recommendations are clearly justified and transparently linked to the supporting evidence.
• Itch – widespread. The sections on management of itch of known and unknown cause have been merged to avoid repetition of text. The recommendations have been updated in line with current evidence in the literature. The recommendations on prescribing oral antihistamines have been amended to consider the use of non-sedating oral antihistamines first line unless there is a history of troublesome nocturnal itch. New sections on Cetirizine, Loratadine, and Fexofenadine have been added to the section on Prescribing information.
• Contraception – progestogen-only. The topic structure has been changed and updated in line with FSRH guidance. Drug interaction of the levonorgestrel intrauterine system (LNG-IUS) with Esmya® (ulipristal acetate 5 mg) has been removed.
• HIV infection and AIDs. Recommendations on post-exposure prophylaxis have been updated in line with the British Association for Sexual Health and HIV (BASHH) UK Guideline for the use of HIV Post-Exposure Prophylaxis 2021.

May:

• Chronic pain is a new CKS topic. It is based on the NICE guideline Chronic Pain (primary and secondary) in over 16s.
• 'Hypertension - not diabetic' has been renamed to 'Hypertension'.
• Immunizations – pneumococcal - The topic has been aligned with the Public Health England publication Immunisation against infectious disease — The Green Book Chapter 25: Pneumococcal, and some minor structural changes have been made.

June:

• Atrial fibrillation - updated to align with the updated NICE guideline Atrial fibrillation NG196 and includes the recommendation to use the ORBIT bleeding risk assessment tool when considering starting anticoagulation in people with atrial fibrillation, and that a direct oral anticoagulant should be used first-line in people considered to be at risk of stroke.
• Multiple topics (Cervical screening, Cervical cancer and HPV, Shingles, Hepatitis B, Glandular fever, Chest infections, Platelets, Seborrhoeic dermatitis, Psoriasis, Diarrhoea, Candida, CKD, HIV infection and AIDs) - updated to highlight HIV indicator conditions in line with the British HIV Association/British Association for Sexual Health and HIV/British Infection Association Adult HIV testing guidelines.
• Hypothyroidism - prescribing advice about patients who experience symptoms on switching between different levothyroxine products has been added to this topic in line with MHRA advice.
• Conjunctivitis – infective – a recommendation that use of chloramphenicol eyes drops is contraindicated in children aged under 2 years has been added.