Medical Centre

Copper intrauterine devices (copper-IUDs) are safer, more effective and cheaper than hormonal contraceptive methods and are the most widely used reversible contraception in the world. However, they are underused in developed countries. In an article published recently In Contraception , Myat Arrowsmith and colleagues from Imperial College London reviewed randomized controlled trials and controlled before-and-after studies to determine the effectiveness of interventions for improving uptake of copper-IUDs. Nine studies representing 7960 women met our inclusion criteria, including seven randomized controlled trials and two controlled before-and-after studies. Meta-analysis from three studies showed contraceptive provision by community workers doubled uptake of IUD, and studies on antenatal contraceptive counselling showed similar increases. One study reported major increases in IUD uptake with postnatal couple contraceptive counselling; a study on postnatal home visits and two studie...

In an article published recently in the journal Psychology, Health & Medicine , Michelle Van Velthoven and colleagues from Imperial College London reviewed the scope, effectiveness, acceptability and feasibility of the use of mobile phone messaging for HIV infection prevention, treatment and care.  They reported that the use of mobile phone messaging had been evaluated for HIV prevention, appointment reminders, HIV testing reminders, medication adherence and for communication between health workers. They also reported that of three randomized controlled trials assessing the use of short message service (SMS) to improve medication adherence, two showed positive results. Other interventional studies did not generally provide significant results. They concluded that there was limited evidence on the effectiveness of mobile phone messaging for HIV care and that this area of medical practice would benefit from additional high-quality studies.

Financial incentives may help improve the delivery of smoking cessation interventions in primary care. However, UK have generally not examined the impact of financial incentives on disparities in the delivery of smoking cessation interventions. In a paper published recently in the Journal of Public Health , Fiona Hamilton and colleagues examined associations between disease group [cardiovascular disease (CVD), respiratory disease, depression or none of these diseases], ethnicity and smoking outcomes following the introduction of the Quality and Outcomes Framework in 2004. They found that significantly, more CVD patients had smoking status ascertained compared with those with respiratory disease (89% versus 72%), but both groups received similar levels of cessation advice (93% and 89%). Patients with depression or none of the diseases were less likely to have smoking status ascertained (60% for both groups) or to receive advice (80 and 75%). Smoking preval...

Medical technology has developed rapidly in recent in recent decades and there is now real potential to apply these technological developments to improve the quality, safety and efficiency of healthcare worldwide. In a report published in the leading medical journal, The Lancet , Peter Howitt and colleagues from Imperial College London examine how medical technology should best be used to improve health in low- and middle-income countries. The report concludes that in many cases, medical technology — almost exclusively developed in rich countries— is not appropriate for use in poorer nations . Although medical technology is making a substantial contribution to global health, there is much more that it could do if developed and applied correctly for low and middle income countries.

The increasing burden of chronic diseases, such as chronic obstructive pulmonary disease (COPD), is placing increasing strains on countries with developing health systems. In an article published in the Primary Care Respiratory Journal , Ailsa McKay and colleagues carried out a systematic review of studies investigating the prevalence of COPD in India. The authors did not identify any studies from which they could draw a rigorous estimate of the prevalence of COPD. Reliable standard estimates of chronic bronchitis were only available for rural populations. They identified four studies that gave estimated prevalences of between 6.5% and 7.7%. Smoking status was an important predictor of COPD prevalence. Residential environs, age, and domestic smoke exposure are also important, but investigation of their effect was limited by study heterogeneity. Ailsa McKay and colleagues concluded that although limited by the number and heterogeneity of studies and their unsuitability for meta-ana...