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Guideline Watch

June 7, 2019

These clinical guidelines were recently released:

 

Updated Recommendations for Diabetes and Chronic Kidney Disease

The American Diabetes Association released updated recommendations for adults with type 2 diabetes and chronic kidney disease based on evidence from the CREDENCE trial. Key recommendations include:

  • Urinary albumin and estimated glomerular filtration rate (eGFR) should be assessed at least annually in all patients with type 2 diabetes, in patients with type 1 diabetes for greater than 5 years, and in all patients with comorbid hypertension.

  • Consider addition of sodium-glucose cotransporter 2 inhibitor or glucagon-like peptide 1 receptor agonist in patients with type 2 diabetes to reduce chronic kidney disease progression and cardiovascular events.

  • Continue to monitor urinary albumin-to-creatinine ratio in patients receiving an angiotensin converting enzyme inhibitor or angiotensin receptor blocker for albuminuria.

More Information.

 

AMA Opioid Task Force Recommendations for Policymakers

The American Medical Association (AMA) released recommendations for policymakers on how to improve access to treatment for patients with opioid use disorder. Key recommendations include:

  • Remove prior authorization, step therapy, and other inappropriate administrative barriers that delay or deny care.

  • Remove administrative and other barriers to comprehensive pain care and rehabilitation programs.

  • Support the assessment, referral, and treatment of co-occurring mental health disorders.

  • Support reform in the civil and criminal justice systems that ensure access to high-quality evidence-based care.

More Information.

 

AHA Recommendations to Reduce CVD Risk in Patients with HIV

The American Heart Association (AHA) released a new scientific statement on preventing and managing cardiovascular disease (CVD) in patients with human immunodeficiency virus (HIV). Key recommendations include:

  • Atherosclerotic CVD (ASCVD) risk should be assessed via a risk calculator in all patients with HIV, being mindful that certain risk factors (such as hepatitis C coinfection, metabolic syndrome, fatty liver disease, low CD4 count, prolonged HIV viremia, or initial antiretroviral therapy delayed) may put a patient at higher risk than the ASCVD calculation indicates.

  • Concomitant use of antiretroviral therapy and simvastatin or lovastatin should be avoided due to drug interactions.

More Information.