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Agilio: Diagnosis and Treatment Guidance November 2025 Update

This update contains 8 significant changes and 11 minor changes.

Significant changes:

  • Anticoagulation – oral —reviewed. A literature search was conducted in May 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to clinical recommendations have been made.
  • Contraception – progestogen-only methods — reviewed. A literature search was conducted in June 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to recommendations have been made. Minor changes have been made to align with updated guidance from the College of Sexual and Reproductive Healthcare (formerly known as the Faculty of Sexual and Reproductive Healthcare).
  • Diabetes – type 1 — reviewed. A literature search was conducted in June 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. The recommendations have been updated in line with evidence in current literature, including the use of diabetes-specific autoantibody testing in adults at diagnosis, and when to suspect hypoglycaemia. The sections on insulin therapy, self-monitoring of blood glucose, and management of hypoglycaemia have been removed, and links to the Prodigy topic on Insulin therapy in Type 1 diabetes have been provided.
  • Earwax — reviewed. A literature search was conducted from September to October 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No significant changes to clinical recommendations have been made.
  • HIV infection and AIDS — reviewed. A literature search was conducted in August 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last version of this topic. The topic has been restructured for clarity, and recommendations have been updated in line with current evidence and guidance.
  • Mental health in students — reviewed. A literature search was conducted in August 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. There have been minor structural changes to the topic, updates to the background information, and basis for recommendation sections in line with the identified literature.
  • Osgood-Schlatter disease — reviewed. A literature search was conducted in September 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of this topic. No major changes to recommendations have been made.
  • Tennis elbow — reviewed. A literature search was conducted in August 2025 to identify evidence-based guidelines, UK policy, systematic reviews, and key randomized controlled trials published since the last revision of the topic. No major changes to recommendations have been made.

 

Minor changes:

  • Anaemia – iron deficiency— minor update. Added information about normal haemoglobin and low ferritin levels in menstruating pre-menopausal women who may benefit from referral for intravenous iron therapy, when symptomatic.
  • Antenatal care – uncomplicated pregnancy — minor update. The information about which immunizations to discuss at the booking appointment has been updated to include respiratory syncytial virus (RSV), and COVID vaccination has been removed as pregnant women are no longer included in the vaccination programme.
  • Bipolar disorder — minor update. Typographical error corrected.
  • Cellulitis – acute — minor update. Added information on drug interaction between rifampicin and doxycycline.
  • Chronic obstructive pulmonary disease — minor update. Changes have been made to the recommendation on when to consider referral to a specialist in respiratory medicine to consider starting oral prophylactic antibiotic therapy in line with NICE guideline Chronic obstructive pulmonary disease in over 16s: diagnosis and management and the British Thoracic Society Guideline for the use of long-term macrolides in adults with respiratory disease.
  • Hypertension — minor update. Removed interaction between calcium channel blockers and theophylline and aminophylline to align with the BNF drug monograph.
  • Leg ulcer – venous — minor update. Added information on drug interaction between rifampicin and doxycycline.
  • Rosacea — minor update. Added information on drug interaction between rifampicin and doxycycline.
  • Sensory neuropathy — minor update. The information that a serum protein electrophoresis with immunofixation test can be considered for people with sensory neuropathy has been moved to the section on additional investigations.
  • Sinusitis — minor update. Added information on drug interaction between rifampicin and doxycycline.
  • Urethritis – male — minor update. Added information on drug interaction between rifampicin and doxycycline.
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