Working with patients who are not willing to engage fully with healthcare services is a common occurrence. The process requires patience and a focus on providing the patient with full information about their condition and then allowing them to make decisions about their treatment. Here, Dr Terry McCormack (GP and Cardiovascular Lead, North Yorks) describes the approach of his practice to a man with hypertension.
Case study: Nurse COPD assessment
This case describes a 56-year old male with a productive cough and worsening breathlessness who presented to a practice nurse. This case study was part of a Health Assessment module at the University of Surrey. The case study was supervised by a GP.
Case study: Painful diabetic peripheral neuropathy
This case study describes the diagnosis and management of 55-year old man with painful diabetic peripheral neuropathy. He is already receiving treatment for his diabetes but is experiencing burning pain in the soles of his feet, especially at night when lying in bed. He has paresthesia and numbness in toes and his sleep is interrupted because of his condition. He also presents with depression and has a number of diabetic complications and co-morbidities.
Case study: Statin intolerance in a patient with high cardiovascular risk
This case study presents a challenging everyday clinical situation for you to review with guidance from an expert in the field.
Case study: Atrial fibrillation
This case study describes the diagnosis and management of atrial fibrillation (AF) in a 70-year old obese male who was referred for cardiac assessment after developing shortness of breath, which had worsened progressively over the previous three months. The case study highlights the role of thromboembolic risk reduction which is the cornerstone of AF management and which can only be achieved with proper anticoagulation.
New NICE guideline on liver disease
A new NICE guideline provides valuable information on the assessment and management of non-alcoholic fatty liver disease (NAFLD) caused by a build-up of fat in the liver.
Improving anticoagulation in patients with atrial fibrillation
A new case study shows the significant reduction in atrial fibrillation-related stroke incidence achieved using the GRASP-AF audit tool. The case study, highlights improvements in key measures including a 4% reduction in the number of patients treated inappropriately, a 5% increase in the use of oral anticoagulation therapy and a 10% reduction in AF-related strokes.