Excessive alcohol consumption has joined smoking and obesity as one of today’s major threats to public health. It is a major cause of liver disease, as well as a range of cancers, cardiovascular disease and mental illness. What’s the solution? We look at how primary care can identify patients who are drinking too much and what interventions can help.
Editorial
As practice nurses, our day at the surgery ends well when everything has gone smoothly and patients and colleagues have gone home happy. But we often feel the greatest sense of achievement when we have had to go beyond our usual routine to try a new approach to a problem, or do something that we never thought we could do.
Recognising the risk of familial hypercholesterolaemia
Familial hypercholesterolaemia (FH)—an inherited genetic defect that causes high blood cholesterol—often goes unrecognised. It is therefore under-diagnosed and poorly managed. This can have devastating repercussions for affected families, since premature deaths from heart disease can occur in people in their 40s or even younger. This article looks at the causes of FH, how to recognise those at risk and how to implement National Institute for Health and Clinical Excellence (NICE) guidance in practice.
Time to start insulin in general practice
General practices are under increasing pressure to initiate insulin in type 2 diabetes, as it would be more efficient for the health service and more convenient for most patients. There are many different approaches to starting insulin, but it is essential for practice nurses to work closely with patients and progress slowly to ensure successful and safe outcomes.
Editorial
Last time I shared my thoughts with you, I was eagerly anticipating the Department of Health’s sexual health policy document for England. Indeed, since publication was promised for spring 2012, I was worried that my comments might be overtaken by events. But the policy will now appear some time this summer, and I am concerned that the resulting delay and uncertainty mean that there may be little time to ensure that we maintain standards of local contraception and sexual health services.
Breaking the vicious cycle of chronic pelvic pain
Chronic pelvic pain presents in general practice at the same rate as asthma and back pain, and is one of the most common reasons for referral to a gynaecologist. Since chronic pelvic pain is a symptom rather than a diagnosis, a thorough history and examination are essential to avoid a sometimes vicious cycle of referrals or investigations that only cause further anxiety for the patient.
Lessons from the Contraceptive CHOICE Project
Increased use of intrauterine contraceptives (IUCs) and implants for regular contraception could significantly reduce the incidence of unintended pregnancy. It has, however, proved challenging to promote use of these long-acting reversible contraceptives (LARCs) in clinical practice. This article explains how lessons from a successful project in the USA are being used to encourage the uptake of LARCs among women in Hull.
Time to think about women with epilepsy
Each year 2,500 women with epilepsy have a baby, and before they conceive only 46% are aware that their condition could affect their unborn child. It is essential to encourage women with epilepsy to think about contraception, conception and pregnancy, and the Quality and Outcomes Framework (QOF) now includes an indicator for these very issues.
Taking the right route to ovarian cancer diagnosis
Recommendations from the National Institute for Health and Clinical Excellence (NICE) aim to prompt rapid investigation of women with patterns of symptoms suggestive of ovarian cancer. But this is just one of a plethora of guidance for primary care, and incorporating it into our daily practice remains challenging. So how should we apply the NICE ovarian cancer guidelines to our patients?
Revealing the truth about labial reduction
Increasing numbers of healthy women are asking their GPs to refer them for labial reduction. This does not just have potentially important cost implications for service commissioners. There are also considerable ethical issues for GPs to consider before referring women for this form of female genital cosmetic surgery.
Lichen sclerosus
Getting it right for our women – the Forum’s next steps
In these uncertain times for contraception and sexual health services, the voice of the Primary Care Women’s Health Forum is becoming ever more important. We have been very active in formulating our latest plans, so that we can respond to our members’ concerns and ensure that we protect services for women.
