Obesity is, quite literally, the big health problem of the 21st century, with rapidly increasing rates in both adults and children. In this article we explore why obesity is such a challenge and the role of primary healthcare professionals in addressing the problem. We try to unravel the wide range of factors that cause obesity before focusing on why people eat what they do and how we can help patients to review their eating habits, introduce changes to eat more healthily and then sustain those changes.
Swollen ankles: preventing, detecting and managing oedema
It is Friday afternoon and, checking your screen, you see your last free appointment has been given to a patient you have seen in the past for routine blood tests. This time when she enters the room you observe that her legs are covered with what looks like kitchen roll, and she is wearing supermarket carrier bags over her feet to protect her shoes. For many of us, this is a ‘heart sink’ patient – with heavy, wet and oedematous legs that are difficult to manage. To be able to manage this type of condition we first need to understand the possible causes of oedema, to identify patients who may be at risk for developing the problem, and to be aware when early intervention could be of benefit.
What is the evidence for statins in the secondary prevention of stroke?
The Stroke Association estimates that about 150,000 people suffer a stroke in the UK each year. Stroke is the third commonest cause of death in developed countries and the leading cause of disability. So can we reduce this burden? In this article, we look at the evidence for statins in the secondary prevention of stroke.
Back to Basics: Urine tests for renal function
Urine tests for renal function: What tests detect different levels of damage?
Venous thrombosis and thromboembolism
Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major public health problem affecting around 100 per 100,000 population per year and causing thousands of deaths annually. Large population-based studies have shown that factors associated with hospitalisation account for half of the attributable risk of VTE.
When to use aspirin in CVD prevention: acting on the latest evidence
What’s new in the BTS guidelines for emergency oxygen use in adult patients?
This brief article summarises some of the key points in the recent oxygen guideline
that are of particular relevance to health professionals working in primary care.
It includes the appropriate monitoring of patients with asthma and COPD as well as
the correct equipment required. For full information on the guideline refer to
www.brit-thoracic.org.uk – emergency oxygen guidelines.
The Challenges of Scoring QOF Points for Asthma and COPD
The Quality and Outcomes Framework (QOF) is now well into its third year and continues
to expand boundaries of quality domains within chronic disease management. In this
article we review some of the challenges in QOF indicators for asthma and COPD and
suggest some tips to make the requirements easier to achieve in daily clinical practice.
Piecing Together the Clues: Diagnosing Asthma in Adults and Older Children
Accurate diagnosis is the fundamental principle underlying effective management of
any condition. Without a correct diagnosis it is not possible to recommend
appropriate treatments, provide relevant educational information or to establish
effective collaborative partnerships between health professionals and patients. In
this article, we provide a ‘how to’ guide to diagnosing asthma. Like a detective, you have to
piece together the clues – including history, lung function and response to treatment – to solve
the diagnosis.
How to do an asthma review
UK primary care health professionals work under increasing demands and time
pressures. While a large proportion of their workload is demand-led (ie by patients
presenting with specific clinical problems), a significant amount of the work relates to
ongoing monitoring and care of patients with chronic illness. While most practices in
the UK achieve a high level of points in the Quality and Outcome Framework (QOF) for caring for
patients with asthma, the standard of the reviews for these patients may not reach a level
recommended in national and international guidelines. A structured approach may, therefore, be
helpful in ensuring quality of care for these patients. This article describes an approach to
reviewing patients with asthma, whether they present in surgery acutely, for follow-up of
uncontrolled episodes or for routine review.
Editorial
Welcome to the first edition of 2008 and my first as Editor in Chief. I want to
thank Jan Procter-King, my predecessor, who has performed an outstanding
role and left the journal in a robust position. I would also like to thank the
members of the Editorial Board – in particular those who have left us or
joined since the last edition. Education for Health (formerly the National
Respiratory Training Centre) has a long reputation in respiratory disease and
we are delighted to be bringing this expertise to the BJPCN Editorial Board.
The Use of Pulse Oximetry in Primary Care
Pulse oximetry is now in common use in all healthcare settings. Until recently regarded as a secondary care device, the pulse oximeter is now routinely used in primary care, both in the general practice surgery and in the community. It can be useful in initial assessment, ongoing monitoring, and in both acute and chronic clinical situations. This article examines the how, when, what and why of pulse oximetry.
