Cases of tuberculosis (TB) have been increasing over the past few years, with recent data
from the Health Protection Agency showing a rise of 2% from 2005 to 2006 in England,
Wales and Northern Ireland, following a rise every year since the late 1980s. Although
London continues to account for the highest proportion of cases – 42% – there have
been outbreaks throughout the country. In this article, we review the cause, pathology, clinical
investigations, diagnosis and management of TB.
Treatments for Hayfever
Over the next few months practice nurses are likely to see many patients with hayfever
(also known as seasonal allergic rhinoconjunctivitis). Although it may appear to be a
minor complaint, hayfever can result in considerable suffering for the individual, who
may or may not seek professional help and advice. Practice nurses play an important
role in improving the management of this condition. In this article, we describe the impact of
hayfever on patients and provide a comprehensive review of the treatments currently available
for hayfever.
Travel tips for patients with respiratory conditions and allergy
Many of your patients will be planning their holidays, but some may be worrying
unnecessarily about their respiratory condition. There are a host of resources and
information available for them, and practice nurses can make sure they provide the
right information about travelling with asthma, COPD or allergies. This article
provides practical tips on how best to advise patients who are thinking of going on holiday.
Thunderstorm Asthma
On 23 June 2005, the Met Office issued a warning that severe thunderstorms were likely
to hit the South East of England in the next 24 hours. On the evening of Friday 24 June,
primary care out-of-hours services and hospital accident and emergency departments
in Northwest London were inundated by patients attending with acute asthma. The
scale of these attendances – eight times more patients than usual in one hospital – meant that
departments had to call in additional staff and some ran out of emergency supplies of
bronchodilators, nebulisers and oral steroids for treating asthma. In this article, we will explain
the background and some of the theories related to this type of epidemic of acute asthma –
Thunderstorm Asthma.
The role of Beta2 agonists in managing asthma
Beta agonists are the only class of drugs that is recommended for the management of
asthma at every level of current guidelines, including those from the British Thoracic
Society (BTS). This means that they are used across the spectrum of severity of
asthma, from mild intermittent disease (step one) to severe asthma symptoms (step
five). In this article, we take you through the key things that you – and your patients – need to
know about these drugs.
The Null Hypothesis: There’s Nothing to it
The Evaluation and Management of Cough in Adults
Cough as a symptom results in significant impairment of quality of life for patients. Its
wide and varied causes and presentations make diagnosis and management complex.
Many sets of guidelines have been produced to help clinicians in the evaluation and
management of acute and chronic cough. This article uses the British Thoracic Society
(2006) guidelines to provide a summary of the evaluation and management of cough.
The effects of the weather on COPD
Those of us working with patients suffering from COPD know anecdotally that cold
weather directly impacts exacerbation rates and hospital admissions in the same way
as thunderstorms affect those with asthma (see BJPCN Vol 1, Issue 2, March 2007).
This article explores the links between COPD and weather patterns. You may not want
to be thinking about the winter but action now should give time to put preventive systems in
place to help at-risk patients before the cold weather appears again.
The changing role of the community pharmacist: COPD and asthma clinics
We continue our series on the changing role of the community pharmacist, with an article
from Alpana Mair in Edinburgh describing the work of a pharmacist in COPD and asthma
clinics based on her experience.
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.
The breathless patient: Is it asthma or COPD?
Breathlessness is a very common problem in the patients we see in general practice, and
there is a range of possible causes. In this article – the first in a series of three looking
at how to diagnose what’s wrong with a breathless patient – we explore how to
distinguish between two of the commonest respiratory causes of breathlessness,
asthma and chronic obstructive pulmonary disease.
The 30-second intervention for smoking cessation
Primary healthcare staff are in an influential position when it comes to helping people to
stop smoking. They clearly understand the dangers of smoking and have access to
excellent smoking cessation services. In addition, the recent public smoking legislation
has given many smokers added motivation to stop (See Prevention in Practice, BJPCN
December 2008). However, there is much still to be done. This article recommends an easy and
effective brief intervention for primary healthcare professionals to help patients towards the
most effective way to stop – support and pharmacotherapy.
