Summer is here and time for a new issue of the BJPCN – packed full of
useful information and news from the respiratory and allergy world.
We cover a lot of different topics in the main articles this month – from
pleural effusions to angioedema, from asbestosis to urticaria. A scan
through the summaries of the latest research in the Evidence in Practice
section will reveal interesting studies with dogs, trees and alcohol! Have
a great read.
Education for Health – Pioneering Primary Care Education 1987-2007
Over the past 20 years, Education for Health and its previous organisation The National Respiratory Training Centre, has provided immensely valuable training support for primary healthcare professionals, particularly in the management of long-term diseases. From small beginnings the organisation has developed into a world leader in nurse training and is actively sharing UK quality and […]
Why Optimise Inhaler Technique in Asthma and COPD?
Asthma UK estimates that 2.1 million patients in the UK are suffering unnecessarily because
they do not use their asthma treatment effectively. This article looks at how inhaled
therapies are deposited in the lungs, and at the basic differences between inhalers – with
a focus on optimising inhaler technique.
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.
Representative sampling – take your pick
How to Manage Sleep Apnoea in Primary Care
The NICE Technology Appraisal of continuous positive airway pressure (CPAP) published in
March 2008 has led to dramatically increased referrals for sleep apnoea in most areas.
Together with the National ‘Referral to Treatment’ (RTT) 18-week target, there is mounting
pressure on Primary Care Trusts to identify patients with obstructive sleep apnoea (OSA).
This article describes how OSA can be identified and diagnosed, and how CPAP can be managed in
primary care.
Editorial
It’s birthday celebrations all round. We are celebrating the 20th anniversary
of the General Practice Airways Group (GPIAG). Founded in 1987 as a small
respiratory special-interest group of six general practitioners, the GPIAG
has developed and grown into the largest primary care specialist society in
the UK. It is also coming up to the first birthday of the journal – and we are
hoping that we are giving you a useful ‘goody bag’ of ‘party gifts’ to take
back to your practice after reading this issue.
What is Bronchiectasis?
Bronchiectasis is characterised by abnormal, permanent distortion and dilation of one or more of the medium-sized bronchi (>2 mm). It occurs most commonly as a consequence of infection or inflammation. Although relatively uncommon, bronchiectasis is an important and probably under-diagnosed condition and it often coexists with COPD. Accurate diagnosis and appropriate management are needed to reduce the symptoms that patients experience. Primary care professionals need to be alert to the signs and symptoms of bronchiectasis to ensure quick referral to specialist services.
Which drugs are contraindicated for asthma patients
One person in every five households in the UK is receiving treatment for asthma,
according to latest figures. As well as treatment for asthma, many of these individuals
also self-medicate for minor illnesses or require prescribed medication for other
conditions. It is important that the drugs they take do not adversely affect their asthma
control. In this article we review which drugs might cause problems in patients also taking
treatment for asthma.
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.
Preventing and Treating COPD Exacerbations
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are common and
have serious implications. They greatly reduce patients’ quality of life and often result
in hospital admissions. Acute exacerbations of COPD are the largest single cause of
emergency respiratory admissions and each exacerbation results in an average hospital
stay of 10.3 days. In this article we review what causes exacerbations in patients with COPD and
how you can help to prevent and treat them effectively.
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.
