BJPCN Archive

Cystic fibrosis (CF) is the most common inherited genetic disease in the UK.
Improvements in both diagnosis and treatment over the last 30 years have resulted in
increased survival with children born in the 1990s now likely to live into their forties.
Although much of the treatment is delivered in hospitals, healthcare professionals in
primary care should be aware of management principles and understand the impact of the
condition on patients and their families. This article provides an overview of CF and shows how
to support patients and families in primary care.

Cough is a common presenting symptom in primary care. It has a prevalence of 30% in
the general European population, and in a US National Medical Case Survey in 1991
cough was the commonest presenting complaint. Between 10% and 38% of all new
patient referrals to UK hospital chest clinics are for chronic cough. This article covers
the physiological nature of cough and its role as an essential protective reflex, focuses on the
differential diagnosis of cough in general practice in both adults and children, and discusses the
use of treatment as a diagnostic tool.

The image of community pharmacy and the role of the community pharmacist have changed
substantially over the past 5-10 years. Things are set to keep changing with the newly
published White Paper for pharmacy in England and the continued restructuring of the
health service in Scotland. The community pharmacist’s role will become much more
integrated into the multi-professional care of patients.

Although the use of asbestos in this country has been tightly controlled for over 30 years
the incidence of asbestos-related lung diseases has increased dramatically over the
last few years. It is expected that this increase will continue during the next decade.
This article describes some of the different lung diseases caused by asbestos and their
management, and provides a useful clinical background to the issues for healthcare workers in
primary care.

Anxiety is a significant problem for many patients with respiratory disease and can have
a very negative impact on the disease course and prognosis. Practice nurses have an
important role to play in identifying anxiety and referring patients for appropriate
treatment. This article will focus on anxiety in such patients and aims to help you
understand what anxiety is, how anxiety affects patients, how to recognise symptoms of anxiety
and how to use the Hospital Anxiety and Depression Scale. A second article, to be published in
the next issue, will focus on management of anxiety.

Anticholinergic drugs are bronchodilators that act by blocking acetylcholine, the
neurotransmitter for the parasympathetic nervous system. By blocking parasympathetic
stimulation, anticholinergics reduce cholinergic tone, therefore producing
bronchodilation. In this article we review when and how these drugs should be used.
What are their potential benefits and what should we tell patients who need them?

Interstitial lung disease (ILD) is a general term for a number of diseases characterised by
progressive pulmonary fibrosis or ‘scarring’ of the lungs. The term fibrosis implies formation
of abnormal connective tissue within the lung parenchyma. These diseases are less
commonly seen in primary care than airways diseases such as asthma and COPD. However,
like COPD, they produce progressive debilitating breathlessness for the patient. It is important
that practice nurses, particularly those with an interest in respiratory diseases, are aware of this
group of diseases and their management as early referral to specialist care is important.