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.
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.
Vascular Risk Checks in Patients with Chronic Kidney Disease
Improving Organ Donation Registration in Primary Care
Organ transplants can save or dramatically improve lives, yet figures for 11 February 2009 showed there were 7,903 people in the UK still on waiting lists for transplants, with the majority waiting for a kidney transplant. Last year, more than 400 people died while on the transplant waiting list.
Back to Basics: Timetable of tests for chronic kidney disease
Editorial
Chronic kidney disease (CKD) has moved rapidly up the healthcare agenda over the last few years. It has shifted from being considered as a rather nebulous condition of interest mainly to nephrologists to the front line of chronic disease detection and prevention in primary care as part of integrated management of vascular risk. In fact, the links between cardiovascular disease, kidney disease and diabetes are so close that CKD could also stand for ‘cardiovascular, kidney, diabetes.’