In this paper, we summarise previously reported findings from the MY-WAIST study, which aimed to evaluate a primary care strategy for identifying people with undiagnosed type 2 diabetes or at increased risk of developing this condition. Recruitment was unexpectedly low, but the qualitative data collected, including interviews with healthcare providers, helped to highlight some of the reasons for poor uptake of the appointments offered. Perceived barriers to recruitment included heavy workloads and competing demands in primary care. Lower uptake in people from harder-to-reach groups was identified in our quantitative findings and was also suggested by healthcare providers’ perceptions about the characteristics of patients who attended.
Coherent management of diabetes, weight & cardiometabolic risk
Successful management of individuals with diabetes, or any other single component of the metabolic syndrome, requires treatment of all the related physiological systems as a whole. This treatment must be underpinned by the management of obesity, and drugs should be preferred that address the entire portfolio of the metabolic syndrome.
The importance of early diagnosis: how to identify patients with FH for diagnosis and referral
Familial hypercholesterolaemia (FH) is under-diagnosed and under-treated, despite clear evidence-based guidelines for identification and management, and the availability of low-cost, generic, high-intensity statin treatment. Genetic cascade testing is the key to early diagnosis, which can help ensure that this treatment is no longer ‘too little, too late’.
HEART UK – The Cholesterol Charity – has provided editorial support and review of this sponsored FH series.This article was made possible by an unrestricted educational grant by Sanofi, who had no control over content.
The ESH/ESC guidelines for the management of arterial hypertension
There still remains a significant gap between the goal of optimal treatment of hypertension and ‘real life’ practice. As a consequence, hypertension remains a leading cause of cardiovascular related morbidity and mortality. There is a continuing need to improve both the detection and management of hypertension, with a view to improving the efficacy of treatment including lifestyle interventions and outcomes. In order to address these issues. The European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) have recently published guidance on the management of arterial hypertension.
Hypertension: an evidence update
Since the publication of the National Institute for Health and Clinical Excellence (NICE) clinical guidance (CG 127) on the management of hypertension in adults two years ago, new evidence has been published which is relevant to – and potentially has an impact on – the guideline recommendations. This evidence is presented and reviewed in the following article.
Regional variation in treatment: the London effect
This study shows that people living in London have better treatment rates with lipid lowering drugs than the general population. This observation may be explained in part by the fact that London is a highly mobile population, so new patient checks are more common.
Liver health in prisoners: an opportunity for care
The prison population in the UK tends to have several risk factors for the development of chronic liver disease. Prison provides a stable environment, which often enables thorough health assessment, monitoring and stabilisation of substance misuse, management of chronic disease and mental health issues, and treatment for viral hepatitis to be performed.
Moving with the times
“Doctors are and should be natural leaders, and part of the skill of being a leader is to work with other leaders in the intricate network of the National Health Service- Sir John Grugeon, hospital doctor, 5th July 1988.
Statins, side-effects and missed opportunities
“I like to think of medicine in our day as an ever-broadening and deepening river, fed by the limpid streams of pure science-
Christian A. Herter (1865-1910), US neurologist, New York.
Cardiovascular disease risk prediction in the UK: which is the best risk prediction model?
Identifying those people at an increased risk of cardiovascular disease (CVD) who might benefit from a therapeutic intervention or lifestyle advice is an important challenge. We summarise here the performance of QRISK2 against the NICE version of the Framingham Risk Score.
NHS Health Checks: time to raise awareness about dementia
The NHS Health Check is changing again. Since the beginning of April 2013, practice nurses have been expected to raise the issue of dementia when seeing patients aged 65-74. But why (I can hear you ask)? Surely we have enough to do! This article explains why dementia matters, and sets out your role in the NHS Health Check.
ENHANCE HF™: optimising the management of heart failure in primary care
Heart failure (HF) imposes a significant burden across the UK, both for patients and the NHS. Optimal management of HF could improve patient outcomes and reduce costs for clinical commissioning groups (CCGs). HF is, however, complex to manage, and despite recent improvements there is evidence of a continuing lack of adherence to guideline recommendations. Enhance HF™ is a tool that supports GPs in optimising the management of HF due to left-ventricular systolic dysfunction to help deliver more costeffective care for patients in their practice.
