Working with patients who are not willing to engage fully with healthcare services is a common occurrence. The process requires patience and a focus on providing the patient with full information about their condition and then allowing them to make decisions about their treatment. Here, Dr Terry McCormack (GP and Cardiovascular Lead, North Yorks) describes the approach of his practice to a man with hypertension.
The 2012 ESC guidelines on heart failure, published only two years after the updated NICE guideline, spell out therapeutic advances about which doctors need to be aware. They include recommendations on mineralocorticoid receptor antagonists (MRAs), ivabradine and cardiac resynchronisation therapy (CRT).
Look before you leap: do patient care plans improve the secondary prevention of heart disease in general practice?Mark Davis
Mark Davis reviews a recent primary care study assessing the impact that tailored care and care plans can have on the secondary prevention of heart disease. Murphy AW, Cupples ME, Smith SM et al. Effect of tailored practice and patient care plans on secondary prevention of heart disease in general practice. BMJ 2009; 339: B4220.