We continue our series of articles on research concepts by explaining what ‘double-dummy’ trials are and why researchers
use them to compare medications that are delivered using different types of inhalers.
What is a ‘double-dummy’ trial?
What do Patients Want from Asthma Therapy?
More than half of people with asthma in the UK have inadequate symptom control,
despite the range of effective therapies now available. Rather than blaming
patients when they fail to take their medications as prescribed, we need to
examine the way we conduct asthma consultations and ask whether we are failing
to meet the needs of individual patients. How can we gain greater understanding about what
people with asthma want from healthcare professionals and treatments, so we can achieve a
more patient-centred approach to care?
What are my responsibilities as a practice nurse?
The role of nurses working in the National Health Service has undergone major development
in recent years with new roles and expansion of skills into new areas which has included
respiratory care. However, as always, an increased role demands increased responsibility
and this article examines the key legislation affecting practice nurses, and how they can
reduce the risk of medico-legal action.
Useful techniques to manage breathlessness
Although breathlessness is a complex symptom, appropriate management in primary
care can be very rewarding, and does not have to rely on complex, hi-tech
interventions. This article discusses the rationale behind the practical interventions
that practitioners in primary care can consider.
Urticaria and angioedema
Allergic diseases such as hayfever and allergic asthma are becoming increasingly common
in westernised countries such as the United Kingdom, with an estimated 25% of the
population now suffering from some form of allergic condition. Urticaria and angioedema
are commonly thought of as allergic problems although in general only acute symptoms
are related to allergen exposure. Here we discuss the diagnosis and management of urticaria and
angioedema in primary care, with particular focus on identifying allergic triggers and managing
long-term symptoms successfully.
Tuberculosis
Cases of tuberculosis (TB) have been increasing over the past few years, with recent data
from the Health Protection Agency showing a rise of 2% from 2005 to 2006 in England,
Wales and Northern Ireland, following a rise every year since the late 1980s. Although
London continues to account for the highest proportion of cases – 42% – there have
been outbreaks throughout the country. In this article, we review the cause, pathology, clinical
investigations, diagnosis and management of TB.
Treatments for Hayfever
Over the next few months practice nurses are likely to see many patients with hayfever
(also known as seasonal allergic rhinoconjunctivitis). Although it may appear to be a
minor complaint, hayfever can result in considerable suffering for the individual, who
may or may not seek professional help and advice. Practice nurses play an important
role in improving the management of this condition. In this article, we describe the impact of
hayfever on patients and provide a comprehensive review of the treatments currently available
for hayfever.
Travel tips for patients with respiratory conditions and allergy
Many of your patients will be planning their holidays, but some may be worrying
unnecessarily about their respiratory condition. There are a host of resources and
information available for them, and practice nurses can make sure they provide the
right information about travelling with asthma, COPD or allergies. This article
provides practical tips on how best to advise patients who are thinking of going on holiday.
Thunderstorm Asthma
On 23 June 2005, the Met Office issued a warning that severe thunderstorms were likely
to hit the South East of England in the next 24 hours. On the evening of Friday 24 June,
primary care out-of-hours services and hospital accident and emergency departments
in Northwest London were inundated by patients attending with acute asthma. The
scale of these attendances – eight times more patients than usual in one hospital – meant that
departments had to call in additional staff and some ran out of emergency supplies of
bronchodilators, nebulisers and oral steroids for treating asthma. In this article, we will explain
the background and some of the theories related to this type of epidemic of acute asthma –
Thunderstorm Asthma.
The role of Beta2 agonists in managing asthma
Beta agonists are the only class of drugs that is recommended for the management of
asthma at every level of current guidelines, including those from the British Thoracic
Society (BTS). This means that they are used across the spectrum of severity of
asthma, from mild intermittent disease (step one) to severe asthma symptoms (step
five). In this article, we take you through the key things that you – and your patients – need to
know about these drugs.
The Null Hypothesis: There’s Nothing to it
The Evaluation and Management of Cough in Adults
Cough as a symptom results in significant impairment of quality of life for patients. Its
wide and varied causes and presentations make diagnosis and management complex.
Many sets of guidelines have been produced to help clinicians in the evaluation and
management of acute and chronic cough. This article uses the British Thoracic Society
(2006) guidelines to provide a summary of the evaluation and management of cough.
