We continue our series on the changing role of the community pharmacist, with an article
from Alpana Mair in Edinburgh describing the work of a pharmacist in COPD and asthma
clinics based on her experience.
Preventing and Treating COPD Exacerbations
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are common and
have serious implications. They greatly reduce patients’ quality of life and often result
in hospital admissions. Acute exacerbations of COPD are the largest single cause of
emergency respiratory admissions and each exacerbation results in an average hospital
stay of 10.3 days. In this article we review what causes exacerbations in patients with COPD and
how you can help to prevent and treat them effectively.
How to Manage Sleep Apnoea in Primary Care
The NICE Technology Appraisal of continuous positive airway pressure (CPAP) published in
March 2008 has led to dramatically increased referrals for sleep apnoea in most areas.
Together with the National ‘Referral to Treatment’ (RTT) 18-week target, there is mounting
pressure on Primary Care Trusts to identify patients with obstructive sleep apnoea (OSA).
This article describes how OSA can be identified and diagnosed, and how CPAP can be managed in
primary care.
Editorial
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.
Research Made Easy
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.
Reducing Hayfever Havoc: Keeping Symptoms at Bay
Hayfever affects around one in ten adults, and an even higher proportion of children and teenagers. Chronic symptoms may lead to poor concentration, impaired learning ability and school absenteeism in children, amongst other problems. In the run-up to the hayfever season, therefore, it is important to identify teenagers or young adults with persistent or severe hayfever symptoms and to treat their symptoms aggressively to prevent poor performance at school and in examinations. Given that approximately 80% of patients with asthma also have rhinitis, asking your asthma patients about their possible hayfever symptoms is a good starting point.
What is IMPRESS?
In the current political and social environment, health care is changing at a frenetic pace and
nurses may feel that they are being left behind. The British Thoracic Society (BTS) and
General Practice Airways Group (GPIAG) support and represent practitioners with an interest
in secondary and primary care respectively. They have set up a joint initiative called
IMPRESS to help respiratory clinicians to understand what is going on and how to get involved.
This article gives an update on what the initiative is, how it works and what it’s done so far.
