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.
The breathless patient: Is it asthma or COPD?
Breathlessness is a very common problem in the patients we see in general practice, and
there is a range of possible causes. In this article – the first in a series of three looking
at how to diagnose what’s wrong with a breathless patient – we explore how to
distinguish between two of the commonest respiratory causes of breathlessness,
asthma and chronic obstructive pulmonary disease.
P-values: what are they?
P-values are commonly included in the results sections of randomised controlled trials (RCTs), but what is a p-value and
how should it be interpreted?
How to care for patients with end-stage COPD
Practice nurses often get to know their patients with chronic obstructive pulmonary
disease (COPD) very well. Over the years, they have attended for reviews, flu injections
and when they have exacerbations. Nurses get to know their families as well as the
patient, and it can be hard to observe the inevitable deterioration as the condition
progresses. This article will outline some of the key issues for practice nurses when their patients
start to have frequent hospital admissions or cannot attend the surgery for reviews. Has their
condition become palliative, and what can practice nurses contribute to their care?
Editorial
The year is racing by – autumn is already upon us! It’s a time which fills me
with great expectations, with memories of starting a new academic year at
school or university. Many of you may still be experiencing this through your
children! I love the feeling of opening a clean ‘exercise book’! Some of you
may even be contemplating starting up studies again. The Education for Health
graduation ceremony is being held in October; it is one of the most thrilling
events in our academic calendar – seeing the smiles on the faces of the
mature graduates and their families as they attain awards that they never felt
would be possible! Let them be an inspiration to you all; it is never too late to
start! Our team here at Education for Health would be delighted to discuss any
programmes you might be interested in.
Lung Cancer: Diagnosis and Therapy
There are over 37,000 new cases of lung cancer each year in the UK and it is the most common cancer in males and second most common after breast cancer in females. The role of the multidisciplinary team is essential in the management of these patients and it is important for all members of the team to know the signs to look for and actions to take in cases of suspected lung cancer. This article reviews the current methods of diagnosis and treatments available for lung cancer and the role of the primary healthcare professional.
What is a ‘double-dummy’ trial?
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.
The 30-second intervention for smoking cessation
Primary healthcare staff are in an influential position when it comes to helping people to
stop smoking. They clearly understand the dangers of smoking and have access to
excellent smoking cessation services. In addition, the recent public smoking legislation
has given many smokers added motivation to stop (See Prevention in Practice, BJPCN
December 2008). However, there is much still to be done. This article recommends an easy and
effective brief intervention for primary healthcare professionals to help patients towards the
most effective way to stop – support and pharmacotherapy.
Oxygen Therapy for COPD: How to use it Safely
Oxygen therapy for patients with chronic obstructive pulmonary disease (COPD) has
recently been hitting the headlines, because major changes in its supply – using
independent contractors – introduced last year initially caused problems in some areas.
In this article, we review why some patients with COPD need oxygen therapy, when it
should be used and how to use it safely.
