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.
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.
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.
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.
The accuracy of GP blood pressure measurements compared with 24-hour ambulatory monitoring
We evaluated the accuracy and predictive value of conventional BP measurements performed by primary care physicians in comparison with ABPM in a cross-sectional study of hypertensive patients in primary healthcare. We found that conventional BP measurements are less accurate than 24-hour ABPM.
CVD and HIV patients
We highlight in this article some of the issues on HIV and cardiovascular disease (CVD) to assist primary healthcare practitioners to improve the health outcomes, particularly in relation to CVD, of their HIV patients.
Strategies to prevent chronic kidney disease progression based on risk assessment in primary care
Chronic kidney disease (CKD) is increasing worldwide. The aim of this study was to identify factors related to progression of chronic kidney disease in a primary care service. Risk factors for progression of CKD were: diabetes, hypertension, uncontrolled systolic pressure and basal creatinine.
Cardiovascular morbidity and mortality in schizophrenia: implications for primary care
People with schizophrenia have substantial premature mortality compared to individuals without schizophrenia. They also have a wide range of co-morbidities and multiple physical health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic underrecognition and under-treatment of cardiovascular disease, which may contribute to the increased mortality seen in this vulnerable patient group.
Should high-intensity interval exercise be recommended for the prevention of long-term conditions?
There is evidence to show that high-intensity interval exercise (HIIE) can increase cardiorespiratory fitness, lower blood pressure, increase insulin sensitivity and reduce body fat. All these are important in preventing the development of type 2 diabetes and cardiovascular disease.
Why prescribe combined hormonal contraception
Renewed publicity about the risk of venous thromboembolism (VTE) with combined hormonal contraception (CHC) may encourage busy GPs to prescribe progesterone-only pills to women declining long-acting reversible contraception (LARC). This article aims to put the bad press into context, outline the lifestyle and long-term health benefits of the combined methods, and offer advice about which CHC might suit which client.
Contraception and sexual health for young people
Young people under the age of 18 present particular challenges for many health professionals, and a structured approach is essential when providing services for this age group. Health professionals have a responsibility to provide information in an approachable manner on all methods of contraception, including long-acting reversible contraception (LARC), and the prevention and testing of sexually transmitted infections (STIs). Professionals also need to be able to accurately assess a young person and undertake safeguarding as needed.
Early pregnancy loss: can we improve our practice?
The majority of pregnancies progress successfully, but some result in a miscarriage or in an ectopic pregnancy. About two-thirds of the related maternal deaths are associated with substandard care due to late or missed diagnosis. Recent NICE guidelines aim to improve outcomes for women, and this article provides practical information on how the new recommendations impact on day-to-day practice in primary care.
