Anxiety is a significant problem for many patients with respiratory disease and can have
a very negative impact on the disease course and prognosis. Practice nurses have an
important role to play in identifying anxiety and referring patients for appropriate
treatment. This article will focus on anxiety in such patients and aims to help you
understand what anxiety is, how anxiety affects patients, how to recognise symptoms of anxiety
and how to use the Hospital Anxiety and Depression Scale. A second article, to be published in
the next issue, will focus on management of anxiety.
Anticholinergics: How do they Work?
Anticholinergic drugs are bronchodilators that act by blocking acetylcholine, the
neurotransmitter for the parasympathetic nervous system. By blocking parasympathetic
stimulation, anticholinergics reduce cholinergic tone, therefore producing
bronchodilation. In this article we review when and how these drugs should be used.
What are their potential benefits and what should we tell patients who need them?
A quick guide to interstitial lung disease
Interstitial lung disease (ILD) is a general term for a number of diseases characterised by
progressive pulmonary fibrosis or ‘scarring’ of the lungs. The term fibrosis implies formation
of abnormal connective tissue within the lung parenchyma. These diseases are less
commonly seen in primary care than airways diseases such as asthma and COPD. However,
like COPD, they produce progressive debilitating breathlessness for the patient. It is important
that practice nurses, particularly those with an interest in respiratory diseases, are aware of this
group of diseases and their management as early referral to specialist care is important.
The problem with asthma…
The current treatment of asthma in the UK is rightfully seen as a triumph of chronic disease management within a primary care setting. Almost all routine asthma care and, increasingly, elements of acute asthma care, are now provided in general practice. Over the past twenty years, significant effort and investment have gone into the production […]
Symbicort® (budesonide/formoterol) Maintenance and Reliever Therapy – Symbicort SMART® – A new approach to asthma management
Nurses know from first-hand experience that although asthma treatment has come a long way over the past few years, many patients with asthma remain uncontrolled. This results in unscheduled hospital appointments for patients and unnecessary limitations on their lifestyle.
Education for Health – Pioneering Primary Care Education 1987-2007
Over the past 20 years, Education for Health and its previous organisation The National Respiratory Training Centre, has provided immensely valuable training support for primary healthcare professionals, particularly in the management of long-term diseases. From small beginnings the organisation has developed into a world leader in nurse training and is actively sharing UK quality and […]
What is Bronchiectasis?
Bronchiectasis is characterised by abnormal, permanent distortion and dilation of one or more of the medium-sized bronchi (>2 mm). It occurs most commonly as a consequence of infection or inflammation. Although relatively uncommon, bronchiectasis is an important and probably under-diagnosed condition and it often coexists with COPD. Accurate diagnosis and appropriate management are needed to reduce the symptoms that patients experience. Primary care professionals need to be alert to the signs and symptoms of bronchiectasis to ensure quick referral to specialist services.
The Use of Pulse Oximetry in Primary Care
Pulse oximetry is now in common use in all healthcare settings. Until recently regarded as a secondary care device, the pulse oximeter is now routinely used in primary care, both in the general practice surgery and in the community. It can be useful in initial assessment, ongoing monitoring, and in both acute and chronic clinical situations. This article examines the how, when, what and why of pulse oximetry.
Scoring Top Marks for Asthma QOF Indicators
Asthma is a chronic disease that has, for a long time, been the domain of primary care nurses, and many have qualifications enabling them to run nurse-led asthma clinics. It is, therefore, essential to fully understand the Quality and Outcomes Framework (QOF) and to be able to maximise the points available to the practice, at the same time as providing a comprehensive service to patients. In this article, we review the QOF indicators for asthma, strategies for optimising record keeping and performing asthma reviews.
Research Made Easy
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.
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.
