One person in every five households in the UK is receiving treatment for asthma,
according to latest figures. As well as treatment for asthma, many of these individuals
also self-medicate for minor illnesses or require prescribed medication for other
conditions. It is important that the drugs they take do not adversely affect their asthma
control. In this article we review which drugs might cause problems in patients also taking
treatment for asthma.
The changing role of the community pharmacist: COPD and asthma clinics
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.
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.
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.
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.
