This article will discuss the evidence for the self-management of long-term conditions, with a focus on chronic kidney disease (CKD). Self-management of CKD can include activities to control and manage blood pressure (BP); changes to diet such as reduced salt intake; smoking cessation; and understanding of the action and side-effects of prescribed medicines.
Back to Basics: What goes wrong in chronic kidney disease
Vascular Risk Checks in Patients with Chronic Kidney Disease
Improving Organ Donation Registration in Primary Care
Organ transplants can save or dramatically improve lives, yet figures for 11 February 2009 showed there were 7,903 people in the UK still on waiting lists for transplants, with the majority waiting for a kidney transplant. Last year, more than 400 people died while on the transplant waiting list.
Back to Basics: Timetable of tests for chronic kidney disease
Choosing the Right Pharmacotherapy to Help Patients Stop Smoking
Most smokers want to stop smoking and intend to stop at some point, according to research. Nearly half of all smokers expect not to be smoking in a year’s time, but only two to three in every hundred actually stop smoking permanently each year. It is widely recognised that healthcare professionals have an important role to play in helping patients to stop smoking, but what is the best way to achieve this?
C-reactive Protein (CRP): an Emerging Marker of Cardiovascular Risk
The major risk factors for cardiovascular disease (CVD) include high blood pressure, dyslipidaemia,diabetes, and smoking, all of which can be managed with lifestyle and therapeutic interventions. C-reactive protein is emerging as a useful new risk marker.
How to Use Brief Motivational Interviewing
Helping people to change risky behaviour is notoriously difficult, but brief motivational interviewing has been found to be helpful. In this article, we look at the research supporting this patient-directed counselling style and how to use it in clinical practice.
Anticoagulation in Practice: Why it Matters that the Dose of Warfarin is Spot On
More and more nurses in primary care are involved in monitoring international normalised ratio (INR) levels and advising patients on warfarin doses as anticoagulation clinics move out of secondary care and into primary care. In this article we explore why warfarin is prescribed, how to monitor patients on the drug and what to look out for in terms of interactions with prescribed medicines, over-the-counter drugs and foods. We also need to be able to advise on lifestyle interventions that go hand-in-hand with taking warfarin.
Postural Hypotension
As we aim for tighter and tighter blood pressure control to minimise the cardiovascular complications of diabetes,the risk of postural hypotension increases. In this article we discuss what postural hypotension is and how to identify it and confirm diagnosis. We also consider the main causes and the relationship between diabetic neuropathy and postural hypotension as well as prevention and treatment strategies.
Editorial
This spring is an important time for the prevention and management of cardiovascular disease in the UK. The new vascular risk assessment and management programme, now known as the NHS Health Check, starts in April. And it’s the fifth birthday of the British Journal of Primary Care Nursing! So close your eyes and make a wish, and we hope we can play some part in making it come true.
Impaired Glucose Tolerance: What it is and How to Manage it
The new national strategy for vascular risk assessment, now being referred to as NHS Health Check, will include testing for diabetes and impaired glucose tolerance (IGT). This follows a major evaluation of the evidence showing that it is more cost-effective to screen individuals for IGT than screening for diabetes alone, but only as part of the broader vascular risk assessment. This article examines the concepts of IGT and impaired fasting glucose (IFG) and offers practical advice as to how these conditions can be managed in primary care.
