Smoking will be banned in public places in England and Wales next year, in line with bans already in place in Scotland and Ireland. PCTs are likely to experience an increase in demand from smokers accessing services to help them quit. It is estimated that there will be around a 50% increase over normal demand from three months before the date of implementation, with the government predicting that around 600,000 people will decide to quit as a result of the legislation. The seasonal nature of stop smoking attempts means that the period between January and April is already a very busy time. This article reviews what practices can do to ensure they are well prepared.
Editorial: COPD
Being able to take a deep breath of fresh air is something that most of us take completely for granted. But for our patients with asthma, chronic obstructive pulmonary disease (COPD), other respiratory diseases such as sleep apnoea, and allergic disorders such as rhinitis, taking a deep breath may not be so easy.
Beating Arrhythmias
Arrhythmias are extremely common. They are usually benign but their significance depends on the symptoms they cause. Some arrhythmias are more serious and can be life-threatening. In this article we clarify the causes of arrhythmias and help you sort out the different types that can occur, dividing them into the two main categories – tachyarrhythmias, where the heart rate is faster than normal, and bradyarrhythmias, where the heart rate is much slower than normal.
Blood Pressure: How Different Devices Measure Up
Organising Care For The Person Newly Diagnosed With Diabetes
The focus of diabetes care is well established in general practice, with practice nurses taking on much of the responsibility for diabetes management. The white paper Our Health, Our Care, Our Say talks about high quality care being delivered to patients close to where they live. So, in the future, general practice can expect to take on more responsibility for conditions such as diabetes. This article discusses the priorities for the newly diagnosed patient, and the importance of sound advice and guidance in the early stages.
Successful combining of antihypertensive drugs
Hypertension (high blood pressure) is estimated to affect 60-70% of people aged over 60 years of age and increases the risk of complications such as coronary heart disease, heart failure and stroke. Although it is well accepted that lowering blood pressure is crucial in reducing overall cardiovascular morbidity and mortality, the number of people whose raised blood pressure is reduced below target levels remains defiantly low. In this article, we review why so many patients fail to reach blood pressure targets and how we can improve this, including use of more than one antihypertensive.
Back to Basics: Diabetic foot guide
Nurse Prescribing: Pandora’s Box or Practical Plan?
Nurse prescribers can prescribe the full range of drugs and other items in the British National Formulary under the latest arrangements from the Department of Health. This move has been met with mixed reactions. Nurses see it as the rightful acknowledgement of their responsibilities, conferring authority commensurate with their role and enabling them to perform their role honestly and openly. In contrast, the British Medical Association, representing doctors, issued public warnings about patient safety if nurses were allowed to prescribe more freely. In this article, we review the opportunities and challenges of nurse prescribing, and explore strategies for its effective and safe implementation.
Heart Murmurs – When Are They Significant?
Heart murmurs – abnormal sounds heard through the stethoscope – are caused by turbulent blood flow in the heart or blood vessels. They can be associated with a range of conditions, including valve defects, high blood pressure and heart failure in adults and congenital heart defects in children. Patients should be investigated carefully to identify the underlying cause, which will determine treatment and prognosis. Some pathological murmurs require no treatment. If they are severe, however, surgery may be needed to correct the causative defect. Drug treatments may be indicated for some murmurs.
Editorial
I am keeping my fingers crossed as I write this that you are all having to apply sun protection factor 30 as a result of a glorious summer and that you are enjoying reading this issue of British Journal of Primary Care Nursing to the accompaniment of gently chinking ice cubes as drinks are served to you while you recline under a parasol! Well it was a nice thought!
The NICE Guidance On Statins – What’s New?
It would be easy to think that there was no more progress for statins to make. Since the publication of the landmark 4S study in the early 1990s, statins have become one of the most commonly prescribed drugs in the UK. But the recent publication of new NICE guidance on statins, and the second Joint British Societies guidance on cholesterol management for prevention of cardiovascular disease (JBS2) have changed the rules yet again. Under their recommendations, millions more patients become eligibile for statins to reduce their cholesterol.
What is New in the QOF?
The Quality and Outcomes Framework (QOF) has been a huge success and primary care in the UK is now delivering some of the best results in the world for the management of chronic disease. The Department of Health is obviously keen to continue to drive up quality in existing domains and extend the QOF to new areas of health care, with an updated list of indicators published earlier this year. In this article we explore what has changed.
