Making Best Practice, Every Day Practice
The management of AF is one of the most rapidly evolving areas of primary care today. How will these changes alter management in the coming months?
Dr Frances Akinwunmi
Consultant Pharmacist (Anticoagulation), Imperial College Healthcare NHS Trust
Professor David Fitzmaurice
Professor of Primary Care, University of Birmingham
Dr Matthew Fay
GP and National Clinical Lead for Atrial Fibrillation, Westcliffe Medical Centre, Shipley
Are they all the same? What are the risks?
Dr Frances Akinwunmi
Consultant Pharmacist (Anticoagulation), Imperial College Healthcare NHS Trust
Professor David Fitzmaurice
Professor of Primary Care, University of Birmingham
Dr Matthew Fay
GP and National Clinical Lead for Atrial Fibrillation, Westcliffe Medical Centre, Shipley
Dr Patrick Kesteven
Consultant Haematologist, Freeman Hospital, Newcastle-upon-Tyne
What are the issues which need to be considered? What are the priorities? Are there pitfalls?
Alison Tennant
Head of Service Improvement and Quality, Dudley Clinical Commissioning Group
There is a Danish proverb that states ‘Better to ask twice than lose your way once’. Unfortunately however, in my opinion, people living with diabetes – especially those with type 2 diabetes – do not question their healthcare professionals enough about what they can expect from living with the condition. This is especially true in the area of hypoglycaemia – or low blood sugar.1 We often attribute diabetes with high blood sugar, but many people don’t appreciate the potential dangers of letting their blood sugar get too low.
High blood pressure is undoubtedly the major modifiable risk factor for cardiovascular disease (CVD). However, despite advances in management, it remains inadequately managed. Across Europe, only about one in four of treated patients achieve guideline-recommended targets for blood pressure. This has important consequences for increasing the risk of CVD, kidney disease, microvascular disease, as well […]
Measuring blood pressure (BP) is one of the commonest tests we carry out in primary care – generally taking several measurements with a digital BP monitor on at least two clinic visits before diagnosing hypertension. Ambulatory blood pressure monitoring (ABPM) has traditionally been used in secondary care hypertension clinics, and in some larger general practices. But new guidelines from the National Institute for Health and Clinical Excellence are making ambulatory monitoring part of routine practice for the diagnosis of hypertension in primary care. What are the new guidelines recommending and why the change to ABPM?
It is clear that hospital admission causes many preventable deaths from venous thromboembolism (VTE) yet the general public and, I would suggest, primary care health workers, still think of air travel as the main risk factor. Is there a role for primary care in helping to reduce the numbers of patients with hospital-acquired VTE?
People with advanced kidney disease are required to make many choices about their treatment throughout the journey of this disease. Opting not to have dialysis or to withdraw from treatment is a difficult decision and there are many factors that influence patients’ decisions. For those who choose not to have dialysis, the implications need to be understood by the patient, their family and carers and healthcare professionals involved in their care. This article provides an update on this important issue to equip primary care professionals with a clear understanding of end-of-life care for patients with advanced kidney disease.
Chronic kidney disease (CKD) is a multifaceted disease that has several associated complications. Anaemia is one of the most common complications that can develop early in the course of the disease process. It is associated with increased mortality,increased hospitalisation rates, and reduced quality of life. Lower levels of kidney function are associated with lower haemoglobin (Hb) levels and a higher prevalence and severity of anaemia.
Over the past five years there have been dramatic changes to the way in which people with chronic kidney disease (CKD) are being managed in primary care. As a result of policy changes there are now many more people with CKD being identified, especially those with stage 3A. This article deals with one of the most important issues for healthcare professionals when caring for people with early CKD – how to tell people that they have the condition and how to best manage it.
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