A recent study concluded that in general practices providing NHS Health Checks, the change in reported prevalence of diabetes, hypertension, coronary heart disease (CHD) and chronic kidney disease (CKD) does not differ from practices that provide usual care. Although the study was not randomised and was not powered to support this conclusion, it is of interest because it raises a number of important questions about the delivery of the NHS Health Check.
Flu jabs: Why you should be the first person on your list
The 2013 measles epidemic in Wales came as a salutary reminder of the importance of immunisation in preventing communicable diseases. Similarly, it took an outbreak of bird flu in 2010 to act as a wake-up call for people who had become somewhat laissez-faire about protecting themselves against the influenza virus. In this article we look at the dangers of flu, why the immunisation programme is important, and what you can do to reduce the impact of the flu bug on your patients’ health and well-being.
CVD mortality: A retrospective audit of disease registers
A retrospective audit of premature deaths (aged under 75) from cardiovascular disease (CVD) in Leeds showed that patients diagnosed with CVD and placed on disease registers lived on average eight years longer than patients who had not been diagnosed prior to their deaths. If innovations like the NHS Health Check can be used to identify CVD patients in a more equitable manner, there is likely to be a major impact in reducing premature mortality with the potential to reduce health inequalities for disadvantaged groups in the population.
Why do we need new options for managing FH?
In patients with both homozygous and heterozygous familial hypercholesterolaemia (FH), statins with or without ezetimibe are now the mainstay pharmacological therapy for lowering low-density lipoprotein cholesterol (LDL-C) levels, combined with lipoprotein apheresis in homozygotes and statin-refractory heterozygotes. These therapies have helped to improve outcomes, but new treatment options areurgently needed, as FH patients continue to be at high risk of premature death due to cardiovascular disease (CVD).
HEART UK – The Cholesterol Charity – has provided editorial support and review of this sponsored FH series.This article was made possible by an unrestricted educational grant by Sanofi, who had no control over content.
Caring for patients following PCI and stents
Most people with coronary heart disease (CHD) can be managed with lifestyle change and optimal medical therapy, but some patients need revascularisation procedures such as angioplasty with stenting (percutaneous coronary intervention [PCI]). These patients spend minimal time in hospital, and GPs have an increasingly important role in follow-up to minimise the risk of adverse events, promote lifestyle change and ensure continuing adherence to medication.
Patient perspectives on AF management: high satisfaction, but could do better
Patient satisfaction with treatment is a key component of the successful management of chronic conditions such as atrial fibrillation (AF). In the EUropean Patient Survey in Atrial Fibrillation (EUPS-AF) survey, UK patients reported the highest rates of satisfaction with their healthcare system and quality of care. However, only about half of UK patients reported receiving regular anticoagulation testing and about one third had never or rarely had a medication review. This survey provides important insights into the current provision of care that should be taken into account when designing and commissioning patient-centred AF services.
The management of familial hypercholesterolaemia
Homozygous familial hypercholesterolaemia (FH) is a rare disorder with a very high risk of premature cardiac death that must be diagnosed and treated from childhood onwards, usually with lifelong lipoprotein apheresis. Heterozygous FH is much commoner, with a high risk of cardiovascular disease in adults that can be prevented by early diagnosis and statin therapy.
HEART UK – The Cholesterol Charity – has provided editorial support and review of this sponsored FH series.This article was made possible by an unrestricted educational grant by Sanofi, who had no control over content.
Telemonitoring for heart failure: experience of the Gloucestershire Telehealth Programme
Remote monitoring is an emerging model of care in heart failure (HF) which has been shown to be clinically beneficial. In this study, patients were recruited to a new telemonitoring programme after referral to a community HF service. Following enrolment, there was a 58% reduction in the risk of HF admissions (0.71 vs. 0.30 per year, p<0.001). During the programme patients received, on average, nine home visits, eight telephone calls and three clinic appointments per person per year.
A primary care guide to alcohol and health
It has become increasingly clear that many people in this country are putting themselves at risk because they are continuing to drink above their recommended weekly units. Most of these people are not drunk drivers in police cells or antisocial drinkers arriving at A&E departments on Saturday night. They are people who come to see […]
IFC resource
Alcohol Concern is the national charity on alcohol misuse for England and Wales, campaigning for effective alcohol policy and improved services for people whose lives are affected by alcohol-related problems.
Editorial: A healthier approach to alcohol
It has become increasingly clear that many people in this country are putting themselves at risk because they are continuing to drink above their recommended weekly units. Most of these people are not drunk drivers in police cells or antisocial drinkers arriving at A&E departments on Saturday night. They are people who come to see us at our chronic disease clinics or for treatment for an acute illness. The inclusion of questions about alcohol in NHS Health Checks is the ideal opportunity to discuss the potential risks of excessive drinking, and this special issue explains how we can help patients to choose a healthier approach to alcohol.
Dying for a drink: alcohol across the lifespan
We are a nation with an alcohol-induced dichotomy: we have a love affair with alcohol but are increasingly aware of its dangers. The pub has been a cornerstone of our society, providing a source of relationships and artistic imagination. However, our nation’s favourite drug is also responsible for as many life-years lost as tobacco, but with additional psychological and socio-economic costs.
