Patient information

Managing patients with recent onset chest pain: what should we do?

Chest pain and discomfort are common symptoms that account for 1% of visits to primary care, 5% of visits to accident and emergency departments and 25% of emergency hospital admissions. Coronary artery disease (CAD) is one of many causes of chest pain and is the commonest cause of death in the UK. However, there are treatments available that can improve symptoms and prolong life, making prompt assessment and diagnosis essential. The National Institute for Health and Clinical Excellence (NICE) has recently published a new guideline on the assessment and investigation of patients presenting with acute chest pain suggestive of acute coronary syndrome (ACS) and stable chest pain suggestive of angina. It includes recommendations that will mean some changes to the way these patients are managed in practice. This article looks at how we can put these changes into action.

Involving patients in decisions about preventive medication: a focus group study

Concise consultation

Assessing cardiovascular risk in the 10-minute consultationSafia Debar, Simon de Lusignan, Juan Carlos Kaski

Cardiovascular disease is a major cause of mortality and morbidity which can be managed successfully in primary care. However, despite the quality of the evidence base and the universal use of practice-based information systems that can flag suboptimally managed patients and calculate risk for individuals opportunistically, there remains a gap in the primary care management of cardiovascular disease.

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.

Building rapport with patients: actions speak louder than words

The use of language is obviously very important in effective communication, and gives important clues as to how people make sense of the world around them, and how they understand their experiences, as we saw in an introduction to neurolinguistic programming (NLP) in the last issue of BJPCN. In this article, we will look at how to use effective body language and non-verbal communication to its fullest extent in the clinic setting.

Maximising healthcare benefits for individual patients and society as a whole

Neurolinguistic Programming: Getting to the Heart of Communication

Imagine what it would be like if you could communicate effectively with every person you meet. What would it be like to know that any messages you want to put across to your patients mean the same to them when they hear them as they mean to you? A few basic pointers in neurolinguistic programming (NLP) may help to improve how clearly you communicate with others. In this article we will look at linguistics, or the use of language, as one part of NLP and a key indicator of how people make sense of, and interpret, the world.

A spoonful of sugar: helping older patients to take their medicines

As people get older, their use of medications tends to rise and elderly patients often take a variety of medicines for an increasing number of health problems. Four in five people over the age of 75 years take at least one prescribed medication, while 36% are taking four or more, according to the 1998 Health Survey for England. How can we help our older patients to take their medicines, optimising convenience and minimising risks of non-compliance and sideeffects?

Phase II cardiac rehabilitation in primary care

Cardiac rehabilitation is an aspect of Coronary Heart Disease (CHD) management that many primary care health professionals admit to knowing relatively little about. In this article, we explore the central role of primary care in cardiac rehabilitation.

What Happens In Phase III Cardiac Rehabilitation?

The aim of cardiac rehabilitation is to help people who have had a cardiac event recover and resume as full a life as possible and help reduce the risk of further cardiac problems. The ‘cardiac hope and confidence programme’ is a good way of describing the rehabilitation process as many patients tell us that this is what they gain most from the programme. We review what happens in phase III cardiac rehabilitation and what it can achieve in practice.

Practice-Based Commissioning: Collaboration or Competition?

Practice-based commissioning – in which practices and other primary care professionals commission services for their patients – is the latest strategy designed to improve the fit between patients’ needs and service provision. In this article, we take a detailed look at why practice-based commissioning has been introduced, what it will mean in practice and how it will work with other purchasing strategies currently operating.

Practical approaches to empowering people with cardiovascular disease or diabetes

For people with long-term conditions, self-care can have as much, if not more, influence on their health than prescribed medication and treatment. Yet, in many cases, healthcare professionals become frustrated when attempts to improve peoples’ self-care behaviours prove unsuccessful. This article looks at some of the reasons why it can be difficult to encourage people with diabetes or cardiovascular disease to look after themselves effectively; what types of practice can help us to increase people’s success in managing long-term conditions; and how we can incorporate empowering techniques in our day-to-day consultations.

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