Making Best Practice, Every Day Practice
The UK faces an epidemic of heart failure (HF). NICE guidelines emphasise the importance of multidisciplinary assessment and care by HF specialists, evidence-based prescribing, and careful discharge planning after hospitalisation. This article highlights areas where improvements can be made in the management of HF including taking lessons from the latest National Heart Failure Audit.
This issue introduces a first-in-class oral treatment for heart failure – sacubitril/valsartan. It provides a comprehensive background to heart failure treatment in the UK, the pathophysiology of the disease and the pivotal trial data on the new drug. Articles give perspectives on the role of the GP, practice nurse, pharmacist and commissioner in using the […]
A number of drug classes are used in the treatment of patients with heart failure. This illustrated Back to Basics poster describes the various drugs and their mechanisms of action to give health care professionals and their patients a greater understanding of heart failure management and where sacubitril/valsartan fits into the picture.
This useful Back to Basics poster describes the damaging changes that take place in three key body systems when HF with reduced ejection fraction is left untreated. The sympathetic nervous system, the renin-angiotensin-aldosterone system and the natriuretic peptide system all undergo significant pathophysiological changes as HF progresses.
The ‘Year of Care’ is a systematic approach to managing long-term conditions, focused on personalised care planning where patients work with the clinician to agree goals, identify support needs, develop and implement action plans, and monitor progress. This article reports the learning from implementing ‘Year of Care’ in primary care practices in Leeds.
Dr David Haslam, chair of the UK’s National Obesity Forum, provides a useful review of SGLT-2 inhibitors and their ability to lower glucose level, body weight and blood pressure in people with type 2 diabetes.
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.
Abnormal proliferation of placental tissue inside the uterus leads to a spectrum of rare benign and malignant lesions that include molar pregnancy and together constitute gestational trophoblastic disease (GTD). GTD can be challenging to diagnose, and primary healthcare professionals should be aware of its signs and symptoms to ensure prompt and appropriate referral.
Heart failure (HF) imposes a significant burden across the UK, both for patients and the NHS. Optimal management of HF could improve patient outcomes and reduce costs for clinical commissioning groups (CCGs). HF is, however, complex to manage, and despite recent improvements there is evidence of a continuing lack of adherence to guideline recommendations. Enhance HF™ is a tool that supports GPs in optimising the management of HF due to left-ventricular systolic dysfunction to help deliver more costeffective care for patients in their practice.
This supplement was developed in conjunction with and its production paid for by Merck Sharp & Dohme Limited.
Echocardiography (ECHO) is the “gold standard” test in the diagnosis of heart failure. Brain natriuretic peptide (BNP) can be helpful to rule outpatients who do not require ECHO. This study used an elevated level of Nterminal prohormone BNP (NT-proBNP) as a criterion for referral to a new community heart failure clinic. Results showed that NT-proBNP could be a useful test in the management of heart failure. The researchers propose to institute age- and sex-related cut-offs to refine its place in the patient care pathway.
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