Making Best Practice, Every Day Practice
The QOF quality and productivity (QP) indicators fall into three categories: prescribing, outpatient referrals and emergency admissions. What will these new indicators mean for primary care and how might they affect the prescribing of cardiovascular drugs and referrals to secondary care ?
Ten per cent of the annual NHS budget is spent on medication, with about 75% of this is prescribed in primary care. Ensuring that this money really improves patients’ health is vitally important. As the population ages, more people require increasing numbers of medications for chronic conditions and a third of elderly patients are taking four drugs or more for a spectrum of conditions. But this creates a major challenge – as research reveals that fewer than half of these patients take their medicines as prescribed. How can this challenge be addressed? This new series will provide simple practical guidance on how to conduct an effective medication review for a spectrum of long-term cardiovascular conditions.
GTN (glyceryl trinitrate) in tablet or spray form is used for the immediate relief of chest pain due to angina. The tablets have a short shelf-life and should be thrown away eight weeks after opening the bottle. The spray lasts longer, but you need to check the expiry date on the bottle. Angina is a […]
Angina is on the increase as people live longer. It is the most common symptom of ischaemic heart disease and occurs when the arteries are no longer able to supply the heart with enough blood to meet its demands. Treatment aims to restore the balance between oxygen supply and demand, to relieve the pain as quickly as possible and prevent further angina attacks, to treat the risk factors, limit the progression of coronary artery disease and reduce the risk of a heart attack. Procoralan (ivabradine) works by specifically inhibiting the If or ‘funny’ channel in the sinoatrial node of the heart (also known as the cardiac pacemaker) to reduce the resting heart rate, matching the efficacy of beta-blockers without their side-effects.
Stable angina is very common. Just under two million people in the UK – over one million men and 840,000 women – have, or have had, angina. In this article we review how new-onset stable angina is assessed, including an update on new investigations, and the latest treatment options including drugs and interventions, based on the most up-to-date guidelines and current practice.
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.
Quality is the latest buzzword in healthcare. The latest GMS contract emphasises this in the Quality and Outcomes Framework (QOF) designed to measure and reward key elements of primary care chronic disease management. In this issue of BJPCN we start a new series – Points mean Prizes – on how to make sure you get all the ticks in the boxes for the data you need to collect to get maximum QOF points. The series will provide a step-to-step guide on how to score on the 76 quality indicators in the 10 clinical domains of care.
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