Making Best Practice, Every Day Practice
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Was it me? Did I blink and miss the spring? There I was, trying to plan my
early initiation of inhaled steroids and nasal sprays to ward off seasonal
exacerbations of allergic rhinitis and asthma but spring just doesn’t seem
to have sprung this year! It made me wonder whether the wet weather
had an influence on hay fever levels.
Interstitial lung disease (ILD) is a general term for a number of diseases characterised by
progressive pulmonary fibrosis or ‘scarring’ of the lungs. The term fibrosis implies formation
of abnormal connective tissue within the lung parenchyma. These diseases are less
commonly seen in primary care than airways diseases such as asthma and COPD. However,
like COPD, they produce progressive debilitating breathlessness for the patient. It is important
that practice nurses, particularly those with an interest in respiratory diseases, are aware of this
group of diseases and their management as early referral to specialist care is important.
Chronic obstructive pulmonary disease (COPD) is the term used to describe a range of
chronic chest conditions, including chronic bronchitis and emphysema. COPD is
characterised by permanent damage to the lungs and as the condition develops, people
experience increasing breathlessness, to the point where even everyday activities such
as getting dressed or walking up stairs become difficult. This article describes the impact of
COPD, explores the value of exercise in COPD management and discusses possible reasons for its
widespread under-use as effective symptom control.
One person in every five households in the UK is receiving treatment for asthma,
according to latest figures. As well as treatment for asthma, many of these individuals
also self-medicate for minor illnesses or require prescribed medication for other
conditions. It is important that the drugs they take do not adversely affect their asthma
control. In this article we review which drugs might cause problems in patients also taking
treatment for asthma.
The BJPCN interviewed Dr Steve Holmes (Chairman of the GPIAG) and
Stephanie Wolf (GPIAG General Committee member) on the 20th anniversary
of the organisation.
This year there is more reason than ever for people to stop smoking, with the ban on
smoking in public places coming into force in July. How can we support smokers
who want to quit? In this article, we provide a comprehensive guide to resources
that can help.
Bless you for your support and best wishes for my fifth London Marathon that took place in
late April. My chosen charities this year (Arrhythmia Alliance, www.arrhythmiaalliance.org.uk
and Stars, http://stars.org.uk) are special for me as I have had a pacemaker for ten years. It
was a surprise to be informed that I would have a new box fitted just three weeks before the
Marathon. However those of you who know me would know that would not stop my attempt!
But there are times when even I have to admit defeat! After completing over half the course in
two hours, I decided to let my heart rule my head for once and bail out gracefully before I
collapsed from heat exhaustion! When I was overtaken by a large carrot I knew it was going
to be a real struggle!
The current treatment of asthma in the UK is rightfully seen as a triumph of chronic disease management within a primary care setting. Almost all routine asthma care and, increasingly, elements of acute asthma care, are now provided in general practice. Over the past twenty years, significant effort and investment have gone into the production […]
What a winter we have had! Many children have seen heavy snow fall for the
first time and London was completely immobilised due to the weather. At the
same time our hospitals have been battling to cope with patients suffering with
respiratory infections and exacerbations of their COPD. GP practices have been
stretched to the limit to cope with the additional burden of coughs and colds.
Building capacity is a real problem for everyone working in the health service and
patients’ demands and expectations continue to grow.
This brief article summarises some of the key points in the recent oxygen guideline
that are of particular relevance to health professionals working in primary care.
It includes the appropriate monitoring of patients with asthma and COPD as well as
the correct equipment required. For full information on the guideline refer to
www.brit-thoracic.org.uk – emergency oxygen guidelines.
Modern medical practice emphasises the use of objective measurements and
evidence. Nobody would diagnose hypertension without measuring the blood
pressure, or manage diabetes without measuring blood sugar and glycated
haemoglobin. Yet it is only relatively recently that any lung function
measurements to support diagnosis and guide management of respiratory disease were
undertaken in primary care.
Patients with recurrent pleural effusions have, to date, mainly been cared for in hospital.
Many have had to undergo repeated hospital admissions, extended hospitalisation,
discomfort and time away from home. This is particularly the case in patients with
recurrent malignant pleural effusion (MPE). However, new technologies mean that these
patients may be managed by close co-operation between primary and secondary care. This
article describes some exciting developments in the management of pleural effusions in a PCT.
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