"There has been recent media coverage around appropriate hormone replacement therapy (HRT) dosing, and subsequent focus in medical journals. The debate has become polarised and women's health is being impacted. I want to provide an explanation so we can all do our
Bipolar disorder (BPD) is a severe mental illness characterised by significant and sometimes extreme changes in mood and energy, which go far beyond most people’s experiences of feeling a bit down or happy. Carolyn Chew-Graham and colleagues offer an update.
Careful, caring and person-centred application of guidance is required to ensure patients benefit from, and are not harmed by, healthcare. I’d like to talk about Joan, an 86-year-old lady who had rarely visited the surgery. We threw the guidelines at her...
Adnan Saad and colleagues provide an easy-to-use 'crib sheet' for commonly issued disease-monitoring drugs in general practice ...
Ask any doctor, and they’ll tell you that talking to patients can be difficult. Mind you, ask any patient and they’ll tell you that talking to doctors can be really difficult too. Ben Hoban discusses how we address the problem.
Imagine having to relive the moment you are told that you have a life-limiting illness every time you need support; every time you feel vulnerable because of a physical or mental complaint that needs attention. Emilie Couchman argues for meaningful informational continuity.
Cyclothymia, a mood disorder, can result in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Here, Carolyn Chew Graham and colleagues define the illness and outline how best to identify, diagnose, and manage cyclothymia in patients
When someone asks you whether you’re telling them it’s all in their head, the most accurate answer is: Yes, but isn’t everything?
"When [the animation was] presented at a recent Mesothelioma UK Patient and Carer Day, attendees broke into spontaneous applause" – Sarah Hargreaves and colleagues present two new tools to aid in early-stage engagement with palliative care for patients with mesothelioma
We attend reputable GP-training events and feel confident that the training delivered will be up to date and relevant. And yet, there's something about menopause where all this somehow falls apart.
As depression in older people can present with somatic and cognitive symptoms, it is often attributed to normal ageing and may be overlooked by the clinician and the older adult. Carolyn Chew-Graham and colleagues share insights from the latest NICE guidance.
As IBS is a chronic condition, many patients will re-present to healthcare services. Here, specialist gastroenterology dietitian's Christian Shaw and Rachel Buckle give an overview of the latest data on dietary therapies, describe findings from their own recent research on dietary therapies
Nitrous oxide is a popular recreational drug that produces transient but intense feelings of euphoria and disassociation. Nada Khan considers what GPs should know.
While it makes no contribution to mortality statistics, the morbidity, economic cost and primary care workload generated by osteoarthritis is of sufficient proportion to render the condition a significant public health problem worthy of urgent investment of resources.
Though it is widely known that kidney donation is common among living donors who are family or friends, there appears to be lower awareness of kidney donation along a non-directed pathway. Here, Rich Armitage describes the process of becoming a non-directed altruistic
Peter McNelly provides an introduction to the role of the mental health practitioner in general practice, and how they can help reduce the workload of GPs.
Some patients with medically unexplained symptoms (MUS) suffer years of referrals and inconclusive tests. Others find themselves overlooked by health care services and feel forgotten. However, diagnostic delay may be due to a disease being rare. Stephen Walker and colleagues offer a
New research into the serotonin theory of depression raises two separate, but related issues. The first is our understanding about the aetiology of depression. The second is understanding why we prescribe antidepressants. Nada Khan reflects on what this means for general practice.
Richard Armitage looks at the health needs of people who work away from home, be they itinerant telecommuters or contract-workers in haulage and construction - should general practice be evolving to meet the access needs of this group? Join the discussion!
Sharon Dixon and colleagues contend that a deeper understanding of safeguarding practices (and how these look and feel on the front-line of multi-agency encounters) is needed if future child safeguarding tragedies are to be avoided.
Richard Armitage argues that good management of hay fever represents an opportunity for general practice to reduce suffering and restore both wellbeing and economic activity to the nation!
TDR programmes consist of a low calorie (around 800 kcal/day) formula diet alongside a stepped food reintroduction as well as regular behavioural support. Yusuf Ben-Tarifite examines the evidence for TDR in Type 2 Diabetes Mellitus.
The winners are in for the Research Paper of the Year award 2021! Carolyn A Chew-Graham and Helen Leach present the winners and stand outs from this year's awards, with reflection on the importance of primary care research for GP trainees working
In April 2020, NICE published new guidance on how to help patients to safely stop antidepressant use. To help GPs to implement this guidance in their practice, Stevie Lewis from the International Institute for Psychiatric Drug Withdrawal and Mark Horowitz have published
Karen Nicholson highlights possible connections between psychological trauma fibromyalgia and chronic pain syndromes - and suggests an audit
Aaron Poppleton, Dennis Ougrin, and Yana Maksymets give a responsive overview of the health needs of Ukrainian refugees and provide a list of useful resources for GPs
Nada Khan considers how to approach HRT shortages in general practice
Nada Khan discusses practical aspects of supporting migrants from Ukraine in UK primary care.
Drs Laura Heath and Sheena Sharma present their bereavement toolkit, designed to aid healthcare practitioners navigate this potentially difficult space by providing real-world consultation ‘tools’.
Ayesha Siddqui shares a clinical case to remind GPs why it is vital to heed clinical cues and check patient vital signs
Krishnakant Buch's GP exploded a telephonic bomb shell: ‘You have type 2 diabetes'. Here he tells us what he did about it, and how he conquered the Diabetes UK, one million step challenge.
The immune-system is complex and is interconnected with the central nervous and endocrine systems. Regina Ford discusses a wide range of scientific research that looks at diet, supplements, exercise, sleep quality and stress/mental health, to give us a holistic overview of health
Making a diagnosis is like detecting the correct clues to solve a crime. But Samar Razaq reminds us that in general practice the crime scene seems to keep on changing......
Data suggests that the interventions put in place to control the pandemic may have reduced the childhood population’s resistance to normal endemic diseases leading to a ‘build-up of susceptibility’. Roshni Mistry and James Hibberd warn us to be prepared for a possible
The good news is that palliative care is reaching more people with cancer, organ failure and frailty and dementia, and is starting earlier. But Scott Murray and Jordi Amblas question why planned and emergency medical care continues to expand even more for
Severe combined immunodeficiency (SCID) affects approximately 14 infants a year in England. The condition is usually fatal by 12-18 months of age without bone marrow transplantation. Public Health England will be performing a two year evaluation of newborn screening for SCID in
The UK Government announced its intention to introduce a national system of medical examiners in England which will result in the scrutiny of all deaths not referred to the coroner. Frances Cranfield explains what we need to know.
From this year GP registrars will be spending two years of their training in the community. Rachel Roberts and her colleagues share their findings from a pilot scheme.
GPDPR is a new initiative from NHS Digital to collect data held in GP medical records, to be available to third parties for research and planning. Unlike most other projects, patients have to actively opt out if they do not want their
Most of those who die by suicide contact primary care in the year or months prior to the suicide. GPs are a trusted and valued source for help-seeking among those who are at-risk of suicide. So how can we help? Maria Michail
Most children removed from their birth family have experienced multiple traumas. Hannah Milton finds that when talking to patients about anxiety, depression, addiction, relationship problems and difficulties with their own children’s behaviour, one her most useful history taking techniques is a simple
