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Clinical - Page 2

BJGP Long Read/Clinical/Opinion

Should we be bothered that we are losing a QOF indicator for people with SMI?

This focus on cardiovascular risk is understandable, but it is not clear why the requirement to maintain a register of people with SMI has been removed, other than possibly to free up financial resources.

15 July 2025
9 mins read
1
BJGP Long Read/Clinical/Opinion

The uncertain promise of continuous glucose monitors in non-diabetic people

It used to be just in the context of type 1 diabetes, but the little white circles on people’s upper arms seem to be more ubiquitous, and it’s clear that the use of continuous glucose monitoring (CGM) is shifting from a medical

29 March 2024
11 mins read
Clinical/Opinion

The risks of medical investigation are often overlooked

Investigations themselves can throw up results that are difficult to interpret, and they may reveal abnormalities of uncertain significance. To highlight these issues to our patients would constitute more ethical practice, would foster greater patient empowerment, and could result in a frame

22 March 2024
13 mins read
AiT/Clinical/International

Reflections for general practice from an Asylum Seeker and Refugee (ASR) GP clinic

Mavin Kashyap shares key practice insights from a specialist community healthcare service for asylum seekers and refugee (ASR) adults.

9 February 2024
7 mins read
BJGP Long Read/Bright Ideas and Innovation/Clinical

Yonder: Surgical site infection, opioid dependence, racial diversity, and Meals on Wheels (February 2024)

Ahmed Rashid muses about surgical site infection, opioid dependence, racial diversity, and 'Meals on Wheels'

24 January 2024
6 mins read
BJGP Long Read/Clinical

Just do it! Ten easy ways to enhance empathy in the consultation

The good news is that there are at least ten evidence-based ways to enhance empathy. These take little time and can pay back the moments invested (sometimes with compound interest).

11 January 2024
10 mins read
2
Clinical/Research

Yonder: Care coordination, anal cancer prevention, lay online communication, and positive body image

Ahmed Rashid curates a selection of useful and interesting papers. This month: Care coordination, anal cancer prevention, lay online communication, and positive body image.

29 December 2023
5 mins read
BJGP Long Read/Clinical

Domestic abuse in the times of COVID and the cost-of-living crisis

With the combination of a global pandemic, cost-of-living crisis and the Government’s austerity measures, over the last few years rates of DA are thought to have increased significantly. Paul McNamara and Anna de Natale reflect on how general practice should respond.

3 December 2023
8 mins read
2
Bright Ideas and Innovation/Clinical

Yonder: Wait and see, identity loss, data failures, and patient organisations (December 2023)

Ahmed Rashid curates a selection of useful and interesting papers. This month: Wait and see, identity loss, data failures, and patient organisations.

30 November 2023
5 mins read
Clinical/Opinion

Clinical Curiosity: an antidote to medical arrogance.

David Jeffrey argues that clinical curiosity is an essential part of a doctor’s empathy and clinical decision-making. It promotes reflective practice, critical thinking and stimulates lifelong learning.

15 November 2023
6 mins read
1
BJGP Long Read/Clinical/Opinion

Making chronic pain less painful – for everyone

People with chronic pain need personalised care – an approach offering patients choice and control over their mental and physical health, basing care on what matters to them personally, and focusing on individual strengths and needs. It is possible.

3 November 2023
13 mins read
2
Clinical/Research

‘What are the sats?’ Challenges to measurement of oxygen saturation in infants and young children in community settings

Chris Bird and colleagues held a workshop in March 2023 with parents, paediatric nurses, GPs, paediatricians, and engineers to identify problems associated with measuring oxygen saturations in infants and young children in primary care. Here they present their findings ...

2 November 2023
5 mins read
Bright Ideas and Innovation/Clinical

Yonder: Ethnic minority maternity experiences, colorectal resection, foreign medical aid and weight stigma

Ahmed Rashid explores: Ethnic minority maternity experiences, colorectal resection, foreign medical aid, weight stigma and the lives of billionaires

25 October 2023
5 mins read
BJGP Long Read/Clinical

The development of primary care mental health over the last 60 years – a witness seminar

Primary care mental health is a fundamental part of general practice, delivering care to many more people than specialist mental health services, and yet there is limited documented history of its development. We sought to address this gap in the narrative by

18 October 2023
14 mins read
AiT/BJGP Long Read/Clinical

Maladaptive Daydreaming In General Practice: An Emerging Challenge

Maladaptive daydreaming is a relatively new concept in the field of psychology experienced by an estimated 2.5% of the population. Sara Noden analyses this proposed mental disorder and the implications for clinicians.

13 October 2023
11 mins read
1
BJGP Long Read/Clinical/Opinion

Should maximising school attendance be a role for frontline GPs?

Lucy Chiddick argues that promoting school attendance is a complex task, best done by those with appropriate expertise. Where GPs engage with the issue there should be appropriate time and care, recognising that there are many drivers of absenteeism and that attendance

9 October 2023
18 mins read
BJGP Long Read/Clinical/Opinion

Domestic abuse as a PUN and DEN for appraisal

Vasumathy Sivarajasingam explores domestic abuse PUNs and DENs as a relevant appraisal topic linked to mandatory safeguarding, with links to learning materials, legislation and further articles.

2 October 2023
10 mins read
3
Clinical

How to help patients safely taper and withdraw from antidepressants

"Withdrawal symptoms are not a sign that a patient needs the drug, but a sign that they need to reduce the drug more slowly" – Stevie Lewis and Mark Horowitz outline how to safely aid patients to withdraw from antidepressants

20 September 2023
12 mins read
AiT/Clinical/Opinion

Problem lists – the forgotten tool

Pablo Millares Martin considers whether the problem list has become a problem (or remains a useful clinical tool).

18 September 2023
9 mins read
1
BJGP Long Read/Clinical/Opinion

Guiding our patients through ‘Transformative’ experiences

So, how can GPs help their patients in facing transformative decisions? The advice, helpfully explained by Richard Armitage, is to reframe the decision-making process with which we approach them.

17 August 2023
11 mins read
BJGP Long Read/Clinical

The Pregnancy Loss Review – what does it mean for general practice?

The Independent Pregnancy Loss Review, published in July 2023, offers recommendations to improve care for women and their families experiencing pregnancy loss, and includes specific advice for primary care. 

4 August 2023
15 mins read
1
Clinical/Research

Why GPs should do online learning on attention-deficit/hyperactivity disorder

"There is a lack of ADHD training for GPs, and GPs are often lacking accurate knowledge and confidence when dealing with ADHD in their practice. In light of this, we received 3-year funding from the ESRC to co-develop and evaluate tailored online

5 July 2023
10 mins read
BJGP Long Read/Clinical

The misuse of do not resuscitate orders – can ReSPECT help?

In general practice we can discuss end of life and treatment escalations decisions with patients before they become very unwell, and this is where the ReSPECT process could potentially give a space for a meaningful patient-centred discussion about preferences at the end

26 June 2023
9 mins read
BJGP Long Read/Clinical

Where are we with physical health checks for people with severe mental illness in the #newnormal?

In an attempt to improve physical health outcomes in this group, patients registered at their GP practice as having a severe metal illness are eligible to undergo an annual health check in a primary care setting. Richard Armitage discusses recent progress.

23 June 2023
8 mins read
Clinical

Suboptimal asthma care: what’s happening, so what and what now?

So what now, given that suboptimal asthma care in the UK is increasing the morbidity and mortality of patients living with asthma coupled with rising asthma care-related carbon footprint? Vasumathy Sivarajasingam offers some useful reflections.

15 June 2023
9 mins read
Clinical/Opinion

Experiencing Asherman’s Syndrome

Yet, from speaking to other women with this condition, I have learnt that it is often their GP that they consult with first, asking: why are my periods lighter since my miscarriage? why have my periods stopped? Could something be wrong, as

14 May 2023
4 mins read
Clinical

Bipolar Disorder – what can we do to make a timely diagnosis?

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.

19 April 2023
14 mins read
Clinical/Opinion/Stories

“We threw the guidelines at her.”

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...

25 March 2023
8 mins read
2
Clinical

An easy-to-use ‘crib sheet’ for commonly issued disease-monitoring drugs in general practice

Adnan Saad and colleagues provide an easy-to-use 'crib sheet' for commonly issued disease-monitoring drugs in general practice ...

17 March 2023
4 mins read
Clinical/Opinion

Seeing and hearing

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.

23 February 2023
8 mins read
Clinical/Opinion

Repetition breeds contempt not continuity

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.

13 February 2023
4 mins read
1
Clinical

Cyclothymia in primary care: an important diagnosis but easy to miss (with consequences)

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

9 February 2023
9 mins read
Clinical/Opinion

Making it real

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?

3 February 2023
10 mins read
Clinical

Caring for mesothelioma patients and their families in primary care: new tools to enable early-stage engagement with palliative care

"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

9 December 2022
8 mins read
Clinical/Opinion

There’s something about menopause…

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.

1 December 2022
12 mins read
5
Clinical/Opinion

Depression in older adults: why medication review should not be just a tick in the box

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.

14 October 2022
13 mins read
Clinical

Dietary therapies in irritable bowel syndrome: an update

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

5 October 2022
9 mins read
Clinical/Opinion

Nitrous oxide use and health risks: no laughing matter

Nitrous oxide is a popular recreational drug that produces transient but intense feelings of euphoria and disassociation. Nada Khan considers what GPs should know.

15 September 2022
6 mins read
BJGP Long Read/Clinical

Osteoarthritis: an overlooked target for health improvement

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. 

9 September 2022
10 mins read
1
Clinical

What GPs need to know about non-directed altruistic kidney donation

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

29 August 2022
15 mins read
1
Clinical/Opinion

An introduction to the mental health practitioner in general practice

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.

17 August 2022
13 mins read
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