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.
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
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
Mavin Kashyap shares key practice insights from a specialist community healthcare service for asylum seekers and refugee (ASR) adults.
Ahmed Rashid muses about surgical site infection, opioid dependence, racial diversity, and 'Meals on Wheels'
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).
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.
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.
Ahmed Rashid curates a selection of useful and interesting papers. This month: Wait and see, identity loss, data failures, and patient organisations.
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.
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.
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 ...
Ahmed Rashid explores: Ethnic minority maternity experiences, colorectal resection, foreign medical aid, weight stigma and the lives of billionaires
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
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.
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
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.
"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
Pablo Millares Martin considers whether the problem list has become a problem (or remains a useful clinical tool).
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.
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.
"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
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
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.
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.
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
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.