Volume 1, Number 2, July 2004

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TOPICBACK TO BASICSA BJPCN Guide – How lipid-modifying drugs work

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TOPICCHDCRunning a successful cardiovascular clinic in general practice
Rona Bennesar

The very good audit data for this practice has led to its winning awards. So how does the practice do it? This ‘day in the life of’ photo diary gives a step-by-step guide to the key elements of running a successful cardiovascular clinic in general practice.

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TOPICDISEASE FOCUSErectile dysfunction (ED) is a common condition that not only causes distress to a couple, but also indicates the likely presence in the man of cardiovascular and other diseases. By diagnosing and treating ED, nurses can therefore help to restore the couple’s relationship and intervene early in the course of potentially serious chronic conditions.
Professor Mike Kirby

EDITORIALWelcome to the second edition of The British Journal of Primary Care Nursing for cardiovascular disease and diabetes management. The first edition has been greeted extremely positively, so a personal thank you to all readers who completed and returned their response forms. Your feedback is essential in helping us to make sure we keep giving you information that is useful and relevant to work at the frontline of primary care nursing in day-to-day practice.
Jan Procter-King

Welcome to the second edition of The British Journal of Primary Care Nursing for cardiovascular disease and diabetes management. The first edition has been greeted extremely positively, so a personal thank you to all readers who completed and returned their response forms. Your feedback is essential in helping us to make sure we keep giving you information that is useful and relevant to work at the frontline of primary care nursing in day-to-day practice.

EVIDENCE IN PRACTICEThere are just not enough hours in the day to read all the research journals, even if you wanted to. This section of the BJPCN – Evidence in practice – will keep you on top of relevant research without having to spend hours in the library.
Each journal review gives you a bite-size summary of new research, pulling out key points for primary care and recommending the action that you might consider taking.
Dr Chris Harris

HAVE YOU HEARD?Information on withdrawal of four insulins by Lilly
Drug and Therapeutics Bulletin and Treatment Notes go online
Stress and heart disease: check out the link
New online service for RCN members – The Oxford Dictionary of Nursing and A-Z of Medicinal Drugs
New website aims to get teenagers moving to reduce risk of heart disease

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TOPICPCTCExpanding the role of health care assistants in primary care
Mavis Bates

As practice nurses take on a growing role in the organisation and implementation of chronic disease management, they need more help in many of the routine – but important – tasks this involves. Health care assistants (HCAs) are providing growing support in this capacity. This article explores what HCAs are taking on and issues regarding their training and regulation.

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TOPICPREVENTION IN PRACTICEImproving the primary care management of obesity
Susan Mayor

Over half of all adults in the UK are overweight, according to latest figures. The number of people who are obese has tripled over the last 20 years, and is still rising. But is weight management an issue for primary healthcare teams? There is clear evidence that it is – with obesity being directly related to increased risk of death and a range of chronic diseases. Obesity reduces life expectancy, on average, by nine years.
At long last there is some encouragement for general practices to optimise detection and management of obesity. The new General Medical Services (GMS) contract includes 208 from a total of 1050 points available in the Quality and Outcomes Framework that are affected by weight loss, offering a major financial incentive to general practices to encourage patients to lose weight.

PREVENTION IN PRACTICEImproving the management of diabetic foot conditions
Anne d’Arcy

Foot complications are very common in patients with diabetes. At least one in six diabetics develop foot ulcers at some point in their lives. This article reviews why foot complications occur in diabetes, how you can detect foot problems early, and treatment and prevention strategies. The National Service Framework for Diabetes suggests that targeted foot care for people at high risk could save hundreds of amputations a year. By detecting complications earlier, we can make a real difference to patients’ lives, reducing morbidity, improving quality of life and even saving limbs.

Q & AYour questions answered

THERAPEUTICS REVIEWOptimising treatment of type 2 diabetes with metformin
Dr Mike Mead

There is good evidence that tight glycaemic control significantly improves outcomes in patients with type 2 diabetes. All practice nurses will be looking to achieve the new General Medical Services contract (GMS2) targets for HbA1c reduction in diabetes (see box). Practices will be developing prescribing strategies to achieve this reduction, in accordance with good clinical practice. Metformin offers an important first-line therapy for type 2 diabetes. The introduction of a new, sustained-release formulation – Glucophage SR – should improve patient compliance with metformin and so improve glycaemic control.