Volume 3, Number 2, March-April 2006

POPULAR
TOPICBACK TO BASICSCalculating Cardiovascular Risk: 'How To' guide for the new British Guidelines
Jan Procter-King

Calculating cardiovascular risk is at the heart of primary prevention – it gives us a practical way of assessing who we should be targeting with lifestyle changes and drug treatment to reduce the chance of them suffering a heart attack or stroke in the future. The new Joint British Guidelines make it very clear who we should be screening for CVD and how to calculate their risk.

DIABETES MANAGEMENTPumping Insulin: when to use Insulin Pumps
Judith Coggles

Insulin pumps – small devices that deliver insulin at regular intervals and on demand – are proving increasingly popular with patients with type 1 diabetes who find their glucose levels difficult to control with injections or who have other complications. They can offer significant benefits in terms of overall glucose control and patient’s quality of life. In this article we review how insulin pumps have developed over the last 40 years, how modern pumps are used, which patients should be considered for their use and cost issues associated with these devices.

POPULAR
TOPICDISEASE FOCUSMetabolic Syndrome: a Cluster of Risk Factors
Mike Kirby

The metabolic syndrome is characterised by a cluster of metabolic risk factors which may include abdominal obesity, dyslipidaemia, high blood pressure and insulin resistance or glucose intolerance. Patients with this cluster are at increased risk of coronary heart disease, stroke, peripheral vascular disease and type 2 diabetes. The dominant underlying risk factors for the syndrome are abdominal obesity and insulin resistance – so the epidemic of obesity means that we will be seeing a major increase in cases of metabolic syndrome over the next few years. Management requires tight control of all risk factors, with weight loss and prevention of weight gain being important preventive measures.

EDITORIALEditorial
Jan Procter-King

Welcome to our second birthday edition of the British Journal of Primary Care Nursing (BJPCN). We can’t promise you cake and candles but we have a lot of goodies that should help smooth the way for primary care nurses in our efforts to improve the management of CVD and diabetes.

EVIDENCE IN PRACTICEEvidence in Practice

There 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.

POINTS MEAN PRIZESThe Exception or the Rule? Exception Reporting in the new GMS Contract
Bev Cox

Under the new GMS (nGMS) contract, practices can report patients as exceptions under certain circumstances. Exception reporting prevents a practice being penalised under the Quality and Outcomes Framework of nGMS for factors outside its control or for a range of other patient-related issues. In this article, we review when patients can be reported as exceptions, how to report exceptions and some practical examples of exception reporting.

POPULAR
TOPICMONITORINGMonitoring Lipids in the Surgery
Sandra Waddingham

Testing patients’ lipids is an important measure in the detection and management of risk factors for cardiovascular disease (CVD). Cholesterol testing and management is one of the success stories of CVD prevention over the past few years. In this article, we review who we should be testing and what lipids we should be measuring. Looking to the future, testing a wider range of patients and using more aggressive treatment to reach targets will enable us to further reduce the number of patients suffering heart attacks and strokes.

POPULAR
TOPICPREVENTION IN PRACTICENew Joint British Guidelines on CVD Prevention
Susan Mayor

Nearly 250,000 people die each year in the UK from cardiovascular disease (CVD), despite all the hard work of healthcare professionals. The new Joint British Societies’ Guidelines on Prevention of Cardiovascular Disease in Clinical Practice (JBS2), published recently by all of the leading societies working to reduce CVD in this country, take a ‘get tougher’ approach to further reduce CVD deaths. They widen the range of patients who should be included in primary prevention, in addition to setting lower targets for total cholesterol (4.0 mmol/L), low-density lipoprotein (LDL) cholesterol (2.0 mmol/L) and blood pressure (140/85 mmHg).

THERAPEUTICS REVIEWPlant Sterols and Stanols: Further Options in Lowering Cholesterol
Jeremy Bray

It is now 10 years since the introduction of the first cholesterol-lowering spread in the UK. There is now an expanding range of products including yoghurts, spreads and milk which include the active ingredients – plant sterols and stanols. With the increasing media focus and advertising spent on these so-called ‘functional food’ products, what advice should we be giving to our patients?