Volume 7, Number 3, Jul-Aug-Sep 2010

BACK TO BASICSMaking sense of drugs that reduce blood clotting

POPULAR
TOPICDIABETES MANAGEMENTCaring for patients with diabetes who have intercurrent illness
Bev Bostock-Cox

Modern treatments available to people with diabetes enable the 1.3 million living with the condition in England alone to minimise and control its impact on their daily lives like never before. But what happens when a person with diabetes develops intercurrent illness, such as a cold or flu? We review the steps to take to ensure that these patients maintain good glycaemic control throughout the ups and downs of other health challenges.

EDITORIALAll change for the NHS; but stay as you were for practice nurses
Jan Procter-King

‘All change’ is hitting the NHS once again. The coalition government’s health white paper shifting commissioning to primary care has prompted headlines predicting ‘the end of the NHS’. There is no doubt that the next few years will see massive change, but patients will still need looking after, and this is where practice nurses will continue to do what we have always done best – providing effective education and care. And the BJPCN will continue to support you in this – with evidence-based information and practical tips on the management of patients with cardiovascular disease 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 BJPCN – Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library or on the worldwide web. Each 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.

HAVE YOU HEARD?Have you Heard?

POPULAR
TOPICPREVENTION IN PRACTICEBeating the post-MI blues: improving detection and treatment of depression after a heart attack
Joanne Haws, Professor Richard Gray

Depression after myocardial infarction (MI) is extremely common, affecting almost half of all patients. The combination of MI and depression reduces the chance of recovery and makes it much more likely that patients will have another cardiac event. Depressed patients are also less likely to get back to work and they use health services more than those who are not depressed. We carried out a survey to investigate the perceptions, attitudes and skills of primary care practitioners in recognising and treating depression in patients following an MI to explore how this important co-morbidity is managed in practice. Readers of the British Journal of Primary Care Nursing (BJPCN) were invited to participate in an online survey, together with readers of the Primary Care Cardiovascular Journal. The survey results show that although primary healthcare practitioners realise that depression after MI is a significant problem, many underestimate quite how common it is and have received little or no training in recognising or managing depression.

POPULAR
TOPICQUALITY MATTERSHow to provide excellent care for patients with diabetes
Professor Mike Kirby

How can primary healthcare professionals take diabetes care beyond the General Medical Services (GMS) contract towards creating a primary care centre of excellence, while earning maximum QOF points in the process? Many patients are currently not achieving good glycaemic control despite incentives to encourage healthcare practitioners to help their diabetes patients reach HbA1c targets. Several new policies and schemes have recently been implemented to provide incentives for reaching treatment goals, and this article discusses how these can be beneficial to both general practices and diabetes patients.

THERAPEUTICS REVIEWCardiac resynchronisation: a new approach to managing chronic heart failure
Professor Mike Kirby

Heart failure affects around three in every hundred people aged 65 to 74 years, and increases with age. About 40% of patients with heart failure will die within one year of diagnosis, underlining the need for prompt diagnosis and effective therapy. In this article we explore what goes wrong in heart failure, and how cardiac resynchronisation can help.

POPULAR
TOPICPATIENTS AS PARTNERSEarly chronic kidney disease (CKD stage 3a): how to tell people they have the condition
Nicola Thomas

Over the past four years there have been dramatic changes to the way in which people with chronic kidney disease (CKD) are being managed in primary care. As a result of policy changes there are now many more people with CKD being identified, especially those with stage 3a. This article deals with one of the most important issues for primary care nurses when caring for people with early CKD – how to tell people that they have the condition and how to best manage it.