Volume 6, Number 2, Apr-May-Jun 2009
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TOPICBACK TO BASICSMaking Sense of how Antihypertensives Work
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TOPICDISEASE FOCUSPostural Hypotension
Sandra Waddingham As we aim for tighter and tighter blood pressure control to minimise the cardiovascular complications of diabetes,the risk of postural hypotension increases. In this article we discuss what postural hypotension is and how to identify it and confirm diagnosis. We also consider the main causes and the relationship between diabetic neuropathy and postural hypotension as well as prevention and treatment strategies. EDITORIALEditorial
Jan Procter-King This spring is an important time for the prevention and management of cardiovascular disease in the UK. The new vascular risk assessment and management programme, now known as the NHS Health Check, starts in April. And it’s the fifth birthday of the British Journal of Primary Care Nursing! So close your eyes and make a wish, and we hope we can play some part in making it come true. POPULAR
TOPICFOOD FOR THOUGHTImpaired Glucose Tolerance: What it is and How to Manage it
Alison Shepherd The new national strategy for vascular risk assessment, now being referred to as NHS Health Check, will include testing for diabetes and impaired glucose tolerance (IGT). This follows a major evaluation of the evidence showing that it is more cost-effective to screen individuals for IGT than screening for diabetes alone, but only as part of the broader vascular risk assessment. This article examines the concepts of IGT and impaired fasting glucose (IFG) and offers practical advice as to how these conditions can be managed in primary care. 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. 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?
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TOPICMONITORINGTaking an ECG: Getting the Best Possible Recording
Rachel Iles An electrocardiogram (ECG) is a quick and non-invasive way of recording the heart’s electrical activity. One of its many uses is in the diagnosis of myocardial infarction, angina, and rhythm disturbances. Although the ECG is a simple and easy test to perform, it is vital to obtain the best possible recording because of its importance. PREVENTION IN PRACTICEKeeping it in the Family: Reducing Risk in Relatives of Patients with Premature Heart Disease
Gillian Morgan In this article, we look at how a primary prevention team introduced a systematic approach to target people who had premature coronary heart disease in their family and offer them a comprehensive cardiovascular disease risk assessment.Based on the findings from the EUROACTION study, the next step was to involve their partners based on the recognition that they often share risk factors due to lifestyle. DIAGNOSTICSC-reactive Protein (CRP): an Emerging Marker of Cardiovascular Risk
Mike Kirby The major risk factors for cardiovascular disease (CVD) include high blood pressure, dyslipidaemia,diabetes, and smoking, all of which can be managed with lifestyle and therapeutic interventions. C-reactive protein is emerging as a useful new risk marker.
THERAPEUTICS REVIEWChoosing the Right Pharmacotherapy to Help Patients Stop Smoking
Paul Aveyard, Amanda Parsons, Rachna Begh Most smokers want to stop smoking and intend to stop at some point, according to research. Nearly half of all smokers expect not to be smoking in a year’s time, but only two to three in every hundred actually stop smoking permanently each year. It is widely recognised that healthcare professionals have an important role to play in helping patients to stop smoking, but what is the best way to achieve this? POPULAR
TOPICPATIENT INFORMATIONYou have been Diagnosed with Impaired Glucose Regulation
Alison Shepherd WORKING AS A TEAMThe Renal Social Worker: an Essential Team Member for Good Renal Care?
Cathy Holman Renal services do not need renal social workers to keep patients alive.Nephrologists, transplant surgeons and renal nurses can manage that challenge without our involvement. So why are social workers attached to a renal service? Are they just an added extra – an upgrade in the service rather than an essential component of it? DRUGS REVIEWUnderstanding the Potential of New Oral Anticoagulant Drugs
Professor David Fitzmaurice, Peter Rose, Ellen Murray Although there are other oral anticoagulation agents available, warfarin is the drug used predominantly in the UK. Warfarin has been in clinical use for over 50 years. It is still referred to by patients as ‘rat poison’ and,indeed, warfarin derivatives are still used as rodenticides.In this article, we take a look at some of the new oral anticoagulants coming along. POPULAR
TOPICPATIENTS AS PARTNERSHow to Use Brief Motivational Interviewing
Christine Mclean Helping people to change risky behaviour is notoriously difficult, but brief motivational interviewing has been found to be helpful. In this article, we look at the research supporting this patient-directed counselling style and how to use it in clinical practice. HANDS ONAnticoagulation in Practice: Why it Matters that the Dose of Warfarin is Spot On
Bev Cox More and more nurses in primary care are involved in monitoring international normalised ratio (INR) levels and advising patients on warfarin doses as anticoagulation clinics move out of secondary care and into primary care. In this article we explore why warfarin is prescribed, how to monitor patients on the drug and what to look out for in terms of interactions with prescribed medicines, over-the-counter drugs and foods. We also need to be able to advise on lifestyle interventions that go hand-in-hand with taking warfarin.
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