The British journal of general practice : the journal of the Royal College of General Practitioners
-
Osteoporosis is a major public health problem with the ageing population in the UK. However, there is no known national algorithm for the management of osteoporosis in primary care. Therefore, a treatment pathway was developed in secondary care for patients in the community. ⋯ This is a pilot project to assess the ability to identify patients who have osteoporosis and review their treatment pathway. The results are promising as the analysed data indicate that GP practice lists can be used to identify and treat high-risk patients for osteoporosis and assess the adherence to the pathway. Using the pathway, GPs can more efficiently diagnose and manage patients.
-
The National Early Warning Score (NEWS) was introduced to standardise early warning scores (EWS) in England. It has been recommended that NEWS should be used in pre-hospital care but there is no published evidence that this improves outcomes. In 2015, the West of England Academic Health Science Network region standardised to NEWS across all healthcare settings. Calculation of NEWS was recommended for acutely unwell patients at referral into secondary care. ⋯ To the authors' knowledge, this is the first study demonstrating that use of NEWS in pre-hospital care is associated with improved outcomes in patients with SOS.
-
Recent immigration from Eastern Europe poses new challenges in engaging with women eligible to have smears. The Roma population have low socioeconomic status, low educational status, and a life expectancy 10 years lower than other EU citizens. An audit of smear uptake in four 'Deep End' Sheffield practices identified as having >1000 registered Roma Slovak patients, demonstrated smear uptakes between 53% to 40%, all of which are below the Sheffield CCG average of 73.5%. ⋯ It is vital that we develop and evaluate appropriate interventions to increase smear uptake in migrant and other vulnerable populations. There is a need for the UK to adapt screening programmes to maximise uptake within 'hard to reach' groups, such as the 'Roma', who are likely to be at the highest risk of cancer and late presentation of the disease.
-
Opioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018. ⋯ Opioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.
-
Bacterial susceptibility to antibiotics changes over time. Knowledge of the susceptibility is important for antibiotic treatment guidelines in general practices. ⋯ The antibiotic susceptibility percentages to the agents tested were stable over the 10-year period, except for ciprofloxacin as was the prevalence of ESBL producing E. coli. Surveillance with regular intervals is warranted.