International journal of clinical practice
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Int. J. Clin. Pract. · Nov 2014
In-patient diabetes care: the impact of diabetes outreach team on long-term glycaemic control.
Our aim is to assess the impact of inpatient diabetes services on glycaemic control in patient with diabetes admitted to a secondary care hospital in UK. ⋯ By providing a comprehensive care, structured education and appropriate intervention through our Diabetes Outreach Team, we have shown a significant reduction in HbA1c for recently hospitalised patients.
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Int. J. Clin. Pract. · Nov 2014
ReviewTherapeutic management of anal eczema: an evidence-based review.
To conduct a systematic review of treatments for anal eczema (AE). ⋯ This review highlights the need to conduct more high-quality clinical trials in patients with AE in order that specific guidelines for the management of this difficult proctological condition can be prepared.
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Int. J. Clin. Pract. · Nov 2014
Relighting behaviour among cigarette smokers seeking treatment: implications for tobacco treatment and policy.
During the recent economic downturn, trends towards fewer cigarettes smoked per day have emerged along with the practice of extinguishing and relighting cigarettes. Few studies have characterised factors related to relighting cigarettes and none have explored this behaviour in those seeking tobacco treatment. This study describes treatment-seeking patients who relight cigarettes and examines implications on tobacco policy and treatment. ⋯ Characteristics linked to economic factors were related to increased relighting. Implications for tobacco treatment include the impact on pharmacotherapy dosing and counselling interventions. The tobacco control community needs to be aware of this phenomenon. Collecting data on 'smoking sessions per day' might be a more accurate depiction of smoking exposure than CPD.
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Int. J. Clin. Pract. · Nov 2014
Determinants of glycaemic control in a practice setting: the role of weight loss and treatment adherence (The DELTA Study).
Examine the association between weight loss and adherence with glycaemic goal attainment in patients with inadequately controlled T2DM. ⋯ Weight loss ≥ 3% and medication adherence were associated with HbA1c goal attainment in T2DM; weight loss was a stronger predictor of goal attainment than medication adherence in this study population. It is important to consider weight-effect properties, in addition to patient-centric adherence counselling, when prescribing diabetes therapy.
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Int. J. Clin. Pract. · Oct 2014
Does medical futility matter in 'do not attempt CPR' decision-making?
The current demographical trend towards an increasingly elderly population combined with advances in end of life care calls for a deeper understanding and common terminology about the concept of futility and additional influences on the resuscitation decision-making process. Such improved understanding of medical futility and other contributing factors when making DNACPR orders would help to ensure that clinicians make appropriate and thoughtful decisions on whether to recommend resuscitation in a patient. ⋯ This information can then be offered to the patient (or the relatives) so that the patient's views about what is acceptable for the survival chance, length and type of survival can be factored into the eventual decision. Given the lack of evidence in this area and the poor level of patient knowledge and the emotive nature of the topic, it is not surprising that clinicians find such discussions hard.