Volume 1, Number 3, June 2007

EDITORIALEditorial
Jan Procter-King

Was it me? Did I blink and miss the spring? There I was, trying to plan my early initiation of inhaled steroids and nasal sprays to ward off seasonal exacerbations of allergic rhinitis and asthma but spring just doesn’t seem to have sprung this year! It made me wonder whether the wet weather had an influence on hay fever levels.

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TOPICEVIDENCE 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.

NEWSNews from Education for Health

NEWSNews from General Practice Airways Group (GPIAG)

DISEASE FOCUSOccupational asthma: how to help the wheezy workers
Lisa Bradshaw

Approximately one in every ten cases of adult-onset asthma is attributable to occupational exposure. Unless occupation is considered, a diagnosis of occupational asthma will be missed so it is likely to be underdiagnosed. An average practice with around 6,000 patients will typically have approximately 600 adult patients with asthma, of whom 60 may have occupational asthma if we assume 10% of cases are related to occupational exposure. Can you think of 60 patients with occupational asthma in your practice?

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TOPICBACK TO BASICSPharmacokinetics of inhaled drugs: where inhaled drugs go

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TOPICPREVENTION IN PRACTICEOptimising nutrition in COPD
Carol Kelly

Although principally an inflammatory respiratory disease, chronic obstructive pulmonary disease (COPD) is now recognised as a complex disorder that also manifests in extrapulmonary and systemic effects. Nutritional manifestations of the disease, notably weight loss and obesity, have been recognised. However, the complexity of nutritional problems in COPD has been poorly understood, and the consequences largely underrated. Now, linked to increasing knowledge regarding systemic inflammation, it is becoming clear that poor nutritional status is not only a manifestation of COPD but also a predictor of mortality and healthcare utilisation.

MONITORINGDiagnosing allergy in asthma and allergic rhinitis
Jan Chantrell

Patients with allergic asthma, intermittent (seasonal) or persistent (perennial) allergic rhinitis, represent a significant proportion of primary care consultations. There is growing awareness of allergy and the possibility of an allergic component as the cause of a wide variety of symptoms. It is important to understand how to diagnose atopy to ensure appropriate management and care of our patients. Diagnosing allergy is initially about asking the right questions, followed by confirming or refuting the diagnosis by objective testing. In this article, we explore history taking and objective testing that will help us to manage and advise patients appropriately.

POINTS MEAN PRIZESScoring top marks for smoking cessation
Philippa Ward

This year, as 1 July and ‘no smoking in public places’ approaches in England, many more patients will want help to stop smoking. Practices in Scotland and Wales are already facing this challenge. How do we optimise the smoking cessation advice we offer at the same time as juggling the many other responsibilities we have? In this article, we look at how to score top marks for Quality and Outcomes Framework (QOF) indicators on smoking cessation – recording information and offering advice that will help patients to quit as well as gaining extra payments for our practices.

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TOPICTHERAPEUTICS REVEWWhich drugs are contraindicated for asthma patients
Rachel Booker

One person in every five households in the UK is receiving treatment for asthma, according to latest figures. As well as treatment for asthma, many of these individuals also self-medicate for minor illnesses or require prescribed medication for other conditions. It is important that the drugs they take do not adversely affect their asthma control. In this article we review which drugs might cause problems in patients also taking treatment for asthma.

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TOPICPATIENTS AS PARTNERSMaking the most of self-management plans in COPD
Bev Cox

The Department of Health’s Expert Patient Programme recognises the role of selfmanagement in many different disease areas and its report Self Care recommends the concept of encouraging people with long-term conditions to self-manage where possible. Diabetes management would never succeed without the active participation of the person with the condition and asthma management plans have been advocated for some time for people with asthma. What can self-management plans achieve in chronic obstructive pulmonary disease (COPD)?

HAVE YOU HEARD?Have you heard?