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. POPULAR
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)
POPULAR
TOPICDISEASE 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? BACK TO BASICSPharmacokinetics of inhaled drugs: where inhaled drugs go
POPULAR
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. POPULAR
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. POPULAR
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?
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