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Clinical Focus

Rescue packs for COPD: problem or panacea?

AECOPD are defined as an acute worsening of the respiratory symptoms associated with COPD, including cough, breathlessness and sputum production and which require additional therapy (NICE, 2019a;...

Allergic rhinitis and its impact on airways disease

Exposure to allergens leads to early and late phase allergic reactions. The early phase reaction is characterised by sneezing and rhinorrhoea as a result of histamine, prostaglandin and leukotriene...

Assessment and examination of the cardiovascular system

A good history taking alone accounts for 75% of diagnoses before performing a physical examination and ordering additional tests are needed (Lown, 1999). With regards to the heart, this will provide...

Shingles in adults: what the practice nurse needs to know

The overall incidence in adults is estimated to be 1.85 to 3.9 cases per 1000 population (National Institute for Health and Care Excellence (NICE), 2021), with an increasing occurrence in older adults...

Insulin for diabetes: 100 years of therapy

During the summer of 1921, an unlikely team consisting of Frederick Banting, a newly established physician specialising in orthopaedics and a professor of physiology, and Charles Best, one of his lab...

What practice nurses need to know about the NICE chronic kidney disease guidelines

Chronic kidney disease (CKD) is defined as a reduction in kidney function, or damage to kidney structure, which has persisted for greater than 3 months and which is associated with other...

Giving travel advice in the uncertain age of COVID-19

Links to recent and upcoming changes in guidance for all 4 areas of the UK (England, Scotland, Wales and Northern Ireland) - https://www.gov.uk/coronavirus.

New approaches to an old challenge: what can we do about smoking?

Raising the subject of smoking with patients should be standard practice in all healthcare settings, but we know from a study published by Cancer Research UK (2019a) that only 53% of primary care...

Back to school with asthma in 2021

Back to school planning in 2021 may be hampered by a primary care system facing a backlog of care, plus a patient population who may be reluctant to access care. According to surveys by Asthma UK...

Sexual history taking in primary care

STIs still carry a degree of stigma in society and to enable a patient to feel free to disclose information to the health professional they need to be confident that their privacy will be respected....

Supporting people to self-manage their allergic rhinitis

Allergic rhinitis symptoms that are not controlled lead to adverse effects that significantly impact quality of life; these include headache, sore throat, hearing problems, sleep disturbance, poor...

Recurrent venous leg ulcers: management in general practice

Once the VLU has healed, the focus needs to be on the prevention of recurrence. However, despite the high recurrence rate and associated costs of treating open ulceration, current Commissioning for...

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