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Tag Archives: primary care

November 2017 Br J Cardiol 2017;24:130

New series on insights from the Bradford Healthy Hearts project

BJC Staff

Abstract

The initiative was launched in February 2015 and in a relatively short period of time, the project achieved success in all three areas with measurable improvement in outcomes, including a reduction in hospitalisations. Over 24 months, there have been around 21,000 clinical interventions, with the emphasis being on delivering change at scale, whilst being fastidious about minimising any extra workload on primary care. In this period, 13,000 patients either started statins or had their statins changed, more than 1,000 patients with atrial fibrillation were anticoagulated, and more than 5,200 hypertensive patients reached a blood pressure targe

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June 2017 Br J Cardiol 2017;24:62-5 doi:http://doi.org/10.5837/bjc.2017.013

Transient loss of consciousness (TLoC) in primary care: a review of patients presenting with first blackout

Lesley Kavi

Abstract

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Using limb-lead ECGs to investigate asymptomatic atrial fibrillation in primary care

June 2014 Br J Cardiol 2014;21:64–8 doi:10.5837/bjc.2014.015

Using limb-lead ECGs to investigate asymptomatic atrial fibrillation in primary care

Wasim Javed, Matthew Fay, Mark Hashemi, Steven Lindsay, Melanie Thorpe, David Fitzmaurice 

Abstract

Introduction Screening has been proposed as a method to detect patients with undiagnosed atrial fibrillation (AF) as it is a dangerous, prevalent condition that may be easily diagnosed with a simple low-cost test, an electrocardiogram (ECG), and the risk of serious sequelae such as ischaemic stroke can be effectively reduced with anticoagulation.1 Hence, it fulfils the Wilson Jungner criteria for a screening programme.2 The potential benefits of AF screening are far reaching, as reducing stroke prevalence has massive implications for both patients and health services in the UK, where stroke consumes approximately 5% of total National Health S

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Audit of communication with GPs regarding renal monitoring in CHF patients: a comment from primary care

September 2013 Br J Cardiol 2013;20:116

Audit of communication with GPs regarding renal monitoring in CHF patients: a comment from primary care

Dr John B Pittard

Abstract

The Sheffield audit of heart failure discharge advice given to GPs by Kanaan, Bashforth and  Al-Mohammed (see pages 113–16) illustrates perfectly the imperfections of implementing research findings and guidelines into every day clinical practice. The paper rightly points out the selective nature of the entry criteria of patients to RALES (Randomised Aldactone Evaulation Study).1 Most research trial patients are more scrupulously managed and monitored than in real world circumstances. The traditional way of organising discharge summaries usually defaults to the least experienced junior staff. The perception is often that a career in account

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March 2012 Br J Cardiol 2012;19:38–40 doi:10.5837/bjc.2012.008

The gap between training and provision: a primary-care based ECG survey in North-East England

Andreas R Wolff, Sue Long, Janet M McComb, David Richley, Peter Mercer

Abstract

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September 2009 Br J Cardiol 2009;16:247–9

Cardiac rehabilitation: are we putting our hearts into it?

Michael Pollard, Caroline Sutherland

Abstract

Introduction Cardiac rehabilitation aims to address all modifiable behavioural risk factors that are susceptible to intervention, including smoking, exercise, diet and weight.1,2 Since less than half of eligible patients attended the out-patient-based cardiac rehabilitation programme at St George’s Hospital, we wanted to establish whether our service was beneficial and popular with patients, and what features might persuade others to participate. This evidence would enable us to improve our service and increase attendance, thereby reducing the risk of further cardiac events, with consequent benefits to patients, their families and healthcar

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July 2008 Br J Cardiol 2008;15:179–80

Cost-effectiveness and use of natriuretic peptides in clinical practice – do we have enough evidence yet?

Ahmet Fuat

Abstract

A recent survey of primary care trusts (PCTs) in England found that only 26% currently offered or had previously offered natriuretic peptides for use in primary care.4 Clinicians and healthcare purchasers (PCTs in the UK) still harbour concerns about appropriate cut-offs, the extra cost of BNP/NT proBNP assays, which assay to use (BNP or NT proBNP/point-of-care or laboratory assay), lack of expedient referral pathways for patients with a raised BNP/NT proBNP level and absence of cost-benefit/effectiveness data from a prospective primary care study. Landmark studies such as the Hillingdon heart failure study5 confirmed the high negative predic

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July 2008 Br J Cardiol 2008;15:199-204–6

Cost-consequences analysis of natriuretic peptide assays to refute symptomatic heart failure in primary care

Michael A Scott, Christopher P Price, Martin R Cowie, Martin J Buxton

Abstract

Introduction Heart failure is a serious syndrome accounting for around 4% of UK general practitioner (GP) consultations in patients over 45 years.1 Diagnosis is complex with frequent co-existing symptoms; misdiagnosis may lead to inappropriate treatment and inefficient use of scarce healthcare resources.2 The National Institute for Health and Clinical Excellence (NICE) guidelines for chronic heart failure state that the 12-lead electrocardiogram (ECG) and/or natriuretic peptides tests (where available) may be used to help exclude heart failure.3 Abnormal ECGs are usually observed in heart failure cases, although in one study, around 20% of pa

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January 2008 Br J Cardiol 2008;15:6

Primary care heart failure services

Jim Moore

Abstract

Setting an example The primary care-based heart failure service in Gloucestershire is now four years old and has promising data from its 2006 audit. The audit comprises data from all patients (n=524) with left ventricular systolic dysfunction managed by the service throughout 2006. Results showed all-cause mortality in this high-risk group of only 8.2%, with half of these patients dying at home. In the group of patients who had died during 2006, almost one third had previously discussed and indicated the place they wished to be cared for during the final phase of their illness, with the vast majority opting for home. In over 70% of these case

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September 2007 Br J Cardiol 2007;14:221-28

Chronic kidney disease in primary care

Juliet Usher-Smith, Andy Young, Simon Chatfield, Mike Kirby

Abstract

Introduction Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease.1 Almost half of all deaths in patients with CKD are caused by cardiovascular events2 and, in diabetic subjects, mortality increases significantly with reduced kidney function.3 As part of the National Service Framework for Renal Services, CKD was added in February 2006 to the Quality and Outcomes Framework (QOF) for primary care in the UK. Within this, up to 27 points can be earned for the production of a register of patients with stage 3–5 CKD and the appropriate monitoring and treatment of hypertension and prescription of angiotensin-conver

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