Meeting demand for opioid dependency in an Inner London borough

2020 ◽  
Vol 2 (9) ◽  
pp. 512-517
Author(s):  
Jeff Fernandez
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Opiate Withdrawal ◽  
Large Role ◽  
Opioid Dependency ◽  
London Borough ◽  
Experienced Nurse

This paper is looking at the development of the Benzodiazepine and Opiate Withdrawal Service (BOWS) in the borough in Inner London to implement a model that would treat patients effectively in GP practices. It is to illustrate what can be achieved with experienced nurse prescribers in treating an emerging group of patients in primary care. Often patients are aware of their dependency on opiate medications and do want to reduce and come off their medications. This paper describes the BOWS service and its approach, illustrating what can be possible, in terms of treatment for patients in general practice. It also shows what can be designed in NHS services to address the growing issue of dependency on prescribed drugs and argues that services having experience in addictive behaviours can play a very large role in achieving this.

Shaping and delivering services in primary care: benzodiazepine and opiate withdrawal service

2021 ◽  
Vol 32 (10) ◽  
pp. 414-418
Author(s):  
Jeff Fernandez
Keyword(s):  
Primary Care ◽  
Case Studies ◽  
Patient Outcomes ◽  
Positive Patient ◽  
Opiate Withdrawal ◽  
Opioid Dependency ◽  
Addiction Services ◽  
Addiction Service ◽  
Improve Patient

Dependency on benzodiazepine and opiates is an increasing problem. Jeff Fernandez uses case studies to show how a nurse-led addiction service based in primary care can improve patient outcomes This article looks at the development of the benzodiazepine and opiate withdrawal service (BOWS) based in addiction services in London. The service was created to implement a manageable and sustainable model that would treat patients with benzodiazepine and codeine-based dependencies. It was envisaged the service would effectively treat patients in GP practices in two boroughs in London. The article outlines what is possible in terms of treatment for patients with issues of opioid dependency, by examining two in-depth case studies. It also illustrates what is possible for nurses in the modern NHS and can be used as a resource to shape and deliver services with positive patient outcomes. Nurses should be seen as shaping and delivering care in the NHS. This is a role that should be promoted to a greater degree, wherever possible.

The Benzodiazepine and Opiate Withdrawal Service: an overview and case studies

2020 ◽  
Vol 9 (2) ◽  
pp. 1-4
Author(s):  
Jeff Fernandez
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Drug Use ◽  
Case Studies ◽  
Opiate Withdrawal ◽  
The Past ◽  
Problematic Drug ◽  
Specialist Services ◽  
Long Time

Patients who have a dependency on benzodiazepines and nonbenzodiazepines have always been able to access drug services in the past in primary care. This has now been expanded to include other problematic drug use on mainly prescribed medications, such as tramadol, gabapentin and pregablin, with the development of the Benzodiazepine and Opiate Withdrawal Service across Camden and Islington. This article looks at the population in general practice in Islington who have been on codeine-based medications for a long time. It examines how treatment can be changed and made more beneficial for them with engaging in specialist services supporting GPs in primary care.

Shaping and delivering services in primary care: benzodiazepine and opiate withdrawal service

2021 ◽  
Vol 3 (11) ◽  
pp. 459-463
Author(s):  
Jeff Fernandez
Keyword(s):  
Primary Care ◽  
Case Studies ◽  
Patient Outcomes ◽  
Positive Patient ◽  
Opiate Withdrawal ◽  
Opioid Dependency ◽  
Addiction Services

This article looks at the development of the benzodiazepine and opiate withdrawal service (BOWS) based in addiction services in London. The service was created to implement a manageable and sustainable model that would treat patients with benzodiazepine and codeine-based dependencies. It was envisaged the service would effectively treat patients in GP practices in two boroughs in London. The article outlines what is possible in terms of treatment for patients with issues of opioid dependency, by examining two in-depth case studies. It also illustrates what is possible for nurses in the modern NHS and can be used as a resource to shape and deliver services with positive patient outcomes. Nurses should be seen as shaping and delivering care in the NHS. This is a role that should be promoted to a greater degree, wherever possible.

Dermatology in primary care: an audit of the proportion of patients who present to general practice with a dermatological problem that could be self-managed

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711053
Author(s):  
Luamar Dolfini ◽  
Yogesh Patel
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Acne Vulgaris ◽  
Clinical Information ◽  
Electronic Record ◽  
Self Management ◽  
Considerable Proportion ◽  
Dry Skin ◽  
Record System ◽  
Common Skin

BackgroundA considerable proportion of GPs’ workload is dermatological. It is important to investigate what common skin conditions encountered in primary care can be self-managed, in an effort to alleviate the burden on primary care.AimThe purpose of the audit was to identify the proportion of consultations that are dermatological in nature and analyse potential for self-management by patients.MethodData was collected using the patient electronic record system (EMIS) in general practice. A search was made for all consultations from the 17 April to 15 May 2019, which included all new presenting complaints that were dermatological in nature. The criteria for self-management included advising over the counter (OTC) medication or reassurance. On the other hand, a case was deemed not self-manageable if prescription only medication (POM) was prescribed or if a referral to dermatology was made.ResultsThere were a total of 2175 consultations, where 246 (11.31%) cases were dermatological. Of the 246, 80 cases (32.5%) could be self-managed. There were 46 different dermatological presenting complaints of which the 5 most common included: rash (51 cases), dermatitis (44 cases), acne vulgaris (13 cases), moles (12 cases), dry skin (11 cases). None of the acne or moles cases could be self-managed, whereas 23%, 68.2%, 72.7% of rashes, dermatitis, and dry skin cases, respectively, could be self-managed.ConclusionCertain dermatological conditions have more potential for self-management than others. Research into teledermatology as a means of addressing patient concern and providing clinical information is important in order to reduce unnecessary consultations.

The Impact of COVID-19 on Primary Care General Practice Consultations in a Teaching Hospital in Shanghai, China

2020 ◽  
Author(s):  
Zhongqing Xu ◽  
Jingchun Fan ◽  
Jingjing Ding ◽  
Xianzhen Feng ◽  
Shunyu Tao ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Teaching Hospital ◽  
The Impact

scholarly journals Cross sectional study estimating prevalence of heart failure and left ventricular systolic dysfunction in community patients at risk

Heart ◽  
2001 ◽  
Vol 86 (2) ◽  
pp. 172-178 ◽  
Author(s):  
O W Nielsen ◽  
J Hilden ◽  
C T Larsen ◽  
J F Hansen
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
General Practice ◽  
Heart Disease ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction ◽  
Cross Sectional ◽  
General Practices

OBJECTIVETo examine a general practice population to measure the prevalence of signs and symptoms of heart failure (SSHF) and left ventricular systolic dysfunction (LVSD).DESIGNCross sectional screening study in three general practices followed by echocardiography.SETTING AND PATIENTSAll patients ⩾ 50 years in two general practices and ⩾ 40 years in one general practice were screened by case record reviews and questionnaires (n = 2158), to identify subjects with some evidence of heart disease. Among these, subjects were sought who had SSHF (n = 115). Of 357 subjects with evidence of heart disease, 252 were eligible for examination, and 126 underwent further cardiological assessment, including 43 with SSHF.MAIN OUTCOME MEASURESPrevalence of SSHF as defined by a modified Boston index, LVSD defined as an indirectly measured left ventricular ejection fraction ⩽ 0.45, and numbers of subjects needing an echocardiogram to detect one case with LVSD.RESULTSSSHF afflicted 0.5% of quadragenarians and rose to 11.7% of octogenarians. Two thirds were handled in primary care only. At ⩾ 50 years of age 6.4% had SSHF, 2.9% had LVSD, and 1.9% (95% confidence interval 1.3% to 2.5%) had both. To detect one case with LVSD in primary care, 14 patients with evidence of heart disease without SSHF and 5.5 patients with SSHF had to be examined.CONCLUSIONSSHF is extremely prevalent in the community, especially in primary care, but more than two thirds do not have LVSD. The number of subjects with some evidence of heart disease needing an echocardiogram to detect one case of LVSD is 14.

Estimating pertussis incidence in general practice using a large Australian primary care database

Vaccine ◽  
2021 ◽  
Author(s):  
Robert Neil F. Leong ◽  
James G Wood ◽  
Bette Liu ◽  
Robert Menzies ◽  
Anthony T. Newall
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Primary Care Database ◽  
Care Database

scholarly journals Mental Illness in Primary Care Settings

1985 ◽  
Vol 9 (1) ◽  
pp. 12-13 ◽  
Author(s):  
Greg Wilkinson
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
General Practice ◽  
Social Security ◽  
General Practitioners ◽  
Research Unit ◽  
Practice Research ◽  
Policy Makers ◽  
Department Of Health ◽  
Primary Care Settings

A Conference on the above topic took place at the Institute of Psychiatry, London, on 17 and 18 July 1984. The Conference was sponsored by the Department of Health and Social Security and was organized by the General Practice Research Unit. Over 100 invited clinicians, research workers and policy-makers took part. The majority of the participants were either psychiatrists or general practitioners, but representatives of all relevant disciplines attended.

Recognition of and Response to Dementia Syndrome in Primary Care: Part 1

2009 ◽  
Vol 2 (4) ◽  
pp. 230-236 ◽  
Author(s):  
Steve Iliffe ◽  
Priya Jain ◽  
Jane Wilcock
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Cognitive Function ◽  
General Practitioners ◽  
Function Tests ◽  
Dementia Syndrome

The theme of this article is the recognition of and response to dementia in general practice. Its aim is to clarify the tasks of diagnosing dementia, to advise on the use of cognitive function tests, to suggest ways of establishing the subtype of dementia where possible and to assist general practitioners in talking about dementia with their patients and their families.

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