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.

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.

scholarly journals Gout in primary care: Can we improve patient outcomes?

2017 ◽  
Vol 6 (1) ◽  
pp. u210130.w4918 ◽  
Author(s):  
Jacqueline Callear ◽  
Georgina Blakey ◽  
Alexandra Callear ◽  
Linda Sloan
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Improve Patient

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.

scholarly journals 002 Gout in primary care: can we improve patient outcomes?

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_3) ◽  
Author(s):  
Georgina Blakey ◽  
Jacqueline Callear
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Improve Patient

scholarly journals A TEAM APPROACH TO THE IMPLEMENTATION OF THE ANNUAL WELLNESS VISIT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S393-S393
Author(s):  
Lucy Guerra
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Practice Change ◽  
Team Approach ◽  
Change Initiative ◽  
Virtual Training ◽  
Highly Effective ◽  
To Come ◽  
Improve Patient

Abstract The success of any practice change initiative is dependent upon a highly effective team. This presentation will focus on the “secret sauce” of our implementation of the AWV in collaboration with the Dartmouth GWEP. Participating in both asynchronous and live virtual training enabled our team to come together to successfully implement the AWV using a team based model. Using the principles of highly effective teaming and a rapid cycle QI approach we have been able to improve patient outcomes in primary care.

Ulcerative colitis

2019 ◽  
Vol 12 (9) ◽  
pp. 501-506
Author(s):  
Charlie Andrews
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Primary Care ◽  
Patient Outcomes ◽  
Colon And Rectum ◽  
Inflammatory Bowel ◽  
Primary Care Clinicians ◽  
Improve Patient ◽  
Prompt Diagnosis

Ulcerative colitis is a form of inflammatory bowel disease. It is a chronic relapsing condition affecting the colon and rectum and can cause a variety of symptoms, the commonest of which is bloody diarrhoea. Prompt diagnosis, as well as flare identification and management by primary care clinicians can improve patient outcomes such as disease progression and effects on quality of life.

How prescribers can use technology to improve patient care

2019 ◽  
Vol 1 (4) ◽  
pp. 198-203
Author(s):  
Sam Shah ◽  
James Coughlan
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Information Technologies ◽  
Mobile Apps ◽  
Clinical Decision Support Systems ◽  
Improve Patient Care ◽  
Clinical Decision ◽  
Electronic Prescribing ◽  
Health Information Technologies ◽  
Improve Patient

Health information technologies (HITs) have become increasingly used in the NHS and offer prescribers the opportunity to prescribe in a more consistent and reliable way. There is a growing use of electronic prescribing systems, especially in primary care. This will likely reduce prescription errors, but evidence is unclear if it will improve patient outcomes. Clinical decision support systems can reduce variability and alert clinicians when prescriptions could cause patients harm; however, automation bias can create new errors to prescribers who over-rely on the system. HITs can better communication by improving discharge letters, facilitating telehealth appointments and supporting those working in remote settings. Mobile apps offer a way to engage patients in their own care and allow remote monitoring of chronic conditions in primary care, and acute conditions in emergency care settings. There are challenges in realising these benefits, with inconsistent infrastructure and a 10-year delay in realising predicted efficiency savings.

scholarly journals Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: A qualitative interview study using vignettes

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0014
Author(s):  
Emily Lyness ◽  
Jane Louise Vennik ◽  
Felicity Bishop ◽  
Pranati Misurya ◽  
Jeremy Howick ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Structured Interviews ◽  
Knee Oa ◽  
Qualitative Interview Study ◽  
Empathic Communication ◽  
Case Vignettes ◽  
Digital Training ◽  
Improve Patient

BackgroundOsteoarthritis (OA) causes pain and disability. An empathic optimistic consultation approach can improve patient quality of life, satisfaction with care, and reduce pain. However, expressing empathic optimism may be overlooked in busy primary care consultations and there is limited understanding of patients’ views about this approach.AimTo explore patients’ perspectives on clinician communication of empathy and optimism in primary care OA consultations.Design & settingVignette study with qualitative semi-structured interviews.SettingPurposefully sampled patients (n=33) aged 45+ with hip/knee OA from Wessex GP practices.MethodFifteen participants watched two filmed OA consultations with a GP, and eighteen participants read two case vignettes. In both formats, one GP depicted an empathic optimistic approach and one GP had a ‘neutral’ approach. Semi-structured interviews were conducted with all participants and analysed using thematic analysis.ResultsPatients recognised that empathic communication enhanced interactions, helping to engender a sense of trust in their clinician. They felt it was acceptable for GPs to convey optimism only if it was realistic, personalised and embedded within an empathic consultation. Discussing patients’ experiences and views with them, and conveying an accurate understanding of these experiences improves the credibility of optimistic messages.ConclusionPatients value communication with empathy and optimism, but it requires a fine balance to ensure messages remain realistic and trustworthy. Increased use of a realistic optimistic approach within an empathic consultation could enhance consultations for OA and other chronic conditions, and improve patient outcomes. Digital training to help GPs implement these findings is being developed.

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