The online home for the primary care professionals managing patients with cardiovascular disease, diabetes and related diseases.

Editorial

Saturday, 28 February 2015
Acommonly heard clinical expression is “He/she is very frail”. It provides a summary statement of an older person that implies concerns over vulnerability and prognosis. This is how we have conventionally considered frailty—as a descriptive label: ‘the frail elderly’. In this article, we will re-frame frailty in a potentially more helpful way. We will examine frailty from the perspective of an abnormal health state that behaves just like a long-term condition. This conceptualisation of frailty opens up new approaches to helping people who are frail.
Category: Editorial
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Saturday, 28 February 2015
The first section of this supplement made the case to consider frailty from the perspective of a long-term condition. This and the next section explore what this means in terms of applying some of the well-developed models for the care of longterm conditions to people who are living with frailty. First, we examine how the highly evidence-based model of supported self-management might be applied to frailty.
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Saturday, 28 February 2015
Supported self-management is feasible and desirable for people with mild frailty, but care and support planning is more appropriate for individuals with moderate frailty. This section considers how the primary healthcare team can apply a whole person and personalised approach to care and support planning.
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Saturday, 28 February 2015
Most nurses are involved in the care of the 1% of the population currently nearing the end of their lives: that is, people considered to be in their final year, months, weeks or days of life. The Gold Standards Framework (GSF) programmes can help provide a structured framework in this challenging area, leading to more proactive and consistent standards of care, and enabling more people to live well and die well where they choose.
Category: Editorial
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Saturday, 28 February 2015
Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves. This means the person is vulnerable to dramatic, sudden changes in health triggered by seemingly small events such as a minor infection or a change in medication.
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Friday, 20 February 2015
Over the next 10 years, an estimated 45,000 quality-adjusted life-years and £850m health and social care costs could be saved, if England saw a 5 mmHg reduction in the average population systolic blood pressure. In addition, substantial reductions in death and disability could be achieved if there was a step change in our approach to detection and treatment of hypertension. This is the rationale behind the Blood Pressure Action Plan that was published recently.
Category: Editorial
Wednesday, 29 October 2014
Insulin therapy is life-saving for people with type 1 diabetes, and a key component of the treatment regimen for many people with type 2 diabetes. At the same time, insulin is a major cause of adverse drug events, some of which are so severe that they cause emergency admission to hospital. There is therefore much that needs to be done to improve the safe use of insulin in order to reduce medication errors and hospitalisation associated with hypoglycaemia.
Category: Editorial
Thursday, 02 October 2014
A recent study concluded that in general practices providing NHS Health Checks, the change in reported prevalence of diabetes, hypertension, coronary heart disease (CHD) and chronic kidney disease (CKD) does not differ from practices that provide usual care.  Although the study was not randomised and was not powered to support this conclusion, it is of interest because it raises a number of important questions about the delivery of the NHS Health Check.
Category: Editorial

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