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

Editorial

Thursday, 27 January 2011
We live in exciting times with the development of several new oral anticoagulant agents, including the recent approval of the direct thrombin inhibitor dabigatran for the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). Dabigatran, an oral agent with fixed dosing, is an attractive alternative to warfarin which has recently been made available in the UK. What are the implications for UK primary care? Many patients with AF receive substandard anticoagulation and are therefore at risk of stroke. Evidence for its efficacy and its potential place in clinical practice is reviewed.
Category: Editorial
Thursday, 27 January 2011
The sulphonylurea group of drugs and the biguanide drug metformin have both been available for use as glucose-lowering therapies for more than 50 years. There were, however, few other clinically relevant developments in this area of pharmacotherapy until about the year 2000. At that time a new class of glucose-lowering therapies, the thiazolidinediones pioglitazone and rosiglitazone, was launched. In 2007 two more new classes of therapy were launched, the dipeptidyl peptidase-4 (DPP-4) inhibitors and the glucagon-like peptide-1 (GLP-1) mimetics; both of these classes of agents work on the incretin pathway.A further new class of glucose-lowering agents, the sodium glucose co-transporter 2 (SGLT2) inhibitors, is likely to be launched in the next year or two. So much activity in glucose lowering pharmacotherapy in this past 12 years perhaps makes up for the previous 40 years of relative inactivity!In this article we discuss new glucose-lowering therapies and consider their place in diabetes management from the primary care perspective.
Category: Editorial
Thursday, 27 January 2011
The QOF quality and productivity (QP) indicators fall into three categories: prescribing, outpatient referrals and emergency admissions. What will these new indicators mean for primary care and how might they affect the prescribing of cardiovascular drugs and referrals to secondary care ?
Category: Editorial
Thursday, 27 January 2011
The first general practitioners with a special interest (GPwSI) in cardiology services were set up more than 10 years ago but there is little information available on the national level about service provision. The authors invited all GPwSIs in cardiology to complete a survey detailing their qualifications and experience, range of services provided, capacity and clinical governance. The results are presented here.
Category: Editorial
Thursday, 27 January 2011
We describe here a project that sets out to reduce the risk of stroke in patients suspected of having a transient ischaemic attack.
Category: Editorial
Thursday, 27 January 2011
It is clear that hospital admission causes many preventable deaths from venous thromboembolism (VTE) yet the general public and, we would suggest, primary care health workers, still think of air travel as the main risk factor. Is there a role for primary care in helping to reduce the numbers of patients with hospital-acquired VTE?
Category: Editorial
Thursday, 27 January 2011
Category: Editorial
Thursday, 27 January 2011
The new coalition government of the United Kingdom (UK) has announced plans to change the NHS radically in England. The Department of Health has published two important documents Equity and excellence: liberating the NHS and Liberating the NHS: commissioning for patients. The implications for primary and secondary care, and for local authorities, mental health services and community providers, will be enormous. The changes are taking place at a rapid pace and every manager and clinician in the NHS will need to keep abreast of developments as they will affect the way in which we all deliver services in the future.
Category: Editorial

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