Abstract
Refugee and Asylum Seeker Patient Health Toolkit
This is a great toolkit for GPs who are involved with the care of refugees and asylum seekers. It was updated in September 2023 and is a really comprehensive overview of current UK processes, eligibility for care and healthcare issues individuals may face.
Dementia prevention
Prompted by a combination of a recent patient (my reflection highlighting both a patient unmet need and a doctor’s educational need) and a letter in a journal, I have been left endeavouring to do more to discuss dementia prevention with patients, but also scratching my head as to how primary care and public health might need to think outside the box about how prevention of this condition is approached. The original article to which the letter refers is also well worth a read, as this will continue to be an important issue for us in general practice.
Willows T and Gopal D (2024). Letter: Rethinking the role of primary care in dementia prevention. British Journal of General Practice 74(738): 13. DOI: 10.3399/bjgp24X735945.
The Health Foundation Podcast
I’m always on the lookout for a new podcast, and at the start of the year I came across The Health Foundation’s podcast. The podcast covers a mix of issues impacting on health often from a political standpoint, ranging from artificial intelligence (AI) to privatisation. A good one for the commute to work.
Assessment of magnesium deficiency
An urgent phone call from the labs to report a low magnesium level had led to an interesting discussion over lunch in the practice around magnesium deficiency. For any readers in need of revision, the ‘Best Practice BMJ’ have a module on magnesium deficiency that was recently revised.
Journalling for mental illness
Speaking of podcasts, journalling is something, which is almost a buzzword, I hear in lots of health and wellness-based podcasts, but it isn’t something I tend to bring up with or recommend to patients. I was interested therefore to see this systematic review of journalling for mental illness. The authors conclude that while some trials do report positive outcomes, there is a lack of high-quality evidence from which to make firm recommendations. However, it is described as ‘low risk’ and ‘low resource’, therefore might be something GPs think about suggesting to patients ‘as an adjunct therapy’. What are your own thoughts?
Sohal M, Singh P, Dhillon BS, et al. (2022) Efficacy of journaling in the management of mental illness: A systematic review and meta-analysis. Family Medicine and Community Health 10: e001154. DOI: 10.1136/fmch-2021-001154.
Remote consultation
Trainees and First5® GPs reading this are working in a different primary care than that of 5 years ago, as a result of the significant shift in healthcare delivery that arose in response to the COVID-19 pandemic. My working day has certainly remained different to pre-pandemic. Payne and Dakin’s article in the British Journal of General Practice made me stop and think. I am fortunate to work in a sociable practice where staff are encouraged to spend time together for coffee or lunch, but it would be easy, with remote working and telephone consultations, to have a much more reclusive – and lonely – working life. And the importance of the patient voice – especially those for whom digital technologies may not be intuitive. How well do we seek their voice in developments around access, online information and remote consultations?
Payne R and Dakin F (2024) The place of remote consultation in modern general practice. British Journal of General Practice 74(738): 7–8. DOI: 10.3399/bjgp24X735873.
National Walking Month
May is National Walking Month. As one of the most accessible and easy ways for people to increase their activity levels, this would be a great campaign for the practice to promote. Posters and webpages could encourage more patients to walk to the practice or to aim for the charity Living Streets’ target of 20 minutes a day (#try20). Or teams within the practice could try to enable all staff to fit a 20-minute walk into their day?
www.livingstreets.org.uk/get-involved/national-walking-month
NICE update for primary care
At the start of the year, I came across the National Institute for Health and Care Excellence (NICE) update for primary care monthly newsletter, which is easy to subscribe to. It contains information about developments to NICE guidelines (such as the new guidance around the low density lipoprotein (LDL) cholesterol target for secondary prevention of cardiovascular disease), links to updated clinical knowledge summaries (CKS) and podcasts, and also ways to get involved with NICE, for example through contributing to consultations and joining committees.
Mirena® update
The United Kingdom Medicines Health Regulatory Authority has approved the extension of the licence of the 52 mg Mirena® intrauterine device from 5 years to 8 years (this is not the case for uterine protection for hormone replacement therapy or for treatment of heavy uterine bleeding, where the licence remains at 5 years).
The Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit has produced a useful summary of the evidence and clarity about the licences and unlicensed use of different products.
Menopause guidance
NICE should be publishing its update on guidance for the diagnosis and treatment of the menopause at the end of May 2024. The draft guidance has produced discussion about its recommendation to include cognitive behaviour therapy for the treatment of menopause symptoms. It will also include updated risk tables to support personalised decision making.
Perinatal mortality
The 2021 data on United Kingdom perinatal mortality was published in December 2023. This showed an overall rise in perinatal mortality (after 7 years of reduction) and further year-on-year gaps related to ethnicity and socio-economic status.
Body diversity
I was struck by a BMJ opinion piece by Dr Joy Hopkinson with her thoughts on body diversity in training. She gave cogent arguments for ensuring that the patient voice and advocacy is included in our training to ensure that we practice on a range of patients. Although she initially referred to a training experience where echocardiogram training was limited to male patients (to avoid struggling with breast tissue), the conversation is wider. In her article she flags the progress made in including different skin colours in dermatology training and images. Are there particular groups of patients who you don’t see in your training? Could you consider discussing with your trainer ways of ensuring a broader mix of patients? This might include spending some sessions in another practice with a different demographic, or one that includes, for example, refugees or homeless services.
Hodgkinson J (2023) Medicine is blind to body diversity – and it’s limiting doctors’ examination skills. BMJ 383(8410): 400–401.
Dementia toolkit
The Living with Dementia toolkit has a variety of resources for patients and carers. There are specific sections organised in five themes: stay safe and well, stay active, stay connected, keep a sense of purpose and stay positive. I thought the sections on culture, language and heritage might be particularly useful.
