The British journal of general practice : the journal of the Royal College of General Practitioners
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Case management may be a feasible solution to the problem of service fragmentation for people with dementia. ⋯ Further investigation is required before case management for people with dementia and their carers can be implemented in primary care.
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Liver disease is a major cause of morbidity and mortality worldwide. Large numbers of liver function tests (LFTs) are performed in primary care, with abnormal liver biochemistry a common finding. Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver injury. Metabolic syndrome, common in people from South Asia, is an important risk factor for NAFLD. ⋯ Abnormal LFTs are common in the population, but are underinvestigated and often remain undiagnosed. Bangladeshi ethnicity is an important independent risk factor for NAFLD.
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Clinical practice guidelines are widely used in primary care, yet are not always based on applicable research. ⋯ Guidelines should specify the extent to which the research evidence underpinning each recommendation is applicable to primary care. The relevance of guideline recommendations to primary care populations could be more explicitly considered at all three stages of guideline development: scoping and evidence synthesis, recommendation development, and publication. The relevant evidence base needs to be presented clearly and concisely, and in an easy to identify way.
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Guidelines suggest that GPs should intervene on patients' weight, but to do so GPs must first recognise that a patient may have a weight problem and weigh them. ⋯ This sample of predominantly trainee GPs perceived overweight and obese weights as being of lower BMI and weight status than they actually are, and this was associated with a lower intention of discussing weight management with a potential patient. This was found to be true for trainee and fully qualified GPs who participated in the study. Healthcare professionals should not rely on visual judgements when identifying patients who may benefit from weight management treatment.