The British journal of general practice : the journal of the Royal College of General Practitioners
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It is known that at least 90% of duodenal ulcers are caused by infection with the bacterium Helicobacter pylori. Eradicating this organism usually results in complete resolution of the disease. Testing for H pylori was introduced relatively recently, and thus, many patients known to have uncomplicated peptic ulcer disease who continue to need long-term treatment with ulcer-healing drugs have never been tested for the infection or offered eradication therapy. In modern computerized practices, this subgroup of patients can readily be identified by reference to morbidity and repeat prescribing data. Eradication of H pylori infection in this group of patients has great potential benefit for the individuals concerned as well as cost-saving benefit for the National Health Service. ⋯ Testing for and eradication of H pylori is worthwhile in general practice in those patients with previous proven duodenal ulceration who need long-term ulcer-healing medication. The high rate of eradication of H pylori achieved with the regimen used in this study compares very favourably with that of other treatment regimens. However, in patients with duodenal ulcers there may be coexisting pathology, and H pylori eradication does not necessarily result in complete disappearance of dyspeptic symptoms. Thus, when monitoring the outcome of treatment it is important to assess improvement of symptoms as well as objective evidence of eradication.
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The views of general practitioners on their increasing role in caring for people with learning disability in the community are not known. ⋯ General practitioners largely accepted their role as primary health care providers for people with learning disability. In contrast, their role as providers of health promotion for this patient group was not generally accepted. Further research into the appropriateness and opportunity costs of health screening for people with learning disability is needed.
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The present postgraduate education allowance structure for general practitioners is unacceptable and inadequate on a number of counts. Improvements could be made in continuing medical education by involving learners more actively, through giving them greater ownership of their continuing medical education aims and by integrating it with the current moves towards reaccreditation. ⋯ It would be more sensitive to current attitudes, more practical, a better use of existing facilities and more logical to improve continuing medical education by linking its improvement to the evaluation of reaccreditation in as acceptable and simple a way as possible. A framework is proposed, based on an annual educational general practitioner assessment visit in which a personal learning plan is developed as a focus for an individual's continuing medical education needs.