Helping people to change risky behaviour is notoriously difficult, but brief motivational interviewing has been found to be helpful. In this article, we look at the research supporting this patient-directed counselling style and how to use it in clinical practice.
More and more nurses in primary care are involved in monitoring international normalised ratio (INR) levels and advising patients on warfarin doses as anticoagulation clinics move out of secondary care and into primary care. In this article we explore why warfarin is prescribed, how to monitor patients on the drug and what to look out for in terms of interactions with prescribed medicines, over-the-counter drugs and foods. We also need to be able to advise on lifestyle interventions that go hand-in-hand with taking warfarin.
Renal services do not need renal social workers to keep patients alive.Nephrologists, transplant surgeons and renal nurses can manage that challenge without our involvement. So why are social workers attached to a renal service? Are they just an added extra – an upgrade in the service rather than an essential component of it?
Although there are other oral anticoagulation agents available, warfarin is the drug used predominantly in the UK. Warfarin has been in clinical use for over 50 years. It is still referred to by patients as 'rat poison' and,indeed, warfarin derivatives are still used as rodenticides.In this article, we take a look at some of the new oral anticoagulants coming along.
The major risk factors for cardiovascular disease (CVD) include high blood pressure, dyslipidaemia,diabetes, and smoking, all of which can be managed with lifestyle and therapeutic interventions. C-reactive protein is emerging as a useful new risk marker.
We often take modern medicine for granted,but a review of the history of a disease and its treatment can help us put the whole thing in perspective.In this article,we trace the development of understanding about the nature and cause of diabetes and the use of insulin as a key treatment.
This article will examine the issues surrounding blood glucose monitoring for people treated with insulin.It will look at the practical skills required for patients to test accurately,the roles of the individual patient and the healthcare professional in successful monitoring,and the equipment required.The aim of the article is to ensure that monitoring justifies the expense and time involved by achieving good glycaemic control.
How much insulin does a patient with type 2 diabetes need for optimal glucose control? It can sometimes be a tricky balancing act to get the dose just right – too much increases the risk of hypoglycaemic episodes and too little risks poor glucose control and the associated long-term complications.In this article we review what the research and guidelines recommend in how to ensure each patient gets the best dose of insulin.