Excess body weight is associated with a higher risk of cardiovascular disease, type 2 diabetes, cancer and a range of other debilitating health conditions, and is the third leading cause of death in high-income countries like the UK. Since practice nurses may have long-term, regular contact with patients, they may be well placed to motivate and support individuals in losing weight. It can, however, be difficult for nurses to find the right words to discuss this very sensitive subject with patients.
The NHS Health Check offers 15 million people aged 40-74 years in England an assessment of cardiovascular risk, together with preventive interventions, once every five years. The programme has aroused some controversy, but there is an urgent need to take action now to reduce preventable, premature death and disability caused by vascular disease.
The last decade has witnessed an explosion of interest in vitamin D. The vitamin has an established role in promoting bone health, but should we be routinely testing vitamin D levels in our patients? And what is the evidence that supplementation improves health beyond the skeleton?
In primary care, sending blood samples to the laboratory is so routine that it is easy to take these tests for granted. But it is important to understand the purpose of each test; when it is appropriate; and how to act on the results. Here red blood cell tests and their role in identifying possible causes for anaemia are discussed.
Over 10 years ago, publication of Women's Health Initiative (WHI) studies affected both public perceptions and our clinical prescribing of hormone replacement therapy (HRT). Front-page reports of higher risks of heart attacks, stroke and breast cancer led to around a million women in the UK stopping HRT, many without medical advice or clinical assessment. Since then, new evidence has emerged, much of which does not support the earlier alarming headlines.
Malnutrition is a cause and consequence of disease, and affects at least 3 million adults in the UK, most of whom live in the community. By helping these vulnerable patients to eat the right types of food rather than use inappropriate supplements, practice nurses can not only help prevent and treat malnutrition, but also save the NHS millions of pounds each year.
Most people with coronary heart disease (CHD) can be managed with lifestyle change and optimal medical therapy, but some patients need to be referred for revascularisation procedures such as angioplasty with stenting (also called percutaneous coronary intervention; PCI). Practice nurses have an important role to play in follow-up of these patients to minimise adverse events, promote lifestyle change and ensure continuing concordance with medication.