Medication & Chronic Disease Management Review

24 hour blood pressure monitoring In some cases, your doctor may recommend 24-hour or ambulatory blood pressure monitoring (ABPM). This is where your blood pressure is tested automatically around every 30 minutes over a 24-hour period using a cuff attached to a portable device worn on your waist. ABPM can help to give a clear picture of how your blood pressure changes over the course of a day. You should continue with your normal daily activities during the test, although you must avoid getting the equipment wet.

A regular asthma review could help you keep free of symptoms and cut your risk of an asthma attack.

This is a great opportunity to talk to your GP about:

• Symptoms getting in the way of things you want to do,
• Asthma attacks – whether you’ve had one, or you’re scared of having one,
• Medicines – how they help, and any side effects,
• Stop smoking advice and other ways to help you avoid asthma symptoms.

Your asthma review is a check-up to see how well you’re managing your asthma, and to see if there’s anything more you and your GP can do to help you avoid symptoms.

Cervical screening (a smear test) checks the health of your cervix. The cervix is the opening to your womb from your vagina. It’s not a test for cancer, it’s a test to help prevent cancer. All women and people with a cervix aged 25 to 64 should be invited by letter. During the screening appointment, a small sample of cells will be taken from your cervix. You’ll get your results by letter, usually in about 2 weeks. It will explain what happens next.

You’ll have regular contact with your care team to monitor your condition.

These appointments may involve:

• mtalking about your symptoms – such as whether they’re affecting your normal activities or are getting worse
• talking about your medicine – including whether you think you might be experiencing any side effects
• tests to monitor your health

It’s also a good opportunity to ask any questions you have or raise any other issues you’d like to discuss with your care team. Contact your GP or care team if your symptoms get suddenly worse or you develop new symptoms between check-ups.

The quality of care provided to patients with dementia can be improved by focusing on the following 6 key areas at this regular review.

This applies both to patients in the community and nursing home residents.

1. Medication Review
2. Mental Health
3. Physical Factors
4. Risk Assessment
5. Assessment of Carers Needs
6. Social Supports Review

Type 2 diabetes check-ups help to make sure your condition doesn’t lead to other health problems.

Every 3 months

Blood sugar checks (HbA1C test) : Checks your average blood sugar levels and how close they are to normal. You have these checks every 3 months when newly diagnosed, then every 6 months once you’re stable. This can be done by your GP or diabetes nurse.

Once a year

• Feet
  Checks if you’ve lost any feeling in your feet, and for ulcers and infections. This can be done by your GP, diabetes nurse or podiatrist. Speak to your GP immediately if you have cuts, bruises or numbness in your feet.
• Eyes
  Checks for damage to blood vessels in your eyes. Speak to your GP immediately if you have blurred vision. Blood pressure, cholesterol and kidneys: Checks for high blood pressure, heart and kidney disease. This can be done by your GP or diabetes nurse.

An electrocardiogram (ECG) is a simple test that can be used to check your heart’s rhythm and electrical activity. Sensors attached to the skin are used to detect the electrical signals produced by your heart each time it beats. These signals are recorded by a machine and are looked at by a doctor to see if they’re unusual. An ECG may be requested by a heart specialist (cardiologist) or any doctor who thinks you might have a problem with your heart, including your GP. The test can be carried out by a specially trained healthcare professional at a hospital, a clinic or at your GP surgery.

Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.

It’s usually associated with a build-up of fatty deposits inside the arteries (atherosclerosis) and an increased risk of blood clots. The exact cause of CVD isn’t clear, but there are lots of things that can increase your risk of getting it. These are called “risk factors”. The more risk factors you have, the greater your chances of developing CVD. The main risk factors for CVD are outlined below.

• High blood pressure
• Smoking
• High cholesterol
• Diabetes
• Inactivity Being overweight or obese
• Family history of CVD
• Ethnic background

If you’re over 40, you’ll be invited by your GP for an NHS Health Check every 5 years. Part of this check involves assessing your individual CVD risk and advising you how to reduce it if necessary.

You’ll have regular contact with your GP or care team to monitor your condition at least every 6 months.

These appointments may involve:

talking about your symptoms, such as whether they’re affecting your normal activities or are getting worse a discussion about your medication, including any side effects tests to monitor your health

It’s also a good opportunity to ask any questions you have or raise any other issues you’d like to discuss with your care team. You may be asked to help monitor your condition between appointments.

Persistently high blood pressure (BP) causes strain on the arteries carrying blood around the body, which may eventually lead to Heart Attacks and Strokes. Please look at the British Hypertension society website for further information.

If you have been diagnosed with hypertension you will usually be advised to start medication if your cardiovascular risk is elevated.

For those with hypertension it is important to monitor your blood pressure regularly. Many patient are measuring their own at home with a purchased device. We recommend that if you do so, you only purchase one that is approved as accurate by the British Hypertension society. Please note that they may need replacing every 3-4years as they will usually lose their accuracy after that.

Take your BP measurements after relaxing for 10 minutes and note down the best of three readings.

We need to see you at the practice annually for a brief review, but we need reassurance that your BP is controlled at other times. Your doctor will be interested to receive readings from you, at 3 monthly intervals unless your GP recommends otherwise.

Guidance on measuring blood pressure using a digital monitor.

Chronic kidney disease (CKD) is a long-term condition where the kidneys don’t work as well as they should.

It’s a common condition often associated with getting older. It can affect anyone, but it’s more common in people who are black or of south Asian origin.

CKD can get worse over time and eventually the kidneys may stop working altogether, but this is uncommon. Many people with CKD are able to live long lives with the condition. You’ll have regular contact with your care team to monitor your condition.

These appointments may involve:

talking about your symptoms – such as whether they’re affecting your normal activities or are getting worse a discussion about your medicine – including whether you are experiencing any side effects tests to monitor your kidney function and general health

It’s also a good opportunity to ask any questions you have or raise any other issues you’d like to discuss with your care team.

You may also want to help monitor your condition at home – for example, by using a home blood pressure monitor.

Contact your GP or healthcare team if your symptoms are getting worse or you develop new symptoms.

Getting your medication reviewed is not only important for you, but also allows the NHS to maintain a good level of service across the board. By regularly reviewing your medication, you can help the NHS save a considerable amount in terms of wasted medication. Medicine reviews can be performed by both pharmacists and GPs. Pharmacists can perform a Medicines Use Review (MUR) during which they can check how you are getting on with your medication. If your pharmacist feels that there are any changes that need to be made, you can then go on to book an appointment with your GP to have your prescription amended accordingly.

Blood tests have a wide range of uses and are one of the most common types of medical test.

For example, a blood test can be used to:

assess your general state of health check if you have an infection see how well certain organs, such as the liver and kidneys, are working screen for certain genetic conditions Most blood tests only take a few minutes to complete and are carried out at your GP surgery or local hospital by a doctor, nurse or phlebotomist (a specialist in taking blood samples).

Rheumatoid arthritis is a long-term condition that causes pain, swelling and stiffness in the joints. The condition usually affects the hands, feet and wrists.

There may be periods where symptoms become worse, known as flare-ups or flares.

A flare can be difficult to predict, but with treatment it’s possible to decrease the number of flares and minimise or prevent long-term damage to the joints.

Some people with rheumatoid arthritis also experience problems in other parts of the body, or more general symptoms such as tiredness and weight loss. See a GP if you think you have symptoms of rheumatoid arthritis, so they can try to identify the underlying cause.

Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage.

Many people don’t realise that their GP can help them quit smoking. Your doctor can do a lot, such as enrolling you in a “stop smoking” clinic, and prescribing nicotine replacement therapy, such as patches and gum, or stop smoking medication such as Champix. Cigarettes are addictive, and self-control alone might not be enough for you to stop entirely.

Give yourself a better chance of success by using nicotine replacement therapy (NRT). This is available on prescription from your GP, from your local stop smoking service or from a pharmacist.