Respiratory disease in practice - 2010


Integrated respiratory care: the primary/secondary care interface
Irem Patel
pp 1-4
We have seen radical changes in the traditional landscape of healthcare delivery in recent decades. Many patients now access healthcare via the telephone, online or after review by a specialist nurse, pharmacist or other healthcare professional working in an enhanced role. On attending A&E, patients will often be admitted under the care of an ‘acute physician’ for short hospital stays, and not necessarily a specialist secondary care team. Conversely, a GP with a specialist interest (GPwSI) can provide specialist input in a primary care setting.
Comment: Oxygen – stuff of life, but also death
Philip W Ind
pp 3-3
Everyone knows we breathe oxygen and that it is necessary for life. It has been used in treatment since 1790, yet there is widespread ignorance of its dangers! It is believed by many that if oxygen is good then more is better – as oxygen-enhanced water and ‘oxygen bars’ testify.
The role of antibiotics in treating long-term and exacerbated bronchiectasis
Pallavi Mandal and Adam T Hill
pp 5-7
First described by Laennec in 1819, noncystic fibrosis (CF) bronchiectasis is a disease of children and adults and is associated with impaired mucociliary clearance and frequent chronic colonisation of the normally sterile airway with bacteria. In the UK, about 100 in 100,000 were estimated to have bronchiectasis in 1950s; this was an era before the use of high-resolution computed tomography (HRCT). The current prevalence is unknown.
Asthma management in the Isle of Wight: the importance of good inhaler technique
Paul Jerram
pp 8-9
Asthma-related hospital admissions can have devastating (and in some cases fatal) consequences, and with 5.4 million people suffering from asthma, an admission occurs every seven minutes in the UK. The Isle of Wight Primary Care Trust (PCT) had previously sought to reduce hospital admissions through a focus on patient inhaler technique, but this had proven unsuccessful at all earlier attempts; thus, a subtly different approach was adopted.
The Asthma Dashboard – a new tool for measuring asthma outcomes
Emily Humphreys
pp 10-11
Asthma is one of the most common long-term conditions in the UK, affecting around 5.4 million people, including 1.1 million children. The costs of asthma care and treatment contribute significantly to NHS spending, with around £1 billion per year being spent on asthma care.

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