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NIHR Signal ‘Care navigation’ is being widely adopted in primary care, but in varying ways
Clinical Commissioning Groups (CCGs) in England are implementing care navigation in primary care to help people with non-medical issues to access alternative services. This ‘social prescribing’, facilitated by nominated care navigators, also aims to reduce the pressure on general practice, and forms part of the NHS Long Term Plan. This NIHR-funded study shows that the role is fulfilled in different ways by people with a wide variety of job titles. This may make it harder for patient...
NIHR Signal Patients, in theory, might prefer GP-led care to self-management for high blood pressure
Patients offered the pros and cons of different monitoring options appear reluctant to self-manage high blood pressure, and prefer frequent monitoring by a GP, pharmacist or via telehealth (where readings are sent to health professionals and medicines managed remotely). The small online survey, completed by 167 patients, was used to explore how patients might feel about moving away from GP-led care to other care models not currently routinely offered in the UK. Perhaps surprisingly, patients, i...
NIHR Signal Repeat thyroid function tests for healthy older people are not needed
Older adults with normal thyroid function or subclinical thyroid dysfunction show notable long-term stability of their thyroid hormone levels. This suggests that it is safe for GPs not to routinely retest older adults unless they have risk factors or develop clinical symptoms of overt thyroid dysfunction. Over five years, about 0.2% older adults with normal thyroid function will develop overt hypothyroidism and about 3.5% will develop subclinical hypothyroidism. Amongst those with subclinical h...
NIHR Signal Paracetamol and alcohol are the most common substances taken by young people and rates of poisoning are increasing
The rates of the five most common types of poisoningin young people haveincreased three to five-fold from 1998 to 2014 and is cause for concern. A study including more than 1.7 million young people aged 10 to 24 in the UK found records of 31,509 people who had been treated for poisoning (2% of the total). Where the substance was recorded, 40% of poisonings involved paracetamol, and 33% involved alcohol. Other substances used included non-steroidal anti-inflammatory drugs, antidepressants and op...
NIHR Signal A blood test threshold for diagnosing heart failure in general practice is reviewed
The cut-off level for the blood test NTproBNP appears to provide the best balance of detecting true cases while excluding false positives when lowered to 125 pg/ml. The trial supported by the NIHR included a sample of people presenting to their GP with suspected heart failure. It aimed to see which method was best for identifying those who needed referral: the blood test alone; clinical decision rules based on clinical symptoms; or the combination of both. The blood test alone at the 125 pg/ml...
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