Elderly medicine

e-Learning | Lower urinary tract infection (UTI)

NICE released new guidelines in Oct 18 on antimicrobial prescribing in lower urinary tract infection (UTI). Public Health England (PHE) has guidelines on the diagnosis and management of UTI, which were update shortly afterwards. There is separate advice on antibiotic prescribing in pyelonephritis, but this doesn't change practice. The PHE guideline especially is really useful.…
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Podcast | I’m a GeriGP

NASGP member Eva Kalmus describes how she became co-chair of the new GeriGP group of the British Geriatrics Society (BGS), and why being a portfolio GP has never been boring. When I did my GP training, about half of the GP trainees undertook a self-made rotation of approved jobs, followed by a year in general…
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e-Learning | Management of dementia

Join the clinical conversation NASGP's GP-only Facebook Group This is a new guideline from NICE on the management of dementia. Most of this is not new, but there were a couple of things I wasn't fully aware of. I'll list the things that were new to me, then do a bit of a summary. Cognitive…
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Nice | Alzheimer’s drugs

This is a guideline update from NICE on the use of  donepezil, galantamine, rivastigmine and memantine in Alzheimer's disease. Donepezil, galantamine and rivastigmine (the acetylcholinesterase - AChE - inhibitors) can now be used in mild disease, as well as in moderate disease. These drugs all work by increasing the level of ACh at sites of…
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Nice | Managing discharge from hospital

This is a new guideline from NICE giving advice about managing discharge from hospital safely. Most of this we already do. There are a couple of points worth noting: Patients felt to be at risk of re-admission need a GP or nurse visit or phone call 24 - 72 hrs after discharge. Palliative care patients…
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Home care for older people

This is a new guideline from NICE on homecare for older people. Most of this isn't new, or is aimed at other health professionals, but there are a couple of points of note for us. Care Coordinator. Nice advise considering organising a named care coordinator. This would normally be a social worker, a practitioner working for…
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Nice | Dementia – advice for those in ‘mid-life’

This is a new guideline from NICE advising that the following advice should be given to people in 'mid-life' to reduce the risk of dementia in later life: stop smoking (strong evidence for an increased risk) be more active (some evidence for an increased risk with inactivity) reduce alcohol consumption (there is an association between…
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Nice | Falls

This guideline gives advice about how to manage and prevent falls in the elderly. It is a remarkably practical guideline. I have tried to distil the important bits. I suspect that this is, in large, what most of us are doing already. It is interesting that NICE actually thinks that we should be doing relatively little…
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Nice | Stroke rehabilitation

Most of this guidance is aimed at secondary care and the services advised seem to be happening already locally. An interesting section on returning to work, is however relevant to us, so I've pulled out some of the less obvious bits: • Both cognitive and emotional changes, in addition to physical ones,  can occur after…
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