Hot Topics Blog
We are getting very excited about our upcoming Autumn 2017 Hot Topics courses!
All the presented material will be new compared to a year ago and the course comes with more associated learning materials than ever before. As well as the paper course book, you can download an electronic version of the book or access it via the new NB Medical App. Across the app, you can browse the whole book or just the 'keep it simple summaries', you can review the course via the webcast to catch up on any topics you want to see again and you can also write reflective notes to ensure that all your learning points are digitally preserved. Clarity users can now synch the app with their Appraisals Toolkit so that all is seamlessly joined up to help ease the process of appraisal and revalidation. As well as the app, the course comes with a wide range of other learning resources (e.g. pre and post course MCQs, access to our CPD Dashboard, CPD Tracker and webcast). New for Autumn 2017 we are moving to a 'paper shorter, electronic longer' version of the book. We are reducing the size of the paper book (it is still over 300 pages!) and expanding the size of the digital formats, to give you even more Hot Topics but less of a heavy weight to carry around!
All the material is 100% independent and free from any external influence or bias. As ever, we shall take a case-based, patient-centred approach to highlight the learning points. Topics to be included for Autumn 2017 will include:
- Cardiovascular medicine Always a Hot Topic we look at the new QRISK3 cardiovascular risk score, the latest evidence and research on the statins debate (including their use in the elderly) and also important new guidelines, research and recommendations on atrial fibrillation. In Scotland we shall look at the SIGN 2017 CV prevention guideline.
- Elderly people We look at the key Hot Topics of how we manage Multimorbidity and Frailty. Detection and better management of severe Frailty is perhaps the biggest Hot Topic in general practice today. Hospitals can't cope, GPs can't cope and above all our poor patients and their families can't cope either. How can we do better? This Hot Topic has been given new impetus for GPs in England with the new GP Contract 2017 It is now a contractual obligation for GPs to detect elderly patients with severe frailty, to undertake an annual review and manage them according to your clinical judgement including reviewing their medication and doing a falls risk assessment. But how can we do this in the most effective, time efficient and evidence-informed way as possible? The new NICE Multimorbidity guideline has been described as the most important NICE guideline ever. Why? And how can we adopt it in a pragmatic, patient-centred way?Undertaking careful medication reviews in patients with polypharmacy is part of this, what tools are out there to help us?
- Cancer diagnosis in people with 'vague symptoms'. We have heard a lot in the last couple of years about new guidelines for earlier detection of cancer, and they have already dramatically changed referral pathways. But what about people who present with vague symptoms? Just about everyone we see in GP has 'vague symptoms', so how do we reduce the chances that we miss a brain tumour, a pancreatic cancer or a myeloma? We also look at new research clarifying the link between raised platelets and cancer.
- Respiratory Medicine. Asthma is a major Hot Topic. We have new guidelines from BTS and SIGN, plus draft new guidelines from NICE that will significantly change practice (e.g. tiotropium and montelukast) and intriguing new evidence suggesting that Vit D supplementation may reduce asthma exacerbations. For COPD, we have major new guidelines from GOLD that change the way we think about and manage the condition. There are so many new inhalers out there (do you know your Relvar from your Onbrez??) you just know you need our Keep it Simple Summary to them...
- Gastroenterology Sigmoidoscopy screening for bowel cancer is now being rolled out through the UK. On what evidence is this based, how will it work and how does it sit alongside faecal occult blood screening (which in turn is being replaced by FIT testing). And we have a fascinating update on Giardia...are we missing this in cases of presumed IBS?
- Allergy How do we assess if a patient has a true penicillin allergy? And if you missed it last year, a great KISS of the latest Sepsis guideline.
- Musculoskeletal We have an update on the new NICE guidelines on back pain and spondyloarthritis, and the evidence that underpin them. We also cover the new 2017 BSR Gout guideline which has significant changes to practice.
- Mental health Eating disorders are a major Hot topic. We cover the new NICE guideline, and include important advice about how to recognise the really sick patient. Why is depression in adolescents such a Hot Topic? And how should we detect cases in this vulnerable and difficult to help group? And why is detecting autistic spectrum disorder important in our patients, and how can we do that better? What about our many patients with health anxiety? This is at epidemic proportions with large number of cases of 'cyberchondria' (internet-fuelled health anxiety). How can we help them?
- Neurology we look at important new research giving us more prophylactic options in migraine. And we have a simple new KISS of contraception options for women taking anti-epileptic drugs.
- Prescribing Hot Topics We have all the updates you need to know about over the last year related to prescribing safely, such as new research clarifying the association between low dose aspirin and bleeding risk (when should patients on low dose aspirin receive PPI cover?). We also look at the debate around the misuse, abuse and addictive potential of gabapentinoids and also this year's most important drug safety alerts.
- Women's Health Great news, 80% of women with breast cancer now survive breast cancer for > 10 years. But, that does not mean that breast cancer survivors are problem free. Their long-term care has moved into primary care, what do we need to know about how best to care for them? Non-invasive perinatal testing (NIPT) is coming into the NHS. We look at the recommendations and the evidence that underpin them. We have a selection of other Hot topics, such as dequalinium for BV and medical termination.
- Plus a selection of clinical cases to end the day e.g. how to manage chilblains, do alpha blockers help acute renal colic, should we test for Lyme disease in idiopathic Bell's palsy and 'doctor, I have blood in my semen'...what should you do?
As ever, the book also contains many interesting topical updates on some of the broader issues we are facing in General Practice today to reflect on e.g. GP Burnout and how to avoid it, 'overdiagnosis', or the problems in applying evidence based medicine to individual patients. We look forward to seeing you soon!
Simon, Neal, Gail, Kevin, Siobhan, Kate, Zoe, Ahmed and Rob
The NB GP Team
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