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Showing posts from February, 2013

User fees in universal health systems

In a letter published in The Lancet, in response to their recent series on universal health coverage, John Lee and colleagues from the Department of Primary Care & Public Health at Imperial College London comment that many people still need to pay a high proportion of total health expenditure out of pocket. Patients’ costs must be reduced to further improve health and provide financial protection in health systems with universal health coverage  Governments should continue to lower user charges in health systems with universal health coverage  Rather than seeing lower financial contributions from patients as an efficiency loss, they should see it as a means to promote prevention and the use of cost-effective services.

Patients' views on improving sickle cell disease management in primary care

Sickle cell disease (SCD) is the most common and fastest growing genetic disorder in England. SCD is an illness in which recurrent pain, also referred to as vaso-occlusive crisis, is a chronic concern. Primary care professionals therefore play a key role during the initial presentation of symptoms, as well as the management of long-term complications including such recurrent pain. In England, London residents account for approximately three quarters of all SCD admissions to hospitals, with the London Borough of Brent being one of the highest risk areas for SCD. Many aspects of SCD can be effectively and efficiently managed in primary care. Previous studies have shown successful interventions that move management of SCD, particularly uncomplicated sickle cell pain episodes, from tertiary towards primary care.

Focus groups may be useful for obtaining developmental input in managing SCD in primary care. In a paper published recently in JRSM Short Reports, Ghida AlJuburi and colleagues r…

Management of chronic obstructive pulmonary disease in India

The burden of chronic diseases such as chronic obstructive pulmonary disease (COPD) is increasing rapidly in low and middle-income countries. Despite this, their management in such countries has often not been well studied. In a paper published in JRSM Short Reports, Ailsa McKay and colleagues reviewed the nature and efficacy of current management strategies for COPD in India. They found information regarding current management – particularly on the implementation of national guidelines and primary prevention – to be very sparse. This led to difficulty in interpreting studies of management strategies, which were varied and generally of positive effect. Data regarding current management outcomes were very limited. They concluded that the current understanding of management strategies for COPD in India is limited due to a lack of published data. Determination of the extent of current use of management guidelines, availability and use of treatment, and current primary prevention strateg…

Views of patients about sickle cell disease management in primary care

Sickle cell disease (SCD) is the most common inherited blood disorder in England. Without prompt diagnosis and proper treatment, it can be a serious source of morbidity and mortality. The complications of SCD can lead to frequent hospital visits and appropriate management is needed to minimize the risk of developing such complications. SCD clinical guidelines recommend that patients see a general practitioner (GP) for routine examination every six months and more often if new problems arise or their treatment protocol changes. In addition, immunizations, prescriptions and other preventive care measures need to be delivered effectively by GPs to prevent recurring infections and pain crisis. In a questionnaire study published in JRSM Short Reports, Ghida AlJuburi and colleagues investigated the views of patients with SCD about the quality of care they have been receiving from their primary healthcare providers and what they thought was the role of primary care in SCD management.

The re…