Medical Centre

Polypharmacy, or the use of multiple medications simultaneously, is a growing concern, especially among older people. Nearly one-third of people aged over 65 years of age in the UK take five or more medications daily. This is because people are living longer and often have multiple chronic illnesses that require medication. The Risks of Polypharmacy When people take many medications, there's a risk that some may not be necessary or might even be harmful. This can lead to: A heavy burden of managing multiple medications daily, which is time-consuming and stressful for patients. Difficulty in sticking to complex medication routines, especially for people with low health literacy or poor English language skills. Increased chances of adverse drug reactions and interactions, leading to potential harm and is severe cases to hospital admission. Given these risks, optimizing medication use is crucial, especially for those with multiple health issues. Medication Reviews (MRs) One way to add...

Alzheimer’s disease (AD) is a devastating condition affecting millions of people worldwide, with a significant impact on patients, families, and healthcare systems. Recent breakthroughs in diagnosis and treatment are offering new hope. Let’s explore these exciting developments and what they mean for the future of Alzheimer’s care based on our recent article in the The Journal of Prevention of Alzheimer's  Disease. The Rising Challenge of Alzheimer’s Disease Globally, Alzheimer’s disease is the most common cause of dementia, contributing to the majority of late-onset dementia cases. With an aging population, the number of people affected by Alzheimer’s is expected to rise, even if the age-specific rates of incidence and prevalence remain stable. This increase poses a significant challenge to healthcare systems, families and carers. Current Diagnostic Pathways Traditionally, diagnosing Alzheimer’s involves a combination of clinical assessments, imaging studies, and cerebrospinal...

The recent media coverage on semaglutide's potential in reducing the risk of cardiovascular disease (CVD) has raised hopes and questions alike. While the drug has shown promise in reducing cardiovascular risk, it's crucial to look beyond the relative risk reduction figures often highlighted in the news. To truly understand the impact of semaglutide, we must delve into the absolute risk reduction, cost-effectiveness, and long-term safety data. While the reported relative risk reduction is significant, it's crucial to consider the absolute risk reduction to accurately assess the semaglutide's effectiveness and calculate the number needed to treat ( NNT ) to prevent one adverse CVD event. These principles can be used to look at how any drug should be used in healthcare system’s such as the UK’s NHS. What are the key considerations? Relative Risk Reduction (RRR): Indicates the percentage reduction in risk between the treatment group and the control group. Absolute Risk Redu...

In some parts of England, proposals are emerging to divide NHS primary care services into separate pathways for acute, same-day care and long-term, complex care. While this approach aims to manage the growing workload in general practice, it raises significant concerns about potential negative impacts on patient care and NHS efficiency. We discuss the implications of these proposals in an article published in the British Medical Journal . The Holistic Strength of General Practice One of the key strengths of general practice lies in its holistic approach, where GPs offer continuous and comprehensive care. This continuity allows GPs to maintain a thorough understanding of a patient's medical history, lifestyle, and psychological aspects, leading to effective and cost-efficient care. Fragmenting services by separating acute and long-term care threatens this holistic approach and can undermine the management of chronic conditions, which often include acute episodes linked to ongoing he...

In our study published in the journal BMC Medicine , we report significant vulnerabilities to infectious diseases among UK migrants due to under-vaccination for diseases preventable through routine immunisations - such as measles, mumps, rubella, and polio. Our mixed-methods study, conducted between May 2021 and September 2022 across several London-based general practices, sheds light on the urgent need for improved healthcare strategies that ensure migrants receive necessary catch-up vaccinations. Background Migrants in the UK and Europe are often at increased risk of vaccine-preventable diseases (VPDs) due to incomplete childhood vaccinations and systemic marginalisation from health services. The COVID-19 pandemic further exacerbated these disparities, highlighting the critical gaps in vaccination coverage among adult and adolescent migrants. The study aimed to quantify these vaccination gaps and explore new strategies to improve vaccination uptake through better integration into pri...

Our new study in the Journal of Multimorbidity and Comorbidity sheds light on the challenges of assigning disease clusters to people with multiple long-term conditions In the world of healthcare, understanding how to manage and treat multiple long-term conditions (MLTC) is a significant challenge. our explores the effectiveness of different strategies for assigning disease clusters to people with MLTCs, aiming to improve our understanding of health outcomes. The study, a cohort analysis using primary care electronic health records from England, involved a massive sample of over 6.2 million patients. It evaluated the performance of seven different strategies for grouping diseases into clusters, with the aim of predicting mortality, emergency department attendances, and hospital admissions. What are Disease Clusters? Disease clusters are groups of conditions that frequently occur together, which may represent underlying shared causes or risk factors. By identifying these clusters, resea...

The general practice workforce is currently in crisis. In 2021/2022, there was an estimated shortage of 4200 full-time equivalent, fully qualified, permanently employed GPs in England, with recent surveys suggesting that 71% of GPs in the UK find their job ‘very’ or ‘extremely’ stressful. And the near future looks to be potentially worse — the Royal College of General Practitioner’s 2022 survey reports that 42% of GPs in England are likely to leave the profession in the next 5 years, and The Health Foundation predict that, without any policy action, there could be a one in two shortfall of GPs by 2030/2031.1,2 In an article published in the British Journal of General Practice , we discuss the NHS Long Term Workforce Plan for general practice and assess whether it can provide the policy solutions to mitigate this workforce crisis.