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Addressing alcohol dependence is a key issue for primary care

The lack of help for alcohol dependent patients was highlighted at the Belfast Nursing in Practice event.

Nurse consultant Mark Holmes shocked delegates by explaining that only 6% of alcohol dependent patients receive treatment each year at the event in the Ramada Plaza.

He said that “in 2009 under 10% of drinkers had discussed their alcohol consumption with healthcare professions - for some reason [health professionals] don't like talking about it”.

He urged nurses to start conversations with patients about their alcohol consumption in their daily practice, as this is often the route cause of problems patients face.

Holmes emphasised the scale of the issue by discussing how a close family member of his had been wrongly diagnosed and treated for Parkinson's disease for three years, before it was recognised his problem was really alcohol dependency.

Diabetes specialist nurse Gareth Thomas gave a presentation on the importance of patient eductaion in diabetes management.

Dr Gylnis Henry head of Health and Social Care (HSC) Clinical Education Centre delivered a speech on how key developments in the nursing profession might affect the current and future work
of primary care nurses.

More education needed for diabetes patients

With £25,000 spent on diabetes every minute, according to new research, treatments for type 2 diabetes were highlighted as a major issue at the Nursing in Practice event in Plymouth.

Sam Rosindale, diabetes lead for Torbay and Devon, stressed the need for changes in primary care for patients with type 2 diabetes in the opening speech.

She said that just 12% of newly diagnosed patients are offered a structured education about type 2 diabetes.

“To improve, we must give type-2 patients information all the way through treatment, like type 1 sufferers have, and this must be evidence-based and quality-assured,” she explained.

Currently, 10% of the NHS budget in England and Wales is spent on drugs for diabetes, and Metformin is often relied upon as an oral first-line treatment to control blood sugars.

The herb-based remedy “actually works with patients even taking a small amount,” she said.

However, if this can't keep patients glycated haemoglobin (HbA1C) levels below 1.6% it must be combined with some other options.

Rosindale explained insulin could be used but often has side effects like weight gain, but a new treatment, Invokana, has been NICE-approved for dual or triple therapy and research suggests it could give patients a sustained 3-4kg weight loss over a two year period. Regardless of the chosen medication, she emphasised that the treatment decision must be patient-centred, well-informed and reviewed regularly.

Other sessions covered topics such as diagnosing an over-active bladder, managing chronic kidney disease, treating chronic airflow limitation, advising travellers, engaging with patients who smoke and responding to depression in everyday practice.

Speaking about the event, Karen Buckman, a practice nurse from Devon Square Surgery in Newton Abbot, said: “It was very useful, the pathway of care for each subject was clear. It just enlightens and refreshes your education.”

Another talk that was very well-received was from Susie Cole, matron/clinical nurse specialist, Royal Devon and Exeter Acute Trust, on the nurses role in diagnosing and referring patients with an overactive bladder (OAB).

“It's not a sexy subject, but it's very much about the patients quality of life. It can be horrendously embarrassing, create low self esteem, reduce patients sex life, and if more elderly people are getting up more at night it can be about life and death.”

She explained that you could have an overactive bladder with or without incontinence and that it can affect all genders and ages, “my youngest patient is five, my oldest is 101,” she said. If you suspect a patient has an OAB it's important to check that it isn't a UTI or stress incontinence (brought on by laughing, jumping etc), and then check the time and frequency, she said.

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