Treatment options Resources

Disorders affecting the brain cover a wide spectrum of conditions and many increase in incidence and prevalence with older age. Their symptoms are variable affecting each individual person differently, with some diseases following a progressive pattern. In these instances, as progression occurs, symptoms may impact on family and friends, as well as having a significant effect on the health and wellbeing of those affected. This article, the second of a two-part series on brain diseases, covers Parkinson’s disease, brain tumours, epilepsy and multiple sclerosis (MS). Signs and symptoms, risk factors, diagnosis, treatment and management and prognosis are explored, with the aim of giving general practice nurses (GPNs) and non-medical prescribers more knowledge and confidence in advising and supporting patients affected by any of the diseases discussed.

Chronic kidney disease (CKD) is an ongoing decline of renal function which may progress quite rapidly or develop slowly over many years. Due to the nature of the disease, it is linked to cardiovascular disease (CVD) and a host of symptoms, comorbidities, high mortality and reduced quality of life. The majority of CKD patients will be identified in primary care. Once diagnosed, patients are likely to become increasingly frequent attenders within general practice. It is therefore useful to have an overview of the disease process and the multifaceted care needs of this specific patient group. General practice nurses (GPNs) are vital members of the multidisciplinary team who are well􀀀placed to identify, monitor and provide ongoing support for patients with CKD.

Chronic constipation is a common disorder affecting 25% of the population at some point in their lifetime (Belsey et al, 2010). The statistical evidence shows a substantial financial burden on the NHS, with many people who have constipation recording unsatisfactory treatment and outcomes. It is difficult to define as professionals often classify the  symptoms in a different way to the patient. It could be argued that as a symptom and not a disease, constipation is a condition that would be preventable in many cases if there was a better understanding among healthcare professionals  and a more consistent approach to treatments offered. This article aims to highlight how thorough appropriate patient assessment, breaking down the social taboo around continence issues, and considering bladder and bowel issues as essential components of health and social care will lead to improved patient experience and satisfaction. General practice nurses (GPNs) are ideally placed to enable early detection of issues and offer appropriate advice or timely referral to specialist services.