Respiratory disorders, in particular asthma and chronic obstructive pulmonary disease (COPD), have been recognised for many years and remain among the most common chronic long-term conditions that are seen in primary care. Despite the development of guidelines, standards and effective treatments, both diseases continue to carry a high morbidity and mortality, a significant societal cost in terms of lost school and work days, and high consultation and admission rates.This article follows the development of our knowledge of these common disorders and looks at how far we have progressed in our diagnosis, knowledge and treatments, as well as what the future may look like in terms of care management and treatment options.
As a consequence of increasing prevalence, cost, and complications of diabetes, there has been a significant shift in the management of patients with diabetes from secondary to primary care in the last decade (Hawthorne et al, 2012). This article explores some of the goals, issues and practicalities in caring for people with diabetes in primary care, based on a community model used by a diabetes specialist team in London, and the role of diabetes specialist teams in supporting general practice nurses (GPNs) and other healthcare professionals in the multidisciplinary team. It also highlights the importance of ongoing diabetes education and training to ensure that all patients receive early diagnosis, appropriate health checks, an individualised treatment plan, and appropriate referral as needed.
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