On the limitations of specialists.
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Clinical Competence↗
Biomedical subjects
Nick Summerton
Publications and source records attributed to Nick Summerton.
Your money or their life. Drug to combat blood pressure may come at a price, but the wider health benefits should not be underestimated, says Nick Summerton.
New anti-hypertensive drugs, although more expensive than conventional treatments, have significant benefits in the management of cardiovascular disease. NICE analysis of cost-benefits don't consider their impact on other risk factors for cardiovascular disease, such as diabetes. A broader perspective is necessary when assessing the public health of anti-hypertensive drugs.
Antihypertensive Agents↗
Clinical management. Where medicine meets management. Uneasy riders.
The NHS needs to form new alliances to address the public health challenges posed by the second Wanless report and the government's consultation paper on public health. Public health physicians need to return to clinical practice if they are to play a credible leadership role. 'Policy partnerships' could promote issues such as health inequalities.
Cooperative Behavior↗
Clinical management. Where medicine meets management. Random factors.
Care is required when applying the findings from randomised controlled trials, systematic reviews of RCTs or national 'evidence-based' guidelines to the broad groups of patients in primary care. N-of-1 trials offer a useful approach to tailor medication and improve the quality of a treatment decision in an individual patient. The length of the relationship with patients makes follow-up important.
Drug Therapy↗
Making a diagnosis in primary care: symptoms and context.
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Decision Making↗
Lung cancer patients' perceptions of access to financial benefits: a qualitative study.
BACKGROUND: Financial worries may add to the stress experienced by patients and their families, but they are often not discussed with health professionals. People with lung cancer usually have to give up work, and many are terminally ill. AIM: To explore the financial concerns, perceptions and experiences of claiming benefits of people with lung cancer. DESIGN OF STUDY: Qualitative study using narrative interviews. SETTING: United Kingdom. METHOD: Interviews with a maximum variation sample of 45 people with lung cancer, recruited through general practitioners, consultants, nurses and support groups. RESULTS: Some people did not know that they could claim financial benefits, others found claim forms complicated, or were unaware that they had no legal right for important allowances to be backdated. Some people had to 'struggle' to obtain much needed benefits to which they were entitled. Patients below retirement age said that they would prefer to be working, and many were shocked by how hard it was to obtain the information needed to make claims. There was some evidence that even those who are seriously ill, and life-time tax payers, feel stigma in claiming financial help. Nurses, doctors and other patients sometimes offered valuable guidance, but many patients did not receive timely advice. The special social security rules (and DS1500 report form), which might have allowed them to claim benefits more rapidly than usual and at a higher rate, were not always understood. CONCLUSION: Many reasons were found as to why people with lung cancer have difficulty getting the benefits that they are entitled to. Hospital and primary care staff who handle the issue sensitively and help set claims in motion provide a valuable service that should be replicated throughout the National Health Service.
Adult↗
Evidence in practice--number 3: Cox 2 inhibitors.
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Anti-Inflammatory Agents, Non-Steroidal↗