Primary Care Guidelines

By: Juan Fernando Florido Santana
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  • Summary

  • A podcast intended for healthcare professionals wanting to keep up to date relevant information about clinical practice guidelines
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Episodes
  • Podcast - The Heart of the Matter (Part 2): NICE Guidelines on CVD risk reduction and Lipid Management

    Podcast - The Heart of the Matter (Part 2): NICE Guidelines on CVD risk reduction and Lipid Management
    Nov 7 2024
    For the introductory video on cardiovascular risk reduction and lipid modification: · https://youtu.be/jIhlkmOcsiI For the second video on cardiovascular risk reduction and lipid modification: · https://youtu.be/QyN3toBGCNU For the NICE guidance on cardiac chest pain video: · https://youtu.be/so97zARpmME For the NICE management of stable angina video: · https://youtu.be/BtWs0VHjp00 This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido, and I am a General Practitioner in the United Kingdom. In this episode, I review the NICE guideline “Cardiovascular disease: risk assessment and reduction, including lipid modification” [NG238], published on 14 December 2023, focusing on what is relevant in Primary Care only. I cover statins for both primary and secondary prevention, assessing response to treatment, optimising therapy and what to do when statins are contraindicated or not tolerated. If you have not already done so, I recommend my previous introductory video on the subject covering CVD risk assessment, recommendations for specialist referral and considerations before starting statin therapy. The link is shown above. For a refresher on the NICE guidance on cardiac chest pain and the management of stable angina, please refer to the corresponding episodes on this channel. The links are shown above. I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the information consulted. You must always use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a YouTube version of this and other videos that you can access here: · The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The resources consulted can be found here:The NICE guideline “Cardiovascular disease: risk assessment and reduction, including lipid modification” [NG238] Published: 14 December 2023 can be found here:· https://www.nice.org.uk/guidance/ng238The online version of QRISK3 can be found here:· https://qrisk.org/The QRISK3-lifetime tool can be found here:· https://qrisk.org/lifetime/index.phpThe NICE guideline on familial hypercholesterolaemia can be found here:· https://www.nice.org.uk/guidance/cg71The Simon Broome criteria for the diagnosis of familial hypercholesterolaemia can be found here:· https://www.nice.org.uk/guidance/cg71/evidence/full-guideline-appendix-f-pdf-241917811The Dutch Lipid Clinic Network (DLCN) criteria for the diagnosis of familial hypercholesterolaemia can be found here:· https://www.mdcalc.com/calc/3818/dutch-criteria-familial-hypercholesterolemia-fhTranscriptIf you're listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today, we’ll look at the NICE guideline on cardiovascular risk reduction and lipid modification, or NG238, which was published in December 2023, focusing on what is relevant in Primary Care only. In this episode we are going to cover statins for both primary and secondary prevention, assessing response to treatment, optimising therapy and what to do when statins are contraindicated or not tolerated. If you have not already done so, I recommend that you listen to the previous introductory episode on the subject covering CV risk assessment, recommendations for specialist referral and considerations before starting statin therapy. The link is in the episode description. If you’d like a refresher on the NICE guidance on cardiac chest pain and the management of stable angina, please refer to the corresponding episodes on this channel. The links are also in the episode description. Right, let’s jump into it. We are going to start reviewing the prescribing of statins for the primary prevention of cardiovascular disease. And, before offering a statin, we will discuss the benefits of lifestyle changes and optimise the management of all other modifiable CVD risk factors if possible. Then, if lifestyle changes are not sufficient, we will offer statin treatment. Equally, before starting statins, we will treat comorbidities and secondary causes of dyslipidaemia, which include, for example, excess alcohol, uncontrolled diabetes, hypothyroidism, liver ...
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    12 mins
  • Podcast - The Heart of the Matter (Part 1): NICE Guidelines on CVD risk reduction and Lipid Modification

    Podcast - The Heart of the Matter (Part 1): NICE Guidelines on CVD risk reduction and Lipid Modification
    Oct 31 2024
    For the introductory video on cardiovascular risk reduction and lipid modification: · https://youtu.be/jIhlkmOcsiI For the NICE guidance on cardiac chest pain video: · https://youtu.be/so97zARpmME For the NICE management of stable angina video: · https://youtu.be/BtWs0VHjp00 This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido, and I am a General Practitioner in the United Kingdom. In this episode, I review the NICE guideline “Cardiovascular disease: risk assessment and reduction, including lipid modification” [NG238], published on 14 December 2023, focusing on what is relevant in Primary Care only. I cover CV risk assessment, recommendations for specialist referral and considerations before starting statin therapy. In the next episode I will cover the rest of the guideline including primary and secondary prevention, assessing response to treatment, optimising therapy and what to do when statins are contraindicated or not tolerated. For a refresher on the NICE guidance on cardiac chest pain and the management of stable angina, please refer to the corresponding episodes on this channel. The links are shown above. I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the information consulted. You must always use your clinical judgement. There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: · https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The resources consulted can be found here:The NICE guideline “Cardiovascular disease: risk assessment and reduction, including lipid modification” [NG238] Published: 14 December 2023 can be found here:· https://www.nice.org.uk/guidance/ng238The online version of QRISK3 can be found here:· https://qrisk.org/The QRISK3-lifetime tool can be found here:· https://qrisk.org/lifetime/index.phpThe NICE guideline on familial hypercholesterolaemia can be found here:· https://www.nice.org.uk/guidance/cg71The Simon Broome criteria for the diagnosis of familial hypercholesterolaemia can be found here:· https://www.nice.org.uk/guidance/cg71/evidence/full-guideline-appendix-f-pdf-241917811The Dutch Lipid Clinic Network (DLCN) criteria for the diagnosis of familial hypercholesterolaemia can be found here:· https://www.mdcalc.com/calc/3818/dutch-criteria-familial-hypercholesterolemia-fh Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through TranscriptIf you're listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today, we’ll look at the NICE guideline on cardiovascular risk reduction and lipid modification, or NG238, which was published in December 2023, focusing on what is relevant in Primary Care only. In this episode we are going to cover CV risk assessment, recommendations for specialist referral and considerations before starting statin therapy. Stay tuned because in the next episode we will cover the rest of the guideline including primary and secondary prevention, assessing response to treatment, optimising therapy and what to do when statins are contraindicated or not tolerated. If you’d like a refresher on the NICE guidance on cardiac chest pain and the management of stable angina, please refer to the corresponding episodes on this channel. The links are also in the episode description. Right, let’s jump into it.For people without established cardiovascular disease, we are now advised to use QRISK3 instead of QRISK2 to calculate the CV risk within the next 10 years. We will do this for those aged between 25 and 84, including those with type 2 diabetes.Because QRISK2 is currently embedded in the electronic clinical systems that most of us use in the UK, NICE accepts that, until the clinical software systems are updated with QRISK3, it may be necessary to continue using QRISK2.However, when assessing the CV risk for people taking steroids or atypical antipsychotics or people with SLE, migraine, erectile dysfunction or severe mental illness, we are advised to use the online version of QRISK3, because QRISK2 does not take these risk factors into account and may underestimate the risk. A link to the online version of QRISK3 is in the ...
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    12 mins
  • Podcast - PSA consensus 2024 - When should you check PSA levels?

    Podcast - PSA consensus 2024 - When should you check PSA levels?
    Oct 21 2024
    For the PSA video:· https://youtu.be/64vGSs6WLws For the NICE management of male LUTS video:· https://youtu.be/fgQcv01YJg0 My name is Fernando Florido, and I am a General Practitioner in the United Kingdom. In this episode, I review the latest guidance on PSA testing as outlined in the PSA Consensus 2024, available through Prostate Cancer UK and also featured in the British Journal of General Practice. I will also discuss recommendations from Public Health England, along with key aspects of the NICE guidelines on prostate cancer (NG12 and NG131) and the Pan London urology cancer referral pathways. You can find links to all of these resources below.Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by any of the institutions.I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the information consulted. You must always use your clinical judgement. There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: · The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The resources consulted can be found here:Guidance updated on PSA testing for prostate cancer by Public Health England can be found here:· https://phescreening.blog.gov.uk/2020/01/20/psa-testing-guidance/The PSA Consensus 2024 for health professionals available in Prostate Cancer UK can be found here:· https://prostatecanceruk.org/for-health-professionals/guidelines/psa-consensus-2024The article published in the British Journal of General Practice: “Optimising the use of the prostate- specific antigen blood test in asymptomatic men for early prostate cancer detection in primary care: report from a UK clinical consensus” can be found here:· https://bjgp.org/content/74/745/e534The leaflet on PSA testing and prostate cancer advice for men without symptoms of prostate disease aged 50 and over can be found here:· https://assets.publishing.service.gov.uk/media/64c3c279331a650014934e2c/PCRMP_patient_info_sheet_update_March_2022_v2.pdfThe NICE guideline on prostate cancer: diagnosis and management [NG131] can be found here:· https://www.nice.org.uk/guidance/ng131The NICE guideline on Suspected cancer: recognition and referral [NG12] can be found here:· https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer#urological-cancersThe Pan-London suspected cancer referral forms can be found here:· https://www.transformationpartners.nhs.uk/programmes/cancer/early-diagnosis/two-week-wait-referral-repository/suspected-cancer-referrals/The information leaflet recommended by Public Health England for well men aged 50 and over containing a summary of the potential benefits and risks of PSA can be found here: · https://www.gov.uk/government/publications/prostate-specific-antigen-testing-description-in-briefThe NICE management of male LUTS video:· https://youtu.be/fgQcv01YJg0 Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through TranscriptIf you're listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I’m Fernando, a GP in the UK. Today, we’ll look at the latest guidance on PSA testing, as outlined in the PSA Consensus 2024, available through Prostate Cancer UK and also featured in the British Journal of General Practice. We’ll also cover recommendations from Public Health England, some aspects of the NICE guidelines on prostate cancer (NG12 and NG131), and the Pan London urology cancer referral pathways, focusing on what is relevant in Primary Care only. You can find links to all of these in the episode description.If you’d like a refresher on the NICE guidance for managing male LUTS, please refer to the corresponding episode on this channel. The link is also in the episode description.Right, let’s jump into it.Although the PSA Consensus 2024 focuses on PSA testing in asymptomatic men, we’ll also cover testing in symptomatic patients.So let’s start with patients with symptoms.While many people with prostate cancer are asymptomatic, we ...
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    13 mins

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