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evaluating the evidence for clinical practice and QOF Wednesday 26th to Friday 28th November 2008 BMA House
Based on our popular and highly-evaluated previous medical meeting, this exciting, new course has updated objectives specifically covering key areas of the QOF targets. Speakers are national experts involved in the production of speciality guidelines. Learning objectives are directly relevant to you and general practice. Sessions are interactive and designed to provide maximum time for questions and discussion. Stroke, Chronic Kidney Disease and Diabetes Heart Failure, Arrhythmia, CHD, Lipids & Hypertension Course fee: £175 per day for up to two days, £160 per day for three days Further information available at www.gpmasterclass.com or contact Liz Banks, Conference Organiser on 020 8346 1838 or [email protected] Stroke, Chronic Kidney Disease and Diabetes • Importance of BP control. (CKD2, CKD3)
• Therapeutic approaches to chronic kidney disease. • The value of ACE inhibitors or ARBs. (CKD5)
9.30am Session 1
• Prescribing in chronic kidney disease. Dr Anthony Rudd. Consultant Physician. Elderly Care Unit, St
CKD1. Register of patients aged 18 years and over with Stage 3 to 5 CKD
CKD2. Record of blood pressure
CKD3. Last blood pressure reading is 140/85 or less
CKD5. Percentage of patients on CKD register with hypertension and
• Definition. Incidence, prevalence and risk factors. Transient Ischaemic Attack.
• Assessment and treatment (STROKE1, STROKE13)
2.00pm Session 3
• Aspirin, lipids and blood pressure (STROKE5, STROKE6,
STROKE7, STROKE8, STROKE12))
Dr Mark Vanderpump. Consultant Endocrinologist, Royal Free
Acute Management of Stroke
Diabetes (Session 1)
Evidence for urgent CT or MRI scan(STROKE13)
Incidence, aetiology and pathogenesis
Viral infections and nutritional factors. Genetics. The burden of obesity (DM2)
• Effective ways to rehabilitate following a stroke. Diagnosis (DM19)
Secondary Prevention
Fasting glucose. Glucose tolerance test. • Risk factors: behavioral and physiological What’s the evidence for current practice?
• Antiplatelet agents – which treatment or combination is • Who should be screened, how often and what methods? best? (STROKE12, AF3)
• Intensive diabetic control. What are the benefits and • Benefits of anticoagulation in AF. When to start • Routine and annual checks (DM11, DM12). Retinal screening
(DM21), peripheral vascular disease (DM9), neuropathy (DM10),
• Is blood pressure reduction effective? (STROKE5, STROKE6)
nephropathy (DM13, DM22)
DM19. Register of Type 1 and Type 2 diabetics aged 17 years and over
• Statins for people with no history of coronary heart disease? DM2. BMI recorded
(STROKE7, STROKE8)
DM21. Record of retinal screening
• Carotid endarterectomy – do the benefits outweigh the DM9. Record of the presence or absence of peripheral pulses
DM10. Record of neuropathy testing
• Diabetic control and other measures (STROKE10)
DM11. Record of the blood pressure
DM12. Last blood pressure is 145/85 or less
STROKE1. Register of patients with stroke and TIA
DM13. Record of micro-albuminuria testing
STROKE13. The percentage of new patients with a stroke or TIA who have
DM22. Record of estimated glomerular filtration rate (eGFR) or serum
been referred for further investigation. STROKE5. Record of blood pressure
DM18. Influenza immunisation
STROKE6. Last blood pressure reading is 150/90 or less
STROKE7. Record of total cholesterol
STROKE8. Last measured total cholesterol is 5 mmol/l or less
STROKE12. Non-haemorrhagic stroke, or a history of TIA, taking anti-platelet
4.00pm Session 4
agent or an anti- coagulant.
STROKE10. Influenza immunisation
Dr Mark Vanderpump. Consultant Endocrinologist, Royal Free
AF3. Currently treated with anti-coagulation or anti-platelet therapy.
Treatment of Diabetes (Session 2)
• Diet. Implementation and monitoring. (DM5, DM20, DM7)
11.30am Session 2
Dr Cormac Breen. Consultant Nephrologist, Guy’s Hospital.
Proteinuria and haematuria
• Other medication. ACE inhibitors and statins for everyone? Urine dipstick testing.
(DM15,DM16,DM17)
• False negatives and false positives. • A practical approach to monitoring the diabetic patient in • Asymptomatic haematuria. Distinguishing renal and DM5. HbA1c recorded
• Asymptomatic proteinuria. What must not be missed? DM20. Last HbA1c is 7. 5 or less
DM7. Last HbA1c is 10 or less
Assessment of renal function (CKD1)
DM15. Diagnosis of proteinuria or micro-albuminuria treated with ACE
Blood tests. The abnormal “U&E”. How to proceed. • Urine tests. Spot and 24 hour urine collections. DM16. Record of total cholesterol
• Calculation of GFR and relevance of stages 1 to 5. DM17. Last measured total cholesterol within previous 15 months is 5 mmol/l
Chronic kidney disease in general practice
• Monitoring of GFR in general practice. When to refer? 9.30am Session 1
2.00pm Session 3
Prof Neil Barnes. Consultant Chest Physician, Royal London
Dr Lieske Kuitert. Consultant Chest Physician, Royal London
Asthma and COPD (Session 1)
Symptoms and Signs of Respiratory Disease in General
Epidemiology and Pathogenesis of Asthma and COPD
Practice (Session 1)
• What are the differences between asthma and COPD? These two sessions will use a problem-based approach to the management of common respiratory symptoms & signs. Areas to Diagnosis
be covered include cough, shortness of breath, haemoptysis, • How to distinguish between COPD and asthma (COPD1,
excessive sputum production and the abnormal chest x-ray. ASTHMA1)
• Lung function tests: spirometry, reversibility testing and steroid challenge. (COPD12, ASTHMA8)
• Extra-thoracic asthma – sinus disease and GI reflux. 4.00pm Session 4
Dr Lieske Kuitert. Consultant Chest Physician, Royal London
COPD1. Register of patients with COPD
COPD12. Percentage of all patients with COPD diagnosed after 1st April 2008
in whom diagnosis has been confirmed by post bronchodilator spirometry Symptoms and Signs of Respiratory Disease in General
ASTHMA1. Register of patients with asthma
Practice (Session 1)
ASTHMA8. Patients aged eight and over with measures of variability or
These two sessions will use a problem-based approach to the ASTHMA3. Patients between the ages of 14 and 19 in whom there is a record
management of common respiratory symptoms & signs. Areas to be covered include cough, shortness of breath, haemoptysis, Smoking 1. Record of smoking status
excessive sputum production and the abnormal chest x-ray. Objectives will be finalised shortly. 5.30pm Close 11.30am Session 2
Prof Neil Barnes. Consultant Chest Physician, Royal London
Hospital.
Drug Treatment of Asthma and COPD
• Value of smoking cessation (Smoking1)
• What drugs are available and how do they act? • What’s new? Combination treatments. Leukotriene receptor • Devices and drug delivery. Use of home nebulisers. • Differences in treatment of children and adults Management Plans in Asthma and COPD
• BTS guidelines and their relevance to general practice. • Patient education, diary cards and compliance. • Monitoring. Use of FEV1 (COPD10, COPD11, ASTHMA6)
COPD10. Record of FEV1 in the previous 15 months
COPD11. Inhaler technique has been checked
COPD8. Influenza immunisation
ASTHMA6. Record of asthma review
Heart Failure, Arrhythmia, CHD, Lipids & Hypertension
9.00am Registration
9.30am Session 1
2.00pm Session 3
Dr Howard Swanton. Former President, British Cardiac Society.
Dr Jonathan Morrell. GP and Hospital Practitioner in Cardiology,
Consultant Cardiologist, The Heart Hospital. Heart failure and arrhythmias
Heart failure
Who to treat? Setting population-based treatment Diagnosis (HF1). How predictive are clinical features?
BNP v echocardiography (HF2)
What is the key measurement? What is the value of total cholesterol? Should we routinely measure Cholesterol:HDL ratio? The significance of triglycerides. Risk factor assessment. Which are the most significant in Beta-blockers. ACE inhibitors. Spironolactone (HF3)
reducing the risk of coronary events? (CHD7, CHD8, STROKE7,
STROKE8, DM16, DM17)
Arrhythmias in general practice
• How effective is diet and weight loss? • Atrial fibrillation (AF1, AF4)
• Warfarin and antiplatelet therapy. (AF3)
• How low should we aim? Does very low cholesterol cause a HF1. Register of patients with heart failure.
HF2. Confirmed by an echocardiogram or by specialist assessment.
• Which statin? What doses are equipotent? Which is the HF3. Currently treated with an ACE inhibitor or Angiotensin Receptor Blocker
most cost effective? Side effects and monitoring. AF1. Register of patients with atrial fibrillation.
• How often should lipid levels be monitored? AF3. Currently treated with anti-coagulation or anti-platelet therapy.
• What about fibrates, cholestyramine and fish oils? AF4: Percentage of patients with atrial fibrillation diagnosed after 1 April 2008
• What combinations of lipid lowering agents are acceptable? with ECG or specialist confirmed diagnosis. CHD7. Total cholesterol measured.
CHD8. Last measured total cholesterol is 5 mmol/l or less
STROKE7. Record of total cholesterol
STROKE8. Last measured total cholesterol is 5 mmol/l or less
11.30am Session 2
DM16. Record of total cholesterol
DM17. Last measured total cholesterol within previous 15 months is 5 mmol/l
Dr Stephen Rex. Consultant Cardiologist based in Windsor and
Ascot and the Royal Brompton Hospital in London. Angina and Myocardial Infarction
• Investigation of chest pain. (CHD1, CHD2)
4.00pm Session 4
Reliability of symptoms, role of RACPC, which tests to use and what is the Calcium score all about? Dr Aroon Hingorani. Senior Lecturer, Centre for Clinical
Pharmacology, University College London. • Statins, betablockers and ACE/ARB (CHD7, CHD8,
Hypertension
CHD10, CHD11)
• Everyone below 135/80? Why? (BP1, BP4, BP5)
• Aspirin, clopidogrel –one or both and when and for how • Automatic machines – are they accurate? Which models are long? (CHD9)
• Revascularisation – PCI or CABG – which, when and for • What to do about isolated systolic hypertension. • What’s the evidence for the effectiveness of current • Acute coronary syndromes – current management strategies. treatments? Low dose thiazides for everyone? • What’s the hype about primary angioplasty? • ACE versus AT2? Which ACE is the most cost effective? Selective beta blockers. Is the outcome as good as atenolol? • Other measures (CHD12)
What are the main benefits? Calcium antagonists and CHD1. Register of patients with coronary heart disease
CHD2. Patients with newly diagnosed angina are referred for exercise testing
BP1. Register of patients with established hypertension
CHD5. Record of blood pressure
BP4. Blood pressure in the previous 9 months
CHD6. Last blood pressure reading is 150/90 or less
BP5. Last blood pressure is 150/90 or less
CHD7. Total cholesterol measured.
CHD8. Last measured total cholesterol is 5 mmol/l or less
CHD9. Aspirin, an alternative anti-platelet therapy, or an anti-coagulant is
being taken
CHD10. Treated with a beta blocker
CHD11. Treated with an ACE inhibitor or Angiotensin II antagonist
CHD12. Influenza immunisation

Source: http://www.ukapa.co.uk/files/Flyer-Nov-08-v4.pdf

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