Suneeta Kochhar, Marcia Excell

This article reviews a service pathway offering people attending their diabetes eye screening appointments an opportunistic blood pressure check to support hypertension case finding and treatment to target. The pathway promotes patient choice and facilitates primary and secondary care collaboration, as well as utilisation of home blood pressure readings. From the 200 participants in the study, 91 (45.5%) had clinic blood pressure readings above 140/90 mmHg, of whom 48 agreed to undertake home blood pressure monitoring. Of those, 33 individuals had elevated home blood pressure readings – 13 with newly diagnosed hypertension and 20 requiring treatment to target of their pre-existing hypertension. All 33 were contacted to ensure that they had been followed up by their GP practice. Participant feedback was positive.

Citation: Kochhar S, Excell M (2024) Hypertension case finding and treatment to target as part of the NHS diabetes eye screening programme. Diabetes & Primary Care 26: [Early view publication]

Article points

1. People attending their diabetes eye screening appointments may be offered an opportunistic blood pressure check to support case finding and treatment to target of hypertension.

2. Pathways for raised blood pressure may utilise home blood pressure readings to facilitate supported self-management.

3. Interface working with community providers/secondary care and primary care providers may result in early treatment of hypertension, and treatment to target is known to improve cardiovascular outcomes especially in people with diabetes.

Key words

– Cardiovascular disease

– Hypertension

– Service delivery

Authors

Suneeta Kochhar, GP Principal and Clinical Lead for CVD Prevention, NHS Sussex; Marcia Excell, RN, East Sussex Healthcare NHS Trust, and Chief Nurse Fellow, University Hospitals Sussex NHS Foundation Trust.

Aim: In this article, we aim to raise awareness of some of the clinical concerns surrounding the management of oncology wounds, particularly malignant fungating wounds. We will also provide practical wound management recommendations for healthcare professionals to consider when managing this wound type. We aim to assess the potential of a 100% chitosan with bioactive microfibre gelling (BMG™) dressing (MaxioCel®), to support wound management and work in partnership with industry to deliver clinical education on the management of oncology wounds, including malignant fungating wounds.

Method: A case study series was undertaken over four weeks, using the chitosan BMG dressing.

Results: We recruited 10 patients during the study. The chitosan BMG dressing facilitated a significant improvement in wound tissue type, exudate levels, and periwound skin, as well as reduced malodour. A reduction in patient-reported pain levels was also noted throughout the evaluation process. 

Conclusion: The introduction of BMG fibre technology demonstrated good outcomes in this patient group, in a short period of time. Importantly for this patient group, the BMG dressing was able to remain in situ during radiotherapy treatment, allowing uninterrupted management of the wounds.

KEY WORDS

Bioburden

Case studies

Malignant fungating wounds

Odour reduction

Oncology wounds

Pathways

SUSY PRAMOD

Lead Nurse Tissue Viability, The Christie NHS Foundation Trust, Manchester

SUE RICE

National Clinical Development Manager, CD Medical, Bolton, Lancashire

Nithesh Naik 1,2, B. M. Zeeshan Hameed2,3 *, Sanjana Ganesh Nayak 4 , Anshita Gera4, Shreyas Raghavan Nandyal 5 , Dasharathraj K. Shetty 6 , Milap Shah2,7, Sufyan Ibrahim2,8 , Aniket Naik 8 , Nagaraj Kamath8 , Delaram Mahdaviamiri 9 , Kenisha Kevin D’costa10 , Bhavan Prasad Rai 2,11, Piotr Chlosta12 and Bhaskar K. Somani 2,13

1 Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India,

2 iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India,

3 Department of Urology, Father Muller Medical College, Mangalore, India,

4 Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India,

5 Gandhi Medical College, Kaloji Narayana Rao University of Health Sciences, Secunderabad, India,

6 Department of Humanities and Management, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India,

7 Robotics and Urooncology, Max Hospital and Max Institute of Cancer Care, New Delhi, India,

8 Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India,

9 Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India,

10 Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India,

11 Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom,

12 Department of Urology, Jagiellonian University in Krakow, Kraków, Poland,

13 Department of Urology,University Hospital Southampton NHS Trust, Southampton, United Kingdom

       Telemedicine is the delivery of healthcare to patients who are not in the same location as the physician. The practice of telemedicine has a large number of advantages, including cost savings, low chances of nosocomial infection, and fewer hospital visits. Teleclinics have been reported to be successful in the post-surgery and post-cancer therapy follow-up, and in offering consulting services for urolithiasis patients. This review focuses on identifying the outcomes of the recent studies related to the usage of video consulting in urology centers for hematuria referrals and follow-up appointments for a variety of illnesses, including benign prostatic hyperplasia (BPH), kidney stone disease (KSD), and urinary tract infections (UTIs) and found that they are highly acceptable and satisfied. Certain medical disorders can cause embarrassment, social exclusion, and also poor self-esteem, all of which can negatively impair health-related quality-of-life. Telemedicine has proven beneficial in such patients and is a reliable, cost-effective patient-care tool, and it has been successfully implemented in various healthcare settings and specialties.

Keywords: telemedicine, telehealth, urology, patients perspective, COVID-19