Prevention of osteoporosis

Osteoporosis and subsequent fracture may be prevented by maintaining adequate calcium and vitamin D levels, undertaking regular weight bearing exercise and not smoking. Bisphosphonates can decrease the incidence of fracture in people with established osteoporosis.

Symptomatic management of osteoarthritis

The key treatment of osteoarthritis is to provide information and resources that help patients to cope, including advice on exercise and weight loss. Safe pharmacological options include paracetamol, topical NSAIDs and capsaicin. If pain is not controlled, oral NSAIDs, opioids, steroid injections and ultimately surgical options, can be considered.

Rheumatoid arthritis - monitoring of DMARDs

Most people with rheumatoid arthritis require early treatment with disease modifying-anti-rheumatic drug (DMARD) therapy to control symptoms and prevent joint damage. Treatment is usually initiated by a specialist, but GPs play an important role in monitoring patients for adverse effects and drug interactions. This article includes a pull out DMARD monitoring table and information on tumour necrosis factor (TNF) inhibitors.

Assessing cardiovascular disease risk

New PHO Performance indicators announced.
GPs experiences of cardiovascular risk assessment.
Finding the best approach to CVD screening in your practice.

Communicating cardiovascular risk - getting your message across

Many GPs find it difficult to explain CVD risk to their patients. Patients who do not understand about their risk are not motivated to make changes to reduce their risk. We present some practical solutions for clearer communication of CVD risk.

Motivational interviewing

An overview of a technique that can be used to help people make changes in their behaviour.

Engaging patients in managing cardiovascular risk

Once a patient understands their CVD risk, the next step is to help motivate them to make changes to reduce their risk. Lifestyle modification is usually best approached by making small changes over time and setting realistic health goals.

Patients understanding of cholesterol

A summary of the findings of a recent study which raises questions about how much people understand about cholesterol and its effect on health.

• Upfront: Cardiovascular risk screening: targeting individuals or populations?
  Professor Rod Jackson (University of Auckland) believes the answer to CVD screening is to target high risk individuals. He debates this with Professor Simon Capewell (University of Liverpool) who believes that greater gains are achieved by population wide strategies.
• Quiz feedback: Results, feedback and expert commentary from BPJ 15 "Special foods and nutrition" quiz.
• Safe Prescribing of Morphine in Primary Care
• Correspondence:Evidence of effectiveness for capsaicin? Metformin and vitamin B12. Aspirin in children.