NICE guidance and the importance of considering multimorbidity

Amit Arora is a consultant physician in care of older people and Chair of the England Council of the BGS. 

Finally, multi-morbidity may be recognized- is this wishful thinking or a BGS victory for our patients?

Whatever it is, it is time for action!

NICE is committed to developing more relevant guidance for GPs that takes into account the complexity of patients they see in daily practice with multiple long-term conditions, the chief executive of NICE told delegates at Pulse Live.

Opening the first day of the conference in London on 29^th April 2014, Professor David Haslam said NICE recognized current single-condition guidance was impractical for GPs dealing with patients with multimorbidity. ‘Single long-term conditions – which is the way NHS is organized generally apart from primary care – is the rarity.’ This of course is a cause close to the hearts and minds of many geriatricians. I have myself written about this on this blog and in some submissions to the health agencies in past.

The Red Flag tool for diagnosing Motor Neurone Disease

Jennifer Bedford of the Motor Neurone Disease Association announces their new tool, Red Flag, for supporting GPs to diagnose Motor Neurone Disease. 

Motor neurone disease (MND) is a devastating progressive degenerative disease of the motor neurones. Whilst it is rare, with a prevalence of 5-7 per 100,000, GPs can expect to see 1-2 cases in their career; and thus  important that awareness of it is raised.

‘She’s been up at casualty with another fall’

Consultant geriatrician at the Queen Elizabeth Hospital in Birmingham and co-chair of the BGS Falls and Bone Health Section, Dr Jonathan Treml, advises on how to tackle this common tricky presentation in a ten minute consultation.  This article first appeared online in Pulse, a website aimed at GPs and other primary care professionals and which tweets @pulsetoday.

Falls are a common and potentially serious problem affecting around a third of older people each year. Often disregarded as an inevitable part of the ageing process by both patients and doctors, falls can be the first sign of frailty, disability and dependence.

Most falls in older people are the result of multiple risk factors, often including impaired gait, balance and mobility. Falls can be the presenting complaint of underlying pathology – including postural hypotension or syncope, vestibular or visual impairment, Parkinson’s or other neurological disease.

A doctor’s main roles in falls prevention are identifying and treating underlying problems, ensuring medication is reviewed for fall risk and bone health, and appropriate referral to falls prevention exercise programmes.