South Birmingham VTS

1
South Birmingham VTS

• COPD/ASTHMA
• Tasks for practice-based learner sets

2
How this will work 1.

• You will know in advance what the small group
  tasks are, so try and pre-prepare a little take
  some resource material with you!
• Within your small group, devolve tasks on both
  topics
• Spend time researching your findings
• Share and discuss your ideas
• Arrange to circulate relevant material by email
  (perhaps include your group leader)

3
How this will work 2.

• Be prepared to discuss issues raised when you
  meet as a large group on the subsequent week at
  Selly Oak Postgraduate Centre and at that point,
  bring a hard copy of important information or
  possibly a laptop containing an electronic
  version
• On the feedback week at the Postgraduate centre,
  the PCMEs will run a session which links with,
  but does not duplicate what you have been doing.
  This may be looking at a more general issues
  relating to the topics you have been covering,
  e.g. ethical issues, health economics etc

4
How this will work 3.

• We will try and make the tasks for the learner
  sets more inventive and interactive as the term
  goes on (as most of you know, we rather like
  using cases and role-play to help illustrate
  points), but will be guided by your feedback
• Be pragmatic about how many of the tasks you
  cover, attendance may vary, so dont feel you
  have to cover everything
• The group members will need to liaise closely to
  ensure things run smoothly. If you are not going
  to be able to attend, then let your colleagues
  know. If there is only one of you, try and join
  another group for the afternoon
• An attendance register must be made for health
  and safety reasons, so that you can let the
  practice know who is in the building at a given
  time

5
COPD

• Critically appraise the QOF targets
• Look beyond the NICE guidance
• www.nice.org.uk/Guidance/CG12
• e.g.
• Evaluate the evidence for inhaled steroids in
  treating COPD
• Is it reasonable to use a therapeutic trial of
  oral steroids to help confirm the diagnosis?
• Are you happy with the diagnosis of flow-volume
  loops?
• When should you give antibiotics in COPD?
• Possibly have a look at or even use a spirometer
  (with careful consent from practice staff)

6
ASTHMA

• Critically appraise the QOF targets
• Look beyond the BTS guidance
• www.brit-thoracic.org.uk/ClinicalInformation
  /Asthma/AsthmaGuidelines
• How is the diagnosis of asthma made and
  how reliable is it (consider infants, children,
  late-onset asthma) (see next slide)
• Does doubling of inhaled steroid in an
  exacerbation help?
• Do practices have asthma clinics and is there any
  evidence to support their use?
• Do breathing exercises help?
• Is the incidence of atopy rising?

7
Predictors of childhood asthma

• BMJ  20083361423-1426 (21 June),
  doi10.1136/bmj.39568.623750.BE (published 16
  June 2008)
• Research
• Long term prognosis in preschool children with
  wheeze longitudinal postal questionnaire study
  1993-2004
• Peter I Frank, director1, Julie A Morris, head of
  medical statistics2, Michelle L Hazell, senior
  research associate1, Mary F Linehan, senior
  research associate1, Timothy L Frank, director1