Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management

Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management
This guideline was developed by a group of clinicians and scientists with expertise in vitamin D and osteoporosis. This is a clinical guideline intended to inform patient management.

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Quality Standards for Osteoporosis and Prevention of Fragility Fractures

Quality Standards for Osteoporosis and Prevention of Fragility Fractures
Identifying vertebral fractures systematically has proven challenging for all clinicians and currently more than two-thirds are undiagnosed. The purpose of this guidance is to ensure that all vertebral fractures are systematically identified, reported using clear terminology to the referring clinician and lead to appropriate management to avoid further fragility fractures.

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One stop Multidisciplinary clinic for patients with Fibromyalgia

Fibromyalgia is a condition affecting around 2% of the adult female population. It is characterised by generalised widespread pain with a spectrum of other symptoms including disturbed sleep and fatigue and is frequently associated with psychological comorbidity. Current guidelines for diagnosis reflect the spectrum of symptoms experienced by patients and this is reflected in treatment recommendations.

In this webinar best practice with regards to the diagnosis and treatment of fibromyalgia is discussed with an emphasis on management in primary care. The most recent treatment recommendations are presented along with a discussion on recent moves away from an emphasis pharmacological therapy.

Coordinating a person-centred pathway to high quality care for people with rare autoimmune disorders

Primary Sjögren’s syndrome is associated with significant direct and indirect costs, and represent a significant impact upon the healthcare system.

Primary Sjögren’s syndrome is a rare autoimmune disease affecting up to 0.4% of the adult female population and leading to severe dryness of the mouth and eyes and often associated with disabling fatigue and systemic manifestations. Patients require input from multiple specialities and diagnosis is often delayed.

In this webinar we describe how we have set up a multidisciplinary clinic run by rheumatologists and attended by oral medicine and ophthalmology to streamline the diagnostic pathway and reduce frequency of visits. Key components are access to a slit lamp for eye examination, provision of a lip biopsy clinic, and standardised histopathological reporting following guidelines we have developed. Patients now have access to a focused, coordinated diagnostic service, coordinated care, and opportunities to participate in research.

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The National Back Pain and Radicular Pain Pathway

In 2008 NICE estimated the cost to the NHS of back pain management was £2.1 billion, or just over £12 million for the average CCG of 300,000 people. In 2013 back pain was responsible for 11% of the total disability in the UK. The NICE guidance published in 2009 in general was not implemented.

The National Back Pain and Radicular Pain Pathway is the product of a unanimous consensus of 29 stakeholders based on best evidence. Its objectives are to provide a streamlined care pathway for radicular pain, and most importantly an effective, managed pathway for patients with low back pain.

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Physiotherapy works: Chronic pain

Evidence briefing for physiotherapy for chronic pain

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NICE Guideline for Spondyloarthritis [NG65]

This guideline covers diagnosing and managing spondyloarthritis that is suspected or confirmed in adults who are 16 years or older. It aims to raise awareness of the features of spondyloarthritis and provide clear advice on what action to take when people with signs and symptoms first present in healthcare settings. It also provides advice on the range of treatments available.

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RCGP e-learning module on axial spondyloarthritis

This course aims to educate GPs about Axial Spondyloarthritis (SpA). The first session will cover the presentation, including which clinical features in patients with back pain should raise suspicion of SpA. A case study will illustrate key features in the history and examination, how to investigate in primary care and the criteria for referral to secondary care. The second session discusses management and the wider impact of SpA, including effects on employment. Co-authored by BRITSpA and NASS.

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Services for spondyloarthritis: a survey of patients and rheumatologists

An online patient survey was emailed to all members of the National Ankylosing Spondylitis Society and advertised widely via social media. Separately, a Web-based questionnaire about axSpA services was sent to rheumatologists at all 172 acute hospital trusts in the UK.

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