The video version of this podcast can be found here: https://youtu.be/MxR8AMtBkDYThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through new and updated recommendations published in November 2024 by the National Institute for Health and Care Excellence (NICE), focusing on those that are relevant to Primary Care only. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The Full NICE News bulletin for October 2024 can be found here:· https://www.nice.org.uk/guidance/published?from=2024-11-01&to=2024-11-30&ndt=Guidance&ndt=Quality+standard The links to the guidance covered in this episode can be found here: Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) can be found here:· https://www.nice.org.uk/guidance/ng245Asthma pathway (BTS, NICE, SIGN) can be found here:· https://www.nice.org.uk/guidance/ng244Endometriosis: diagnosis and management can be found here:· https://www.nice.org.uk/guidance/ng73Menopause: identification and management can be found here:· https://www.nice.org.uk/guidance/ng23TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we are looking at the NICE updates published in November 2024, focusing on what is relevant in Primary Care only. In today’s episode we’re covering 3 really important clinical areas. We’ll look at the updates on endometriosis, the all-important menopause, and, of course, the wow factor, the one guideline that we’ve all been waiting for: the new collaborative guideline on asthma! Yes, it’s finally here! Right, let’s jump into it And, of course, we have to start with the star of the show, the new guideline on the diagnosis, monitoring and management of chronic asthma. This is a new collaborative guideline developed jointly by NICE, the British Thoracic Society (or BTS), and the Scottish Intercollegiate Guidelines Network (or SIGN).It updates and replaces parts of the BTS/SIGN guideline as well as previous NICE guidance. There’s also an updated asthma pathway, which presents the same recommendations in a different format. This is a major development, so today I’ll just focus on the highlights. But I will dedicate the next episodes to cover this guideline in detail, so stay tuned.When someone presents with a history suggestive of asthma, we need to confirm the diagnosis with objective tests. And from a diagnosis perspective, there are 3 groups of patients:· Those aged over 16· Those aged 5 to 16 and · Those aged under 5So, to confirm the diagnosis in anyone over the age of 16 with suggestive asthma symptoms we will start by measuring the blood eosinophil count or FeNO level.And we will diagnose asthma if:The Eosinophil count is high, orFeNO level is 50 ppb or more.Then, if these tests are negative and we still suspect asthma, we will do a spirometry with reversibility and diagnose asthma:· if FEV1 increases by ≥ 12% from baseline and by ≥ 200 ml or, and this is new,if the FEV1 increase is 10% or more of the predicted normal FEV1(that is, not the baseline)If spirometry is unavailable or it is delayed, we will use peak flow (PEF) variability checking readings twice daily over 2 weeks and diagnose asthma if variability ≥ 20%.If all tests are negative and there are still diagnostic doubts, we will refer for a bronchial challenge test.The process is slightly different in children aged 5 to 16, because, as the initial test we will just:measure FeNO levels ...
Show more
Show less
13 mins
10 mins
10 mins
Dec 11 202412 mins
11 mins
11 mins
9 mins
Nov 13 20248 mins