NB Hot Topics Podcast

Welcome back to the Hot Topics podcast from NB Medical with host Dr Neal Tucker. In this episode, we start by thinking about the news. Firstly, the overwhelming consensus from GPs in England to not support the imposed contract. Secondly, the ongoing discussion around physician associates in general practice, where we touch on an interesting report from South Mississippi around the costs and other outcomes of non-doctor-led primary care. Thirdly, NHS patient satisfaction - is important to take note but why does staff satisfaction never hit the headlines?In research, we look at two papers. First, the rate of familial hypercholesterolaemia coded in practices - how far are we away from what we should expect? And in those with a diagnosis, how good are we at optimally treating them? Second, a paper on which interventions might help people maintain their independence. After an estimated £1.15 billion pounds of research in this area, what does this new systematic review and network meta-analysis tell us?ReferencesAMA Report on PA/NA from South MississippiNHS Staff Survery ResultsBJGP Familial Hypercholesterolaemia rates in GPNICE Guideline FHSimon Broome Diagnostic Criteria for FHBMJ Community Interventions to Maintain Independencewww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about another year of imposed GP contract on practices in England, the BMA response and where it may lead. In research, we have three fascinating new papers. Firstly, a paper examining how to maintain weight loss after a low-calorie diet – is structured exercise, liraglutide or both better than usual care? Secondly, in the BMJ a systematic review exploring whether exercise should be considered a genuine treatment for depression. And finally, in the NEJM, a study looking at the link between microplastics in carotid arterial plaques and subsequent risk of cardiac vascular events (hint: it’s not good news…).ReferencesBMA GP Contract Changes 2024/25Pulse EditorialLancet Discovery Science paper on weight loss maintenanceWeight maintenance author interviewBMJ Exercise and DepressionNEJM Micro/nanoplastics in your arteriesNEJM Microplastics editorialwww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we think about the pay offer for practices in England, a new King’s Fund report on the under-funding of primary care for three decades, and the introduction of Pharmacy First. In new research, we have two papers. First, in the BMJ, can an online combined exercise and psychological programme improve quality of life for patients struggling after hospitalisation with covid? Second, in JAMA, can serum urate levels help predict future flares of gout and guide us on who might benefit the most from urate-lowering therapyReferencesKings Fund Report on Primary CareBMJ Post-covid-19 syndrome and online programmeJAMA Serum urate and recurrent goutwww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we consider the current state of general practice in the UK and what lessons the countries can learn from each other. We examine a new paper in the BJGP on how patients feel about general practice in Scotland since the introduction of the 2018 GP contract. Is it meeting patient and policymaker goals? In other research, we see what lessons a new paper in JAMA on weight loss and cancer association can tell us about a seemingly obvious connection, and from the NEJM what effect testosterone replacement for hypogonadism has on men's fracture risk.ReferencesBJGP Patient experiences of Scottish GP paperBJGP Family physician's moral distress when managing health inequalitiesJAMA Cancer diagnoses after weight lossNEJM Testosterone replacement for hypogonadism and fracture riskwww.nbmedical.com/podcast

Welcome to the Christmas Hot Topics Podcast from NB Medical with Dr Neal Tucker. It’s time for a bit of light-hearted festive fun so if you’ve finished signing all your scripts for Christmas then join us for a discussion with Dr Stephen Bradley and Dr Alice Harper about “Great Expectations: GPs estimations of time required to deliver BMJ’s 10minute consultations”.This new paper explores how long it REALLY takes to do everything that’s recommended in clinical guidance. If you’ve ever felt like there just isn’t enough time in your general practice day, this might explain it, and you are not the only one.Merry Christmas everyone, see you in the New Year. NealReferencesGreat Expectations: GPs estimations of time required to deliver BMJ’s 10minute consultationsThe Health Foundation: Identifying Operational Failures in General PracticeBMJ Guidelines should consider clinicians time needed to treatwww.nbmedical.com/podcast

Prof. Hazel Everitt, a GP and lead author on a significant study regarding amitriptyline for IBS, joins the discussion. She shares insights into how low-dose amitriptyline can effectively manage IBS symptoms. The conversation also dives into the controversial use of methotrexate for hand osteoarthritis, revealing the complexities of pain management. Additionally, they explore a patient information leaflet aimed at alleviating lower urinary tract symptoms and whether such resources can be more beneficial than traditional medications. Empowering patients remains a key focus.

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. The highlight of this episode is our interview with Prof Miriam Santer, lead author of recent research in the BMJ exploring the effectiveness of spironolactone for acne in women. Does it work? Is it a treatment for general practice? And if so, is it safe, what monitoring is required, and where does it fit with current acne pathways?In the news, we think about the current issues around physician associates in general practice. In research we have two papers on diabetes: first, in the Lancet, is a new once-weekly insulin injection as effective as a daily treatment for type 1 diabetes; and second, in JAMA, is the additional tirzepatide better than prandial insulin in addition to glargine for managing type 2 diabetes? ReferencesEczema Care OnlineBMJ Spiro for acneLancet Once weekly insulin vs daily insulin in T1DMJAMA Tirzepatide vs prandial insulin in T2DMwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we talk to Dr Jessica Watson, lead author of the Why Test study, published in the BJGP exploring the use of blood tests in general practice and how often they make a difference - positive or negative.In other research we look at a BMJ paper comparing rosuvastatin and atorvastatin for secondary prevention, and in the Lancet, the PATHFINDER study, exploring the role of multi-cancer early detection blood tests - will this be useful for diagnosing cancers earlier?Plus the usual news, views, and a song about vaccinations.www.nbmedical.com/podcast ReferencesBJGP Why Test StudyPACT - primary care academic collaborative websiteBMJ Rosuva vs Atorva for secondary preventionLancet PATHFINDER MCED studyLancet EditorialRCGP Manifesto Seven Steps To Rebuild General Practice and Save the NHSwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr. Neal Tucker. As we celebrate 25 years of NB Medical and the Hot Topics course, in this podcast we chat with co-founder Dr Simon Curtis about the changes in general practice and medical education since its inception, we discuss three of the most influential research papers over the era, and what the future may hold for GPs. In research, we examine two new papers. The first in the NEJM is on semaglutide for patients with heart failure and preserved ejection fraction. Can it help improve symptoms and quality of life? Could it improve mortality? The second paper from the Lancet looks at a practice nurse-delivered insomnia intervention using sleep restriction therapy. Could this be a useful, cost-effective option for helping people struggling to sleep? ReferencesNEMJ Semaglutide + HFPEF with obesityLancet Nurse-led Insomnia intervention www.nbmedical.com/podcast

Welcome to Season 5 of the Hot Topics podcast from NB Medical with Dr Neal Tucker. Despite celebrating our 25th birthday (don't forget to check out our NB Plus birthday special here) the world of medical news and research never stops. In this episode we look at research in the BJGP about the motivations behind being a GP, whether adding NSAIDs may improve efficacy of emergency contraception, and whether we should be worried about cancer in patients with reflux.www.nbmedical.comReferencesBJGP Mapping GP MotivationsLancet Levonorgestrel + piroxicam for ECBMJ Non-erosive reflux and oesophageal cancer riskwww.nbmedical.com/podcast