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Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the first in a series of special podcasts where we talk to the movers and shakers of general practice.
We will talk to people in GP politics, leadership, media and research and discuss how their careers evolved, how they see current general practice and how they may be influencing the future of the specialism.
We start with Dr Claire Fuller, GP and current primary care medical director for NHS England. Hugely influential, you will probably know her as the author of the Fuller Stocktake report. We discuss how she came to the job, what this report found, and how it is impacting general practice in England.www.nbmedical.com/podcast
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Welcome to the latest Hot Topics Podcast from NB Medical with Dr Neal Tucker. In this episode, we look at two new papers on the drugs de jour: GLP1 receptor agonists and SGLT2 inhibitors. Can the former reduce pain in knee osteoarthritis and can the latter prevent recurrent renal stones?
Our third paper is a consensus paper published in the BJGP on optimising PSA testing for the early detection of prostate cancer in asymptomatic men. Sponsored by Prostate Cancer UK, Neal is joined by Dr Alex Norman, a GP, and Dr Oliver Hulson, a consultant radiologist who undertakes prostate biopsy, to discuss the outcomes of this paper and the latest research in this area. For further information from Prostate Cancer UK including educational resources and webinars see the links below.
References
NEJM Semaglutide & knee OA
BMJ SGLT2i & renal stones
BJGP Consensus Paper on PSA Testing in Asymptomatic Men
NB Podcast on role of DRE in identifying prostate cancer
PCUK Prostate Cancer Education for Health Professionals
PCUK Consensus Paper Webinarwww.nbmedical.com/podcast
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Fehlende Folgen?
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three exciting new papers.
Firstly, in the BMJ a network meta-analysis on acute migraine treatments - can the new GEPANTs drugs beat existing therapies? Secondly, a paper in NEJM does screening for prostate cancer using MRI actually help? Finally in the BJGP can first contact physio be better than a GP appointment? Listen on!
References
BMJ Acute migraine therapies
NEJM Prostate cancer screening with MRI
BJGP First contact physio in GPwww.nbmedical.com/podcast
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Welcome to Season 6 of the Hot Topics podcast with Dr Neal Tucker. The summer holidays are over and itâs back to work so time for a new podcast.
In this episode, we look at research on whether SGLT2i might prevent dementia, on if it is safer to de-escalate sooner rather than later from dual anti-platelet therapy post-MI, and how effective is the new RSV vaccine at preventing hospitalisation in older people.
References
BMJ - SGLT2i & dementia
Lancet - De-escalation of DAPT post-MI
JAMA - RSV Vaccination Efficacy in Older Peoplewww.nbmedical.com/podcast
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Have you ever walked into a pharmacy and wondered whether those nasal sprays suggesting they can stop the common cold actually do anything?
Ahead of the inevitable coughs and colds of the autumn, the Lancet Respiratory provides some answers and they wonât be the ones you think... Still, right now it's the summer and time to get outside and active - especially if you have recurrent back pain. We look at a paper in the Lancet exploring whether just simply walking can be the problem. Finally, from the BJGP we examine a paper looking at what being a "full-time GP" means and how, sometimes, definitions can be REALLY important.
Resources
BJGP Trends in Full-Time Working in GP
Lancet Effectiveness of Walking for Back Pain
Lancet Resp Nasal Sprays for URTIswww.nbmedical.com/podcast
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Welcome to a new episode of the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Today is election results day but we're not talking about politics, we're focusing on the research.
We look at a paper in the latest BJGP which looks at which factors influence a patient's decision to discontinue anti-depressants, explore a paper in the Lancet on whether a symptom-clinic led by GPs can improve outcomes for patients with multiple and persistent symptoms, and discuss trends in cardiovascular disease in the UK over the past 20 years, published in the BMJ this week.
References
NB Blog on Discontinuation of Antidepressants
BJGP Discontinuation of antidepressants
Lancet Symptom clinic
BMJ CVD trendswww.nbmedical.com/podcast
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Welcome to the Hot Topics Podcast from NB Medical with Dr Neal Tucker. It's election time but we're going to put aside politics and focus on the latest medical research!
In this episode, we look at an important BJGP paper highlighting the rates of follow-up after a significant asthma attack, a paper in the Journal of Infection showing the high rates of second antibiotic prescription in ongoing cough, and a RCT in JAMA examining if, as suggested by observational data, aspirin can truly prevent recurrence or metastasis of breast cancer.
References
BJGP Post-hospitalisation asthma management in primary care
BJGP Editorial Asthma Deaths in Children
J of Infection Repeat Antibiotics for Cough
eCancer Aspirin for Cancer
JAMA Aspiring & Breast Cancer Recurrencewww.nbmedical.com/podcast
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about the GP workforce courtesy of four papers in this month's BJGP - does more GPs boost life expectancy (of the patients...)? do PCNs help health inequalities? is practice-based continuity as good as individual continuity?
For a more directly clinical update, we look at new research in the BMJ on which is the best oral option in T2DM after metformin. Can the SGLT2 inhibitors prove their worth?
References
BJGP Does the shortage of GPs matter?
BJGP PCNs, deprivation and funding
BJGP Continuity in GP
BJGP Continuity in Norwegian GP
BMJ Best drug after metformin in T2DMwww.nbmedical.com/podcast
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. To DRE or not to DRE? This is the question and the main event in this episode.
We have a fantastic interview with Amy Rylance, Head of Improving Care at Prostate Cancer UK, and Sam Merriel, GP and academic clinical lecturer, discussing their recent Clinical Practice paper in the BJGP: Is the digital rectal exam any good as a prostate cancer screening test?
In other research, we have two papers with a common theme. Firstly, a paper in the BMJ looking at long-term outcomes after diagnosis with atrial fibrillation, and secondly, a paper in the BJGP examining the role of BNP testing as a marker for future cardiovascular disease in patients with a new diagnosis of hypertension. Both show that while these conditions make us think of stroke and MI, we also should be thinking about heart failure.
Resources
BJGP Clinical Practice paper on DRE for prostate cancer screening
Prostate Cancer UK Patient Risk Checker
European Urology Oncology Journal Performance of DRE in PCa Screening
NEJM 2004 Prevalence of PCa in men with a PSA <4
BMJ AF and future risk paper
BJGP HT and future risk paperwww.nbmedical.com/podcast
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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 ÂŁ1.15 billion pounds of research in this area, what does this new systematic review and network meta-analysis tell us?
References
AMA Report on PA/NA from South Mississippi
NHS Staff Survery Results
BJGP Familial Hypercholesterolaemia rates in GP
NICE Guideline FH
Simon Broome Diagnostic Criteria for FH
BMJ Community Interventions to Maintain Independencewww.nbmedical.com/podcast
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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 â 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: itâs not good newsâŠ).
References
BMA GP Contract Changes 2024/25
Pulse Editorial
Lancet Discovery Science paper on weight loss maintenance
Weight maintenance author interview
BMJ Exercise and Depression
NEJM Micro/nanoplastics in your arteries
NEJM Microplastics editorial
www.nbmedical.com/podcast
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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 Kingâs 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 therapy
References
Kings Fund Report on Primary Care
BMJ Post-covid-19 syndrome and online programme
JAMA Serum urate and recurrent goutwww.nbmedical.com/podcast
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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.
References
BJGP Patient experiences of Scottish GP paper
BJGP Family physician's moral distress when managing health inequalities
JAMA Cancer diagnoses after weight loss
NEJM Testosterone replacement for hypogonadism and fracture riskwww.nbmedical.com/podcast
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Welcome to the Christmas Hot Topics Podcast from NB Medical with Dr Neal Tucker. Itâs time for a bit of light-hearted festive fun so if youâve finished signing all your scripts for Christmas then join us for a discussion with Dr Stephen Bradley and Dr Alice Harper about âGreat Expectations: GPs estimations of time required to deliver BMJâs 10minute consultationsâ.
This new paper explores how long it REALLY takes to do everything thatâs recommended in clinical guidance. If youâve ever felt like there just isnât 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. Neal
References
Great Expectations: GPs estimations of time required to deliver BMJâs 10minute consultations
The Health Foundation: Identifying Operational Failures in General Practice
BMJ Guidelines should consider clinicians time needed to treat
www.nbmedical.com/podcast
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we talk to Prof Hazel Everitt, a GP and lead author of a recent Lancet paper exploring whether amitriptyline is effective for IBS, and where it might fit in to general practice management.
We also look at research in the Lancet on treating hand osteoarthritis with methotrexate - what's the rationale and does it work? - plus a BMJ paper on using a patient information leaflet to improve lower urinary tract symptoms in men. Are PILS better than pills?
Resources
Lancet ATLANTIS paper on IBS & amitriptyline
ATLANTIS trial website with patient information
Gut journal CBT for IBS
National Institute for Health and Care Research - how to get involved
NIHR Local research groups - how to get involved
Lancet Methotrexate for hand OA with synovitis
BMJ Leaflets for LUTSwww.nbmedical.com/podcast
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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?
References
Eczema Care Online
BMJ Spiro for acne
Lancet Once weekly insulin vs daily insulin in T1DM
JAMA Tirzepatide vs prandial insulin in T2DMwww.nbmedical.com/podcast
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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
References
BJGP Why Test Study
PACT - primary care academic collaborative website
BMJ Rosuva vs Atorva for secondary prevention
Lancet PATHFINDER MCED study
Lancet Editorial
RCGP Manifesto Seven Steps To Rebuild General Practice and Save the NHSwww.nbmedical.com/podcast
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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?
References
NEMJ Semaglutide + HFPEF with obesity
Lancet Nurse-led Insomnia interventionwww.nbmedical.com/podcast
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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.com
References
BJGP Mapping GP Motivations
Lancet Levonorgestrel + piroxicam for EC
BMJ Non-erosive reflux and oesophageal cancer riskwww.nbmedical.com/podcast
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Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Wondering where the sunshine is? Then this song is for you. Have a good summer everyone and the podcast will be back in September.
In the meantime have a look at www.nbmedical.com for our latest courses - we have live webinars for the new Hot Topics course, our new Paediatrics and Child Health course, our updated dermatology course and much more in September.www.nbmedical.com/podcast
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