Clinical Update

0.5 CPD hoursParkinson’s disease is ‘not a condition of one person’ because the families of people with Parkinson’s are very much affected by the condition, according to Dr Alistair Church. In this episode of the Clinical Update podcast, he talks to MIMS Learning editor Pat Anderson about the role of GPs in the management of the condition. He says GPs are ‘the spider in the middle’ of support for patients — first in picking up signs and symptoms, referring promptly, and helping patients with all the aspects of the condition that can be managed in primary care. Dr Church also highlights ‘lots of energy’ around the development of disease-modifying therapy for Parkinson’s in the medium term.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Recall the prevalence of Parkinson’s diseaseUnderstand how Parkinson’s is a ‘family disease’ in terms of the family’s rolePick up signs and symptoms that may suggest Parkinson’sBe alert to the possibility of Parkinson’s in younger patientsDistinguish Parkinson’s from other neurological conditionsUnderstand the key role of exercise in managing Parkinson’sSupport patients by managing non-motor aspects of the diseaseBe aware of the prospects for disease-modifying therapy in futureYou can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.ResourcesMIMS LearningGuidance update: latest NICE guidelines on neurological conditionsTremor - red flag symptomsGuidance update: latest NICE guidelines on neurological conditions

Sophie is 28 years old, lives with obesity, and has just discovered that she is pregnant with her second child. Prior to her pregnancy, a blood glucose test indicated that she had pre-diabetes. In this episode, the first of a three-part podcourse, GP Dr Patrick Holmes reviews how to support Sophie through pregnancy, and after delivery,how to reduce the risk of further weight gain and progression to type 2 diabetes.Educational objectivesAfter listening to this podcourse episode, healthcare professionals should be more aware of:How to raise the issue of weight sensitivelyThe modifiable and non-modifiable factors that can drive obesityManagement priorities in a pregnant woman with obesityLong-term goals after pregnancy in a woman living with obesityListen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and test your knowledge, to ensure you are up to speed with all the key points primary care professionals need to know about obesity management.If you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you.MIMS LearningObesity podcourse with Dr Patrick Holmes, part 1: metabolic vulnerabilityObesity podcourse with Dr Patrick Holmes, part 2: established metabolic diseaseObesity podcourse with Dr Patrick Holmes, part 3: obesity and multiple comorbidities

After seeing Sophie at 28 years (first episode) and at 35 years (second episode), the third and final episode of this podcourse looks at Sophie at 40 years old. She now has multiple obesity-related comorbidities — hypertension, type 2 diabetes, dyslipidaemia, obstructive sleep apnoea and metabolic dysfunction-associated steatotic liver disease. GP Dr Patrick Holmes reviews how to reduce Sophie's risk of experiencing a cardiac event and improve her quality of life.Educational objectivesAfter listening to this episode, healthcare professionals should be more aware of:The effect of having multiple obesity-related comorbidities on life expectancy and quality of lifeHow weight loss medication, such as tirzepatide, could improve the health status of a person living with multiple obesity-related comorbiditiesThe need to provide non-pharmacological support to people living with obesity, regardless of whether they are taking weight loss medicationsHow, without effective intervention, a person with obesity can progress from metabolic vulnerability, to established metabolic disease, and to having multiple comorbiditiesListen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and test your knowledge to ensure you are up to speed with all the key points primary care professionals need to know about obesity management.If you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you.MIMS LearningObesity podcourse with Dr Patrick Holmes, part 1: metabolic vulnerabilityObesity podcourse with Dr Patrick Holmes, part 2: established metabolic diseaseObesity podcourse with Dr Patrick Holmes, part 3: obesity and multiple comorbidities

‘Successful opioid deprescribing is built on trust. Listen to patients, acknowledge that their pain is real, avoid stigmatising language, and involve them in every decision. Patients are much more likely to engage when they feel supported rather than judged,’ Dr Faheem Shakur says in this episode of the Clinical Update podcast.Dr Shakur explains that while opioids do have a role in the management of acute pain, they should not routinely be used to manage chronic pain. He reviews how primary care teams can identify patients who may benefit from coming off opioids, how best to reduce opioid use while deploying other ways to manage pain, and how to build trust with patients so that they engage in the process.If an opioid is appropriate, according to Dr Shakur, it should be prescribed at the lowest effective dose for the shortest possible duration with a clear stop date or review date. Patients should be informed, from the beginning, that the opioid will only be used for a limited time. Educational objectivesAfter listening to this podcast, healthcare professionals should be more aware of:When prescribing an opioid is, and is not, appropriate in primary careThe place of opioid deprescribing within strategies for better pain management How to ensure patients are not left on opioids long termHow practices can identify patients on opioids who would benefit from a medication reviewRed flags that indicate a patient may be dependent on opioidsStrategies for deprescribing opioids, including how to engage patients in the processHow to identify and manage withdrawal symptoms  You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningOsteoarthritis: clinical reviewCase study: chronic pain reviewGuidance update: NICE guidelines on chronic pain in over 16s

0.5 CPD hours‘There are a lot of things the GP can do’ for transgender patients, according to GP lead for East of England gender services Dr Kamilla Kamaruddin, interviewed for the Clinical Update podcast by MIMS Learning editor Pat Anderson. She says this begins with listening to patients and using preferred names and pronouns, and develops into long-term support as patients navigate their way through gender identity clinics and other services. She says providing support in this way promotes the physical and mental health of transgender individuals, who are at substantial risk of self-harm and suicide, and addresses inequalities in healthcare.This podcast episode contains references to self-harm and suicide. Sources of support include the Samaritans, BMA Your Wellbeing service, and NHS Practitioner Health.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Reflect on the high prevalence of self-harm and suicidality among transgender individualsListen to transgender patients and communicate sensitivelyUnderstand that supporting transgender patients is a long-term processConsider how best to meet the needs of transgender patients Provide services for patients on gender identity clinic waiting listsHelp patients attending gender identity servicesProvide long-term care for transgender patientsKnow where to find more support to improve their practiceYou can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.ResourcesMIMS LearningTransgender healthcare: why is it important?Transgender healthcare: consultation skillsTransgender healthcare: management and referral to gender identity clinicsSkin problems in transgender people

‘Resistant hypertension is when you’re taking three or more medications and you’ve not reached target, and usually one of those medications is a diuretic,’ Professor Terry McCormack explains in this episode of the Clinical Update podcast. He adds that determining whether patients are truly resistant or just not taking their medication can be difficult. However, he recommends asking subtle questions such as ‘We all forget to take our tablets. How, how often do you forget to take your medication’ to gain meaningful answers.Professor McCormack also looks at management options — including combination pills, NICE-recommended therapies, and new treatments that are on the horizon. He observes that patients with resistant hypertension are the ‘highest risk patients’ for adverse outcomes such as stroke and, therefore, ‘we need to try our best to get them to take at least the three medications that are available to us at this time, to consider single pill combinations and, in the future, consider other treatments,’.Educational objectivesAfter listening to this podcast, healthcare professionals should be better able to:Sensitively ask patients about their adherence to antihypertensive medicationsEncourage patients to adhere to medications regimens by discussing of risks of not taking their medications (such as a debilitating stroke)Understand the pros and cons of single-pill combination therapy for managing hypertensionReview NICE recommendations on managing resistant hypertensionDiscuss new treatments on the horizon for managing resistant hypertensionYou can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.MIMS LearningGuidance update: NICE guidelines on hypertensionIschaemic heart disease: clinical reviewStroke: clinical review

0.5 CPD hoursIf you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you. Listen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and complete a multiple choice quiz to ensure you are up to speed with all the key points primary care professionals need to know about migraine. This episode continues the case of Simone, focusing on her children, with learning points provided by GP Dr Deborah Kerr. She provides advice on recognising migraine in children, eliminating red flags, addressing lifestyle and routine, and pharmacological therapy for acute management and prevention.MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser. Educational objectivesAfter listening to this podcourse, healthcare professionals should be better able to:Recall the characteristics of migraine and abdominal migraine in children and adolescentsReflect on red flag symptoms and differentials to consider Provide advice on lifestyle and use of supplements Advise on pharmacological options for acute attacks and prophylaxisBe aware of links between neurodiversity and migraineKnow where to find more information about prescribing and supportMIMS LearningMigraine podcourse with Dr Deborah Kerr, part 1: diagnosis and managementMigraine podcourse with Dr Deborah Kerr, part 2: menstrual-related migraineGuidance update: NICE and SIGN guidelines on headacheHeadache - red flag symptomsHeadaches in children - red flag symptoms

0.5 CPD hoursIf you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you. Listen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and complete a multiple choice quiz to ensure you are up to speed with all the key points primary care professionals need to know about migraine. This episode continues the case of Simone, with learning points provided by GP Dr Deborah Kerr. She provides advice on the definitions of menstrual and menstrual-related migraine, tips on lifestyle and pharmacological management, pregnancy planning and looking ahead to menopause management. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser. Educational objectivesAfter listening to this podcourse, healthcare professionals should be better able to:Recall the characteristics of menstrual migraine and menstrual-related migraineProvide advice on lifestyle and use of supplements Understand how hormones such as the contraceptive pill may be used in patients wit migraineKnow which medications could be used to try and prevent menstrual-related attacksProvide advice to women planning a pregnancy, and those who are breastfeedingRecall treatment options for acute management and preventative therapyUnderstand when to refer patients to specialist careMIMS LearningMigraine podcourse with Dr Deborah Kerr, part 1: diagnosis and managementMigraine podcourse with Dr Deborah Kerr, part 3: migraine in childrenGuidance update: NICE and SIGN guidelines on headacheHeadache - red flag symptomsHeadaches in children - red flag symptoms