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03-09-2012 | Article

GPs need support to use new breakthroughs

The pace of change in modern medicine is truly amazing, with new techniques and novel therapies regularly appearing in everyday practice as if from nowhere. Of course, these innovations do not suddenly appear out of thin air. They are trialled, researched and refined before they are deployed in front-line practice to be used for the benefit of patients.

The problem is that if you blink you may miss their introduction - and fall behind in your knowledge and practice. So it is important to be aware of what is happening on the horizon. The univadis GP News service recently provided a glimpse of the near future, with two articles highlighting promising new advances, one a diagnostic test and the other a new use for an existing therapy.

The existing therapy is gabapentin and according to the article it "can relieve coughing and other symptoms among patients with long-term refractory chronic cough" (click here). If this is proven by subsequent study and approval is given for general clinical use then this would represent a very useful breakthrough. What was also interesting was that, according to the study's authors, "chronic cough is an increasing clinical problem, currently affecting more than one in 10 people". I must admit that statistic surprised me - I did not expect chronic cough to be so common.

Meanwhile the other article reported: "GPs could soon be offering patients a colour coded blood test to check for hidden liver damage due to drinking above-recommended levels of alcohol" (click here). This could help us to stratify patients into high and low risk when abnormal liver function tests are identified, a relatively common scenario. The high-risk people could be further investigated while a more observational role could be taken in the lower risk people.

If these potential breakthroughs do appear in clinical practice, it will very much involve GPs and we will have to find the knowledge, skill and expertise to handle these new interventions. Sadly, training in new breakthroughs can be somewhat hit and miss and involve the GP reading around the topics and gently dipping their toes into the water.

Sometimes there are organised clinical training sessions, which can be very helpful. However, because of the service commitment expected from us, these are not always easy to fit into our crowded schedule. Let us hope that with forthcoming innovations introduced into clinical practice, they will be accompanied by the relevant, well organised training for all of us. Now that would indeed be a major breakthrough!

Best wishes,


Dr Harry Brown, editor-in-chief univadis

By Dr Harry Brown