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Anticipatory prescribing for end of life care
In patients receiving end of life care at home, anticipatory prescribing can provide a back-up for when urgent symptom control is needed. This article discusses the practicalities surrounding anticipatory prescribing, including the use of ‘just in case’ boxes, the role of family members and how to handle difficult conversations with patients.
Joy Ogden

Diagnosis, assessment and management of headache
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Headache is a common presentation in primary care, but assessment and treatment can be complex. This article provides an overview of the current guidelines on diagnosis and management of headache and migraine, with an emphasis on a patient-centred approach.
Manuela Fontebasso

Improving the efficiency of out-of-hours prescribing
GP out-of-hours services are part of a complex system of care available to patients when their GP surgery is closed and they urgently need a prescription. This article discusses how efficiency could be increased by improving integration of services and transfer of patient information, as well as educating patients about how to make optimal use of the services available.
Angela Dowden

Management of type 1 and type 2 diabetes requiring insulin
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Insulin is a required therapy for people with type 1 diabetes, and its use in the treatment of type 2 diabetes has been increasing in recent years. This article discusses the main types of insulin currently available, their properties and their role in the management of both type 1 and type 2 diabetes.
Dorothy Abiola, Thozhukat Sathyapalan and David Hepburn

Safinamide: add-on therapy for Parkinson’s disease
Safinamide (Xadago) was launched in the UK in May for the treatment of adults with idiopathic Parkinson’s disease as add-on therapy to levodopa in mid- to latestage fluctuating patients. This article describes its mode of action, efficacy and adverse effects.
Steve Chaplin

Statins: the battle for hearts and minds
A decade ago, statins were hailed as wonder drugs, capable of preventing strokes and heart disease on an industrial scale. These potent inhibitors of cholesterol synthesis were shown to reduce cardiovascular morbidity with relatively few side-effects. Prescribing them to high- to moderate-risk patients was considered a public health no-brainer.
Rob Munro

The hidden problem of herb-drug interactions
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Potentially harmful interactions between herbs and prescription medicines are common, yet healthcare professionals often do not ask about herbal remedies when prescribing and patients do not volunteer that they are taking them. This article discusses the types of herb-drug interaction that can occur and how they can be recognised and avoided.
Mark Greener

The treatment challenges of restless legs syndrome
Restless legs syndrome is a common disorder characterised by the uncontrollable urge to move the legs, particularly during inactivity or rest. Although the condition is common and has a high impact on quality of life, diagnosis and appropriate management remain a challenge in the primary care setting.
Sanjay Gangadharan, Lauren Perkins, Anna Sauebier and K Ray Chaudhuri

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