Sun protection advice: the 10-year view

Individualised sun protection advice has a beneficial effect but outcome measures beyond 1 year haven’t been considered. Hedevik and colleagues report on a study that first enrolled patients in 2005. All participants received an individualised sun protection intervention, but two groups received advice directly from a GP. There were significantly lower Sun Exposure and Protection Index scores at 10 years in the groups which received their advice personally from a doctor compared with those receiving written advice.

Reducing proton pump inhibitor prescribing

The long-term use of PPIs can be associated with risks for patients and deprescribing is an important aspect of care. Rebound acid hypersecretion can be a real barrier to successfully stopping these medications. Coyle and colleagues report on a programme of education and short-term symptom management with alginates that was trialled in the UK. They report that after a year, over 75% of 6249 patients had stepped down or stopped PPIs. A simple intervention of a 20-minute appointment with a trained nurse adviser significantly reduced PPI overprescribing reducing the risk of long-term complications like increased fractures.  

Coeliac disease: is case-finding better than random testing?

It has been estimated that over 75% of patients, half a million people, with coeliac disease are not diagnosed. How do we identify at-risk groups and diagnose more people? Chandler and Robins report on a pragmatic study around opportunistic case-finding in primary care. Just 1.1% of cases gave a positive result; the results suggest current case-finding strategies, or their implementation by clinicians, are no better than random testing of patients.