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Incentivised case finding and other stories . . .

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5361 (Published 03 September 2014) Cite this as: BMJ 2014;349:g5361

At its best, general practice can be a wonderful human interchange, carried out in short encounters over many years. At its worst, it can be like the dysfunctional processes described in a qualitative study (BMJ Open 2014;4:e005146, doi:10.1136/bmjopen-2014-005146) of incentivised case finding for depression in patients with chronic heart disease and diabetes in primary care in Leeds. “Do three blood pressure readings, loads of blood tests, trouble getting a vein, had to check their feet, loads of faffing around, only got 20 minutes” is one nurse’s description of what she was expected to do while asking a patient about low mood. Like most of the patients asked about depression in the study, readers of this paper will either laugh or burst into tears.

Of the commonly prescribed drug classes, angiotensin converting enzyme inhibitors are the most likely to cause angio-oedema. Over one year, a total of 88 patients taking these drugs presented to an American university hospital with this condition …

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