Patient Resources

Choose the best option for YOU, with our help

Category Title Description Link Key Words
Anal fissure

Anal Fissure in adults - Brief Decision Aid.

Anal Fissure in adults - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Fissure, BDA, Louise Quayle, Dave Tomson, Fiona Beyer, constipation, hard stool, acute, chronic, diltiazem ointment, GTN ointment, glyeryl trinitrate, botox, local anaesthetic, steroid creams, treatment option, benefits, risks, consequences, side effects, anal, brief decision aid, benefits, risks, options, together, right, me
Atrial fibrillation

Atrial fibrillation - Brief Decision Aid.

Atrial fibrillation (non-valvular) and reducing the risk of a stroke - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Atrial fibrillation, BDA, Shirley Simpson, Dave Tomson, Jane Skinner, Prof Richard Thomson, CHA2DS2-Vasc score, HAS-BLED score, anticoagulant, anticoagulation, apixaban, dabigatran, rivaroxaban, NOAC, DOAC, warfarin, treatment option, benefits, risks, consequences, stroke, bleed, side effects, brief decision aid, benefits, risks, options, together, right, me
Carpal tunnel syndrome

Carpal tunnel syndrome - Brief Decision Aid.

Carpal Tunnel Syndrome, (Pressure on the median nerve in the wrist) - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

BDA, Carpal Tunnel Syndrome, Tom Holland, Dave Tomson, Roland Pratt, Darren Flynn, MAGIC Team, watchful waiting, no active treatment, physiotherapy, splinting, injection, surgery, decompression of carpal tunnel, taking the pressure off, treatment option, benefits, risks, consequences, stroke, bleed, side effects, wrist strap, steroid injection, pregnancy, hypothyroidism, low thyroxine level, brief decision aid, benefits, risks, options, together, right, me
Contraception

Contraception - Brief Decision Aid.

Contraception - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Natural methods, Combined pill, the pill, Progestogen only pill, Contraceptive patch, Combined vaginal ring, Barrier methods – e.g. male condom, Contraceptive injections, Contraceptive implants, Intrauterine device (IUD) (sometimes called a coil) or Hormone-releasing intrauterine system (IUS), Sterilisation, Tubal tie, Vasectomy, POP, COC, preferences, treatment option, benefits, risks, consequences, stroke, bleed, side effects, LARC, long acting reversible contraception, permanent, sexually transmissible infections, medical condition, overweight, medicine, failure rate, forgetful, heavy of painful periods, contraceptive injection, IUD, hormonal coil, male sterilisation, female sterilisation, contraception, brief decision aid, benefits, risks, options, together, right, me
Cramps

Cramps - Brief Decision Aid.

Cramps in Legs - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Peter McDowall, Dave Tomson, Matt Grove, MAGIC team preferences, treatment option, benefits, risks, consequences, Lifestyle and simple measures, Stretching exercises and posture, Quinine tablets. avoid medications, Diuretics (water tablets), nifedipine, cimetidine, salbutamol, statins, terbutaline, lithium, clofibrate, penicillamine, phenothiazines, nicotinic acid, Avoid, alcohol, dehydration, over exertion, cramps, quinine, stretches, brief decision aid, benefits, risks, options, together, right, me
Heavy Periods

Heavy Periods - Brief Decision Aid.

Heavy Mentrual Bleeding (Heavy Periods) - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

BDA, Heavy Menstrual Bleeding, Dave Tomson, Richard Thomson, Diana Mansour ,Watchful waiting, Intrauterine system, IUS, hormonal device, womb, Medication, tablets taken before and during periods, combined oral contraceptive pill, progestogens, Surgery, endometrial ablation, hysterectomy. heavy periods, brief decision aid, benefits, risks, options, together, right, me
Irritable Bowel syndrome

Irritable Bowel syndrome - Brief Decision Aid.

Management of IBS (Irritable Bowel syndrome) - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

BDA, IBS, Dave Tomson, Mark Welfare MAGIC, understanding the diagnosis, eating habits, fibre, drinks, patterns of eating, Using medications, treating the various symptoms, treatments working on mind and body together, CBT, bowel symptoms, TCA, amitriptyline, antidepressants, buscopan, linaclotide, peppermint oil, probiotics, loperamide, brief decision aid, benefits, risks, options, together, right, me
Osteoarthritis - Knee

Knee osteoarthritis - Brief Decision Aid.

Osteoarthritis (OA) of the Knee - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Tom Holland, Dave Tomson, Dominic Inman, Derek Kramer, Karen Storey, Fiona Beyer MAGIC Team, Lifestyle changes, increasing exercise, weight loss, Physical treatments, physiotherapy, shoe insoles, knee supports, walking aids, heat, TENS machine, Pain medication, tablets, creams/gels, injections into the joint. joint injections, Surgery, arthroscopy, osteotomy, joint replacement, paracetamol, topical NSAIDs, non-steroidal anti-inflammatory drugs, knee replacement, brief decision aid, benefits, risks, options, together, right, me
Osteoathritis Pain

C-TOP tool for Comparing treatment options for osteoarthritis pain (pain calculator)

C-TOP tool for Comparing treatment options for osteoarthritis pain

pain, osteoarthritis, James McCormack, Mike Allan, PEER, exercise, intra-articular corticosteroids, SNRIs, duloxetine, oral NSAIDs, topical NSAIDs, glucoasamine, chondroitin, viscosupplementation, opioids ,benefits, risks, options, together, right, me
Plantar fasciitis

Plantar fasciitis - Brief Decision Aid.

Plantar Fasciitis (Heel/Foot Pain) - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

BDA, Foot/Heel Pain, Dave Tomson, David Clements, Darren Flynn, Simple measures, insoles, heel pads, arch supports, Specific exercises, steroid injections, extracorporeal shockwave therapy, surgery, paracetamol, ibuprofen, brief decision aid, benefits, risks, options, together, right, me
Prostate enlargement

Prostate enlargement - Brief Decision Aid.

Prostate Gland Enlargement - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

BDA Prostate Gland Enlargement,Dave Tomson, Prof. Robert Pickard, MAGIC, Watchful waiting, monitoring, self-help, lifestyle changes, Medication, tablets, Surgery, trans-urethral, resection of prostate (TURP), laser techniques, brief decision aid, benefits, risks, options, together, right, me
Stopping smoking

Stopping smoking - Brief Decision Aid.

Stopping smoking, Ways to stop - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Stopping smoking, BDA, Shirley Simpson, Dave Tomson, Christine Dryden, Sharon Williams, Carole Dodd, MAGIC, Going it alone, Stop smoking, advice and support, nicotine replacement, Varenicline, Champix, Bupropion, Zyban, NRT, save money, e cigarettes, vaping, brief decision aid, benefits, risks, options, together, right, me
Tennis elbow

Tennis elbow - Brief Decision Aid.

Tennis elbow - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Tennis Elbow, Tom Holland, Dave Tomson, Roland Pratt, Modifying activity, rest, changing the way you use the arm, Pain relief, ice, creams, gels, tablets, patches, Supports, supportive strap, Physiotherapy, Injection, steroid injection, autologous blood, botulinum toxin, Surgery, brief decision aid, benefits, risks, options, together, right, me
Urinary Tract Infection

UTI - Brief Decision Aid.

Simple urinary tract infection (UTI) - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Benefits, harms antibiotics, Symptoms, UTI CKS, SIGN, three day course, trimethoprim, nitrofurantoin, women, dysuria, frequency, suprapubic, discomfort, Cates plots cystitis, amoxicillin, VisualRx, www.nntonline.net, Clinical knowledge Summaries, lower urinary tract infection, benefits, risks, options, together, right, me
Warts and verrucae

Warts and verrucae - Brief Decision Aid.

Plantar Warts (Warts and Verrucae - Management Options - Brief Decision Aids are designed to help you answer three questions, Do I have options? What are the benefits and risks of these options, (and how likely are they)? How can we make a decision together that is right for me?

Warts, Verrucae, David Clements, Dave Tomson, Do not treat, home treatment covering, occlusion, chemical burning, salicylic acid, freezing, cryotherapy, Liquid Nitrogen Cryotherapy, intensive freezing, minor surgery, duct tape, brief decision aid, benefits, risks, options, together, right, me
Gout treatment options

Pros and cons decision aid for the treatment of gout

Print off this decision aid and take it to your GP

Keith Birrell, gout, lifestyle, weight loss, medications, alcohol, purines, fructose, urate, uric acid, colchicine, naproxen, prednisolone, allopurinol, febuxostat, diuretics, amlodipine, losartan
Irritable bowel syndrome

Shared decision options audio. Dr Keith Birrell with Joanne who has Irritable bowel syndrome

Listen to Dr Keith Birrell guiding Joanne to make informed decisions to improve her irritable bowel symptoms

Audio, shared decision options,irritable bowel syndrome, bloating, constipation, diarrhoea, abdominal pain, informed decision, cognitive behavioural therapy, CBT, low FODMAP diet
Irritable bowel syndrome

Shared decision options audio. Dr Keith Birrell with Rachel who has Irritable bowel syndrome

Listen to Dr Keith Birrell guiding Rachel to make informed decisions to improve her irritable bowel symptoms

Audio, shared decision options, irritable bowel syndrome, bloating, constipation, diarrhoea, abdominal pain, informed decision, low FODMAP diet, CBT, cognitive behavioural therapy
Irritable bowel syndrome

A condition in which the milking action of the bowel misfires and causes pain, bloating, constipation or diarrhoea

Link to Patient Information Leaflet from patient.info

Audio, shared decision options, irritable bowel syndrome, bloating, constipation, diarrhoea, abdominal pain, informed decision, low FODMAP diet,
Irritable bowel syndrome

Low FODMAP diets - If you have Irritable Bowel syndrome certain foods can trigger bloating and abdominal pain. A dietician can help you to figure out which foods to avoid.

Link to Patient Information Leaflet from patient.info

Audio, shared decision options, irritable bowel syndrome, bloating, constipation, diarrhoea, abdominal pain, informed decision, low FODMAP diet,
Irritable bowel syndrome

Probiotics and prebiotics - The healthy bacteria in our guts are linked with our health. Consider taking a course of probiotics if you take antibiotics. What we eat affects the health of our gut bugs. Thin people have different bugs from overweight people. It is possible to cure crohns disease with a faecal transplant.

Link to Patient Information Leaflet from patient.info

Audio, shared decision options, irritable bowel syndrome, bloating, constipation, diarrhoea, abdominal pain, informed decision, low FODMAP diet, probiotic, prebiotic, faecal, crohns,
Irritable bowel syndrome

Options for managing IBS – decision aid and handout

Print off this decision aid and take it to your GP, so that you can share the decision on how to manage your IBS.

Shared decision making tool, IBS, irritable bowel syndrome, soluble fibre, ispaghula, low FODMAP diet, sorbitol, peppermint oil, CBT, cognitive behavioural therapy, amitriptyline, hypnotherapy, NNT
Osteoarthritis, options for pain relief

Options for treating osteoarthritis pain – pros and cons decision aid

What are the benefits and risks of each treatment for osteoarthritis pain?

osteoarthritis, pain, placebo, topical nsaids, topical non steroidal anti-inflammatories, non steroidal anti-inflammatories, opiates, codeine, tramadol, surgery, paracetamol, TENS, acupuncture, capsaicin cream, chilli powder cream, glucosamine, chondroitin sulphate, shared decision options, options, Keith Birrell, James McCormack, understanding your pain, livewellwithpain, Functional pain, complementary, over the counter medication, lifestyle, exercise, healthy weight, NSAIDs, prescription medication, duloxetine, opioids, oxycodone, morphine, amitriptyline, nortriptyline, medication to help sleep, joint injections, intra-articular corticosteroid injection, joint replacement, benefits, serious harms and side effects, paincalculator.com
Polycystic ovary syndrome

Shared decision options audio. Dr Keith talks to his patient about her options for polycystic ovary syndrome

Listen to Dr Keith Birrell talking to Madeline about polycystic ovary syndrome and her options. Madeline is interested in becoming pregnant again and preventing endometrial cancer.

PCOS, polycystic ovary syndrome, polycystic ovarian syndrome, preventing, prevention, endometrial cancer, hairiness, infrequent periods, obesity, overweight, metformin, type 2 diabetes, how to lose weight, pregnancy
Polycystic ovary syndrome

Shared decision options audio. Dr Keith talks to his patient about her options for polycystic ovary syndrome

Listen to Dr Keith Birrell talking to Avril about polycystic ovary syndrome and her options.

Audio, shared decision options, informed decision, polycystic, ovary, syndrome, PCSO
Polycystic ovary syndrome

Options for managing polycystic ovary syndrome – decision aid and handout

Print off this decision aid and take it to your GP, so that you can share the decision on how to manage your Polycystic ovary syndrome (PCOS)

Shared decision making tool, PCOS, polycystic ovary syndrome, polycystic ovarian syndrome, NNT, overweight, obese, BMI, endometrial cancer, hairiness, hirsuitism, exercise, diet, progesterone, cosmetic options, yasmin, dianette, spironolactone, finasteride
Phobia

EMDR treatment for phobia or PTSD

Listen to Dr Keith Birrell teaching Jessica the technique of EMDR to help her face her phobia of flying

Eye, movement, desensitisation, reprocessing, phobia, EMDR, PTSD, post-traumatic, stress, disorder, fear, flying
Alcohol consumption

Simple brief interventions for alcohol excess

A tool for clinicians to use to help patients see the connection between harmful alcohol consumption and their health concerns. The SBI tool helps clinicians to support patients to cut back their drinking.

Shared decision making tool, harmful drinking, hazardous drinking, alcohol, binge drinking, benefits of cutting back, SBI, target, Plan, less cancer
Alcohol consumption

Shared decision options audio. Dr Keith Birrell with Monica. Monica’s health is affected by drinking too much. Monica drinks in a hazardous or harmful way.

Listen to Dr Keith Birrell guiding Monica to help her to make the connection between her drinking habits and her health concerns. Dr Birrell uses the structured brief intervention tool and negotiates a plan to reduce Monica’s alcohol intake.

Audio, shared decision options, informed decision, high blood pressure, BP, risk reduction, heart attack, angina, stroke, alcohol, SBI tool, hazardous, harmful, drinking habit, units, Target, sensible, recommended, limit, poor sleep
Alcohol consumption

Options for managing alcohol excess – decision aid and handout

Print off this decision aid and take it to your GP, so that you can share the decision on how to cut back your drinking.

Shared decision making tool, NNT, high blood pressure, overweight, risk of cancer, liver disease, dementia, brain damage, anxiety, depression, poor sleep, alcohol dependence, DTs, delirium tremens, baclofen, action plan, cutting back alcohol
Anxiety and depression

Shared decision options audio. Dr Keith Birrell with Hannah. Hannah is anxious and perhaps depressed.

Listen to Dr Keith Birrell guiding Hannah to make informed decisions to reduce her anxiety levels and to improve her mood.

Audio, shared decision options, informed decision, anxiety, depression, stress, mood, talking therapy, CBT, cognitive behavioural therapy, mindfulness
Anxiety and depression

Shared decision options audio. Dr Keith Birrell and Hannah. Hannah is considering using a medicine for anxiety and her mood.

Listen to Dr Keith Birrell guiding Hannah to make informed decisions to reduce her anxiety levels and to improve her mood. They decide together if medicine for anxiety and depression might be worth trying. Which medicine might suit Hannah?

Audio, shared decision options, informed decision, fluoxetine, sertraline, citalopram, mirtazapine, buproprion, zyban, venlafaxine, duloxetine, amitriptyline
Anxiety and depression

Options for anxiety and depression – pros and cons decision aid

Print off this pros and cons decision aid to help you, and your doctor or therapist, decide what might suit you.

options, anxiety, depression, decision, aid
Anxiety and depression

Options for anxiety and depression – Mayo clinic decision aid for antidepressants

Print off this decision aid to help you, and your doctor to decide what might suit you.

options, anxiety, depression, decision, aid, antidepressants
Blood Pressure

Options for managing Blood pressure – decision aid and handout

Print off this pros and cons decision aid and take it to your GP, so that you can share the decision on how to manage your blood pressure.

Shared decision making tool, lifestyle, lo salt, reduce salt, healthier diet, reduce alcohol intake, flaxseed, linseed, weight loss, blood pressure medications, amlodipine, ACE inhibitors, Losartan, A2 drugs, angiotensin 2 inhibitors, thiazides, bedroflumethiazide, aldosterone antagonists, spironolactone, beta blockers, alpha blockers, heart attack, stroke, angina, type 2 diabetes, NNT
Blood Pressure

Options to reduce cardiovascular risk when the risk is high.

Audio. Dr Keith Birrell talks to Douglas about how to reduce his future risk of heart attacks and strokes. Douglas has high blood pressure, chronic kidney disease and a high risk of cardiovascular disease. We use the absolute cvd risk/ benefit tool

Shared decision making tool, lifestyle, smoking cessation, physical activity, Healthy diet, mediterranean diet, lower blood pressure, lo salt, reduce salt, healthier diet, reduce alcohol intake, flaxseed, linseed, weight loss, blood pressure medications, statins, low intensity statins, high intensity statins, metformin, personalised risks assessment, absolute CVD risk / benefit calculator, heart attack, stroke, angina, type 2 diabetes, NN
High risk of cardiovascular disease

Options to reduce cardiovascular risk when the risk is high.

Audio. Dr Keith Birrell talks to Douglas about how to reduce his future risk of heart attacks and strokes. Douglas has high blood pressure, chronic kidney disease and a high risk of cardiovascular disease. We use the absolute cvd risk/ benefit tool

Shared decision making tool, lifestyle, smoking cessation, physical activity, Healthy diet, mediterranean diet, lower blood pressure, lo salt, reduce salt, healthier diet, reduce alcohol intake, flaxseed, linseed, weight loss, blood pressure medications, statins, low intensity statins, high intensity statins, metformin, personalised risks assessment, absolute CVD risk / benefit calculator, heart attack, stroke, angina, type 2 diabetes, NN
Type 2 diabetes mellitus

Shared decision options audio. Dr Keith Birrell with Christine who wants to understand what she should do about her type 2 diabetes

Listen to Dr Keith Birrell guiding Christine to make informed decisions about how to manage her type 2 diabetes

Audio, shared decision options, informed decision, type two diabetes, newly diagnosed, manage, blood pressure, statin, weight, prevention, heart attack, angina, stroke, blood vessels, kidneys, blindness
Type 2 diabetes mellitus

Shared decision options audio. Dr Keith Birrell with Gordon who has newly diagnosed type 2 diabetes

Listen to Dr Keith Birrell guiding Gordon to make informed decisions about how to manage his type 2 diabetes

Audio, shared decision options, informed decision, type two diabetes, newly diagnosed, manage, blood pressure, statin, weight, prevention, heart attack, angina, stroke, blood vessels, kidneys, blindness
Type 2 diabetes mellitus

Options for managing type 2 diabetes – decision aid and handout

Print out this shared decision aid and take it to your diabetes review appointment.

options, informed decision, type two diabetes, newly diagnosed, manage, blood pressure, statin, weight, prevention, heart attack, angina, stroke, blood vessels, kidneys, blindness
Fibromyalgia

Shared decision options audio. Dr Keith Birrell with Melanie who has fibromyalgia

Listen to Dr Keith Birrell guiding Melanie to make informed decisions to improve her pain, sleep and stress levels

Audio, shared decision options, fibromyalgia, widespread pain, poor sleep, stress, stress levels, informed decision, tai Chi, amitriptyline, cognitive behavioural therapy, CBT
Fibromyalgia

A condition that includes widespread painful trigger points, poor sleep, tension and often brain fog. Make sure that you are getting enough vitamin D, use our one page insomnia questionnaire to highlight your sleep problems and get help to solve them. Get help to become more active and tackle the stresses in your life.

Link to Patient Information Leaflet from patient.info

Audio, shared decision options, fibromyalgia, widespread pain, poor sleep, stress, stress levels, informed decision, tai Chi, amitriptyline, cognitive behavioural therapy, CBT
Fibromyalgia

Options for treating fibromyalgia – decision aid and handout

Print off this decision aid and take it to your GP, so that you can share the decision on how to treat your fibromyalgia. Lifestyle changes are worth exploring too.

Shared decision making tool, Fibromyalgia, vitamin D, tai chi, amitriptyline, gabapentin, tramadol, depression, anxiety, CBT, Cognitive behavioural therapy, NNT
Functional illnesses

Fibromyalgia, Irritable Bowel Syndrome and the problems that medical tests don’t show up

Dr Keith Birrell explains how some health problems can cause such misery without anything to find when you do a test

functional, illness, test, fibromyalgia, IBS, irritable
Functional illnesses

Functional neurological symptoms

This website is about Functional Neurological Disorder (FND). This is when someone has NEUROLOGICAL SYMPTOMS (such as limb weakness, numbness, shaking or blackouts) which are REAL (and not imagined) and due to a PROBLEM with the FUNCTIONING of the nervous system not due to damage or structural disease of the nervous system causing difficulties for the person who experiences them. Some people have troublesome symptoms that they wish to understand without necessarily having a 'disorder' - these are called functional neurological symptoms, and this site is for you too. FND and functional symptoms surprisingly common but can be difficult for patients and health professionals to understand. This website, written by a neurologist with a special interest in these problems, aims to give you a better understanding of these symptoms. It has no advertising and is free. I hope you find it useful

Functional limb, weakness, tiredness, fatigue, pain, headache, Word, finding, difficulty, dissociation, sleep, problems, dizziness call bladder symptoms, complex, regional, pain, Health, anxiety
Preventing heart attacks angina and stroke

Preventing Heart attacks, Angina and Strokes - instructions for use of an online tool

Could you be at risk? Download the following attachment. Print it off and ask your receptionist, nurse or doctor to give you the following numbers; your top (systolic) blood pressure; your cholesterol number; your healthy (HDL) cholesterol number; your height in cm; your weight in kg; and whether you have chronic kidney disease, atrial fibrillation rheumatoid arthritis or diabetes. If you do not have familial hypercholesterolaemia (uncommon), nor have you had a heart attack, angina, a stroke or narrowed arteries, then you can decide with the Prevention Heart attacks 2018 tool, whether it is worth doing something about your risk. The tool will tell you what your risk is at the moment and which options might help you.

preventing, informed decision, high blood pressure, BP, risk reduction, heart attack, angina, stroke, absolute CVD risk benefit Calculator, statin, diet, exercise, activity, blood pressure, linseed, flaxseed, alcohol, Weight loss,hypertension, medication
Preventing heart attacks angina and stroke

Shared decision options audio. Dr Keith Birrell with Julia who has high blood pressure. Julia is interested in reducing his future risk of heart attacks and stroke.

Listen to Dr Keith Birrell guiding Julia who has high blood pressure to make informed decisions to reduce her future risk of heart attacks and stroke.

Audio, shared decision options, informed decision, high blood pressure, BP, risk reduction, heart attack, angina, stroke, absolute CVD risk benefit Calculator, statin, diet, exercise, activity, blood pressure, linseed, flaxseed, alcohol, Weight loss,hypertension, medication
Preventing heart attacks angina and stroke

Shared decision options audio - Dr Keith Birrell talks to Monica who has high blood pressure

Listen to Dr Keith Birrell guiding Monica who has high blood pressure to make informed decisions to reduce her future risk of heart attacks and stroke.

Audio, shared decision options, high blood pressure, BP, risk reduction, heart attack, angina, stroke, informed decision, absolute CVD risk benefit Calculator, statin, diet, exercise, activity, blood pressure, linseed, flaxseed, alcohol, Weight loss,hypertension, medication,
Preventing heart attacks angina and stroke

Shared decision options audio. Dr Keith Birrell with Paul who has high blood pressure. Paul is interested in reducing his future risk of heart attacks and stroke.

Listen to Dr Keith Birrell guiding Paul who has high blood pressure to make informed decisions to reduce his future risk of heart attacks and stroke.

Audio, shared decision options, high blood pressure, BP, risk reduction, heart attack, angina, stroke, informed decision, absolute CVD risk benefit Calculator, statin, diet, exercise, activity, blood pressure, linseed, flaxseed, alcohol, Weight loss hypertension, medication
Preventing heart attacks angina and stroke

The Absolute CVD Risk/Benefit Calculator. Calculate your own 10 year risk of having a heart attack or a stroke. Click on Qrisk2 to get British risk numbers.

You will need your age, sex, ethnic origin, smoking status, do you have diabetes?, your top (systolic) blood pressure, whether you are on blood pressure medicine, your cholesterol number, your healthy (HDL) cholesterol number, whether your parents or siblings had a heart attack, or angina, before 60, if you have chronic kidney disease, atrial fibrillation of the heart, rheumatoid arthritis and also your height (in cm) and your weight (in kg). This computer programme will only work for you if you are 40 or above and don’t already have obvious damage to your blood vessels (heart attack, angina, a stroke or narrow blood vessels to your legs). It does not work for those people who have familial hypercholesterolaemia (uncommon - 1 in 500 people). The computer programme should give you a risk number. This is the chance that you might have a heart attack, angina or a stroke in the next 10 years. This is shown with red and pink faces. If your number is higher than 20% then you should definitely discuss this with your GP. If the number is 10-19% you should probably talk to your nurse.

absolute, CVD, Risk/benefit, calculator, heart attack, stroke, angina
Preventing heart attacks and strokes

Options to reduce cardiovascular risk when the risk is high.

Audio. Dr Keith Birrell talks to Douglas about how to reduce his future risk of heart attacks and strokes. Douglas has high blood pressure, chronic kidney disease and a high risk of cardiovascular disease. We use the absolute cvd risk/ benefit tool

Shared decision making tool, lifestyle, smoking cessation, physical activity, Healthy diet, mediterranean diet, lower blood pressure, lo salt, reduce salt, healthier diet, reduce alcohol intake, flaxseed, linseed, weight loss, blood pressure medications, statins, low intensity statins, high intensity statins, metformin, personalised risks assessment, absolute CVD risk / benefit calculator, heart attack, stroke, angina, type 2 diabetes, NN
Hormone replacement therapy and the menopause

Shared decision options audio. Dr Keith Birrell with Tina who is considering using HRT.

Listen to Dr Keith Birrell guiding Tina to make informed decisions relating to the use of HRT (Hormone replacement therapy).

Audio, shared decision options, informed decision, HRT, hormone replacement therapy, flushes, sweats, hot flashes, vaginal dryness, urinary tract infections, incontinence, breast cancer, deep vein thrombosis, DVT, pulmonary embolism, PE, clot, pessary, patch, tablet, topical
Hormone replacement therapy and the menopause

Options for HRT – decision aid and handout

Print this sheet off to take to your appointment with your GP or practice nurse. The type of HRT that might suit you depends on whether you still have a uterus.

Audio, shared decision options, informed decision, HRT, hormone replacement therapy, flushes, sweats, hot flashes, vaginal dryness, urinary tract infections, incontinence, breast cancer, deep vein thrombosis, DVT, pulmonary embolism, PE, clot, pessary, patch, tablet, topical
Insomnia

Epworth Sleepiness Scale

The Epworth Sleepiness Scale (ESS) is a scale to measure daytime sleepiness using a very short questionnaire. This can be helpful in diagnosing sleep apnoea. It was introduced in 1991 by Dr Murray Johns of Epworth Hospital in Melbourne, Australia.

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Read Dr Keiths article on sleep

Dr Keith Birrell lists a number of factors and helpful tools to deal with Insomnia

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Shared decision options audio of Dr Keith Birrell with insomniac Carl

Listen to Dr Keith Birrell talk to Carl about his sleep problems linked to stress

Sleep, alcohol,waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Sleep Diary

The Sleep Diary is useful when a more comprehensive assessment is required. The times that are written down need only be estimated.

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Sleep Hygiene

A leaflet describing things to avoid, helpful hints and notes on illness related to poor sleep

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Shared decision options audio of Dr Keith Birrell with insomniac Neil

Listen to Dr Keith Birrell guiding Neil to make informed decisions to improve his sleep.

Poor sleep, insomnia, audio, insomniac, shared decision options, sleep, informed decision, sleep hygiene, sleep restriction, insomnia questionnaire, epworth score, sleeping tablets, amitriptyline, melatonin, anxiety, stress, depression, pain, CBTi, cognitive behavioural therapy for insomnia, sleepio app
Insomnia

Sleep Booklet

Dr Dave Tomson's booklet guiding a patient through their sleep problems

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Insomnia Questionaire

A one page questionaire to help track sleep issues

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Insomnia

Sleep Restriction

Sleep Restriction is used to more closely match the amount of time you spend in bed with the amount of sleep your body is currently producing. This document shows techniques to be used for sleep restriction

Sleep, waking, insomnia, night, apnoea, stress, Epworth, restriction, audio, questionnaire, sleep hygiene, sleep problem, sleep restriction
Chronic kidney disease

Options to reduce cardiovascular risk when the risk is high.

Audio. Dr Keith Birrell talks to Douglas about how to reduce his future risk of heart attacks and strokes. Douglas has high blood pressure, chronic kidney disease and a high risk of cardiovascular disease. We use the absolute cvd risk/ benefit tool

Shared decision making tool, lifestyle, smoking cessation, physical activity, Healthy diet, mediterranean diet, lower blood pressure, lo salt, reduce salt, healthier diet, reduce alcohol intake, flaxseed, linseed, weight loss, blood pressure medications, statins, low intensity statins, high intensity statins, metformin, personalised risks assessment, absolute CVD risk / benefit calculator, heart attack, stroke, angina, type 2 diabetes, NN
How to lose weight

Shared decision options audio. Dr Keith Birrell with Mark who wants to lose weight

Listen to Dr Keith Birrell guiding Mark to make informed decisions to help him lose weight

Audio, shared decision options, lose weight, obesity, overweight, slimming, informed decision, low GI index, low GI diet, fast diet, five and two diet, 5 and 2 diet, Mediterranean diet, activity, activity monitor, pedometer, Health app
How to lose weight

Low GI Diet - Slow release carbohydrates that help to keep you blood sugars down and prevent type 2 diabetes

Link to Patient Information Leaflet from patient.info

lose weight, obesity, overweight, slimming, informed decision, low GI index, low GI diet, fast diet, five and two diet, 5 and 2 diet, Mediterranean diet, activity, activity monitor, pedometer, Health app
How to lose weight

Mediterranean Diet - A combination of foods from the mediterranean proven to protect against heart disease

Link to Patient Information Leaflet from patient.info

lose weight, obesity, overweight, slimming, informed decision, low GI index, low GI diet, fast diet, five and two diet, 5 and 2 diet, Mediterranean diet, activity, activity monitor, pedometer, Health app
How to lose weight

5:2 (fast) diet - On 2 convenient days a week you follow a low calorie diet. The rest of the time it’s OK to be a little naughty. A great way to lose weight. Ideal for those who aren’t good at sticking to diets.

Link to Patient Information Leaflet from patient.info

lose weight, obesity, overweight, slimming, informed decision, low GI index, low GI diet, fast diet, five and two diet, 5 and 2 diet, Mediterranean diet, activity, activity monitor, pedometer, Health app
How to lose weight

Options for maintaining and losing weight – decision aid and handout

Print off this decision aid and take it to your GP, so that you can share the decision on how to manage your weight.

Shared decision making tool, prevent weight gain, exercise, diet, CBT, cognitive behavioural therapy, alcohol, orlistat, diabetes, Polycystic ovary syndrome, metformin, GLP-1 agonist, SGLT2 inhibitors, bariatric surgery, fruit and vegetables, linseed, flaxseed, fast diet, 5 and 2 diet, 5:2 diet, low GI diet, low glycemic index diet, very low calorie diet, weight loss, how to lose weight, sleep apnoea, high blood pressure, type 2 diabetes, cancer, depression, death, NNT
Menstrual cycle symptoms

Shared decision options audio. Dr Keith Birrell with Laura who has symptoms linked to her menstrual cycle

Listen to Dr Keith Birrell guiding Laura to make informed decisions to reduce symptoms linked to her menstrual cycle.

Audio, shared decision options, informed decision, menstrual cycle, period, premenstrual, tension, heavy periods, painful periods, dysmenorrhoea, menorrhagia, low mood, anger
Migraine

Shared decision options audio. Dr Keith Birrell with Pippa who gets migraine headaches

Listen to Dr Keith Birrell guiding Pippa to make informed decisions about how to treat and prevent migraines

Audio, shared decision options, informed decision, migraine, headache, prevention, treat, treatment, amitriptyline, beta blockers, riboflavin,
Migraine

Shared decision options audio. Dr Keith Birrell with Ross who gets migraine headaches

Listen to Dr Keith Birrell guiding Ross to make informed decisions about how to prevent migraines

Audio, shared decision options, informed decision, migraine, headache, prevention, amitriptyline, beta blockers, riboflavin
Migraine

Options for preventing migraine – decision aid and handout

If you have migraines twice a week, or more, you might want to explore options for preventing migraines. Print off this decision aid and take it to your GP, so that you can share the decision.

Audio, shared decision options, informed decision, migraine, headache, prevention, amitriptyline, beta blockers, riboflavin
Migraine

Options for treating migraine – decision aid and handout

Print off this decision aid and take it to your GP, so that you can share the decision on how to treat your migraine. Lifestyle changes are worth exploring too.

Audio, shared decision options, informed decision, migraine, headache, prevention, amitriptyline, beta blockers, riboflavin
Osteoporosis, osteopaenia and bone health

Shared decision options audio. Dr Keith Birrell with Margaret. Margaret has osteoporosis (weak bones).

Listen to Dr Keith Birrell guiding Margaret to make informed decisions to about how to keep her bones healthy and prevent broken bones.

Audio, shared decision options, informed decision, osteoporosis, weak, bones, Health, prevent, broken, calcium, vitamin D, calcium calculator, bone health choice decision aid, Mayo Clinic
Osteoporosis, osteopaenia and bone health

Calcium Calculator (Edinburgh)

Online tool to help you to work out if you have enough calcium in your diet to keep your bones strong. If your calcium intake is low your doctor may recommend that you take calcium supplements.

shared decision options, informed decision, osteoporosis, weak, bones, Health, prevent, broken, calcium, vitamin D, calcium calculator, bone health choice decision aid, Mayo Clinic
Osteoporosis, osteopaenia and bone health

Bone health choice decision aid (Mayo clinic)

Online tool to help you, and your doctor, to decide if it is worth you taking a bisphosphonate medicine. What would be the benefit of you taking a weekly tablet like alendronic acid for up to 3-5 years. What side effects or harm might the alendronic acid cause?

Audio, shared decision options, informed decision, osteoporosis, weak, bones, Health, prevent, broken, calcium, vitamin D, calcium calculator, bone health choice decision aid, Mayo Clinic
Pain

Pain - Introducing the pain resources on realgeneralpractice.org

Listen to Dr Keith Birrell introducing the pain resources on realgeneralpractice.org to David who has for osteoarthritis and neuropathic pain

pain, sleep, opioids, driving, chronic pain, self-care, options
Pain

Brenda - Chronic low back pain and sciatica. Shared decision option discussion for painkillers

Dr Keith Birrell shares the evidence for options for managing long term low back pain with intermittent sciatica with Brenda

Audio, Chronic, low, back, pain, sciatica, Shared, decision, option, discussion, painkillers
Pain

Pain (long-term and flare-up), medication options

Use this Option Grid™ decision aid to help you and your healthcare professional decide which tablets you may like to take for longterm and flare-up pain of the muscles, ligaments, or soft tissue. This medication information applies to the United Kingdom only.

Chronic, tablets , pain, muscles, Shared, decision, option, discussion, painkillers
Pain

Pain (nerve type), medication options

Use this Option Grid™ decision aid to help you and your healthcare professional decide which tablets you may want to consider for the management of all nerve type pain, such as stabbing, shooting, or burning pain, except for patients with diabetic neuropathy or trigeminal neuralgia. This medication information applies to the United Kingdom only. Consider carbamazepine for trigeminal neuralgia and duloxetine for diabetic neuropathy.

Chronic, tablets , pain, muscles, nerve, Shared, decision, option, discussion, painkillers
Pain

Neuropathic pain - shared options discussion

Dr Keith talks to his patient about their experiences of neuropathic pain

neuropathic, pain, muscles, nerve, Shared, decision, option, discussion, painkillers
Pain

C-TOP tool for Comparing treatment options for neuropathic pain

C-TOP tool for Comparing treatment options for neuropathic pain

neuropathic, pain, muscles, nerve, Shared, decision, option, discussion, painkillers
Pain

Live well with pain website

For people who are living with pain. Really useful information and resources to help you live well, despite the pain.

pain, sleep, opioids, driving, chronic pain, self-care
Pain

Options for managing osteoarthritis pain

Dr Keith Birrell talks to David to help him to choose an option for managing his painful osteoarthritis

osteoarthritis, pain, placebo, topical nsaids, topical non steroidal anti-inflammatories, non steroidal anti-inflammatories, opiates, codeine, tramadol, surgery, paracetamol, TENS, acupuncture, capsaicin cream, chilli powder cream, glucosamine, chondroitin sulphate, shared decision options, options, Keith Birrell, James McCormack, understanding your pain, livewellwithpain, Functional pain, complementary, over the counter medication, lifestyle, exercise, healthy weight, NSAIDs, prescription medication, duloxetine, opioids, oxycodone, morphine, amitriptyline, nortriptyline, medication to help sleep, joint injections, intra-articular corticosteroid injection, joint replacement, benefits, serious harms and side effects, paincalculator.com
Pain

Options for neuropathic pain using the C-TOP tool

Listen to Dr Keith Birrell sharing the options to manage neuropathic pain, with David using the C-TOP tool

Options, neuropathic pain, C-TOP tool, placebo, amitriptyline, CBD oil, gabapentin, pregabalin, du-loxetine, diabetes, shared decision options