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Primary Care

Study protocol for a randomized, controlled trial comparing the efficacy of two educational interventions to improve inhalation techniques in patients with chronic obstructive pulmonary disease (COPD): TIEPOC Study.

Authors: José Leiva-Fernández, Francisca Leiva-Fernández, Rubén L Vázquez-Alarcón, Antonio García-Ruiz, Daniel Prados-Torres, Pilar Barnestein-Fonseca

Up to 75% of patients with COPD do not use a correct inhaler technique. In this article, the authors provide details of a study protocol for a randomized controlled trial to test the efficacy of two educational interventions aimed at improving inhalation techniques in a cohort of patients in southern Spain.

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The non-anticoagulation costs of atrial fibrillation management: findings from an observational study in NHS Primary Care

Authors: George Kassianos, Chris Arden, Simon Hogan, Laura Baldock, Ahmet Fuat

Atrial fibrillation (AF) management represents a significant burden on the UK NHS. In this article the authors review data from 825 patients in routine UK clinical practice and describe the non-anticoagulation costs associated with AF management. Understanding these costs better may help inform future health care planning and policy development.

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Initial combination therapy for patients with type 2 diabetes mellitus: considerations for metformin plus linagliptin

Authors: Jeffrey Freeman

In this article the author discusses the implications for clinical practice of the results of a recent Phase III trial. He concludes that initial combination of linagliptin plus metformin which was found to be weight neutral, well tolerated and associated with a low frequency of hypoglycaemia, may have advantages for a large proportion of patients with type 2 diabetes, particularly those with a relatively high HbA1c at diagnosis.

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Optimizing glycemic control and minimizing the risk of hypoglycemia in patients with type 2 diabetes

Authors: Stanley S Schwartz

In this article the author argues that in type 2 diabetes, an approach that emphasizes diet and exercise and features a treatment regimen tailored to the needs of the individual to reach glycemic targets is warranted in most patients and provides microvascular and cardiovascular benefit, provided that hypoglycemia is avoided.

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Therapeutic approaches to slowing the progression of diabetic nephropathy – is less best?

Authors: Eva Vivian, Chelsea Mannebach

In this article authors review recent studies and evaluate the benefits and risks of combination therapy with an angiotensin converting enzyme (ACE) inhibitor and angiotensin II receptor blocker (ARB), or a direct renin inhibitor (DRI) to attenuate the progression of diabetic nephropathy.

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