March 2024
Use various calculators such as Osteoporosis Risk Benefit to work out the benefits of treatment with different drugs and Dietary Calcium questionnaire to assess intake as a part of managing patients with Corticosteroid induced Osteoporosis. More info here: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/corticosteroid-induced-osteoporosis/
Harmful Gambling is an urge to gamble continuously despite negative or harmful consequences or a desire to stop. Clinicians can use the PGSI mini-screening tool for assessment. Detailed info about support services and PIL can be accessed here: https://apps.nhslothian.scot/refhelp/guidelines/mentalhealthadult/gamblingproblemsadult/
Please see an overview of Lothian’s Sexual Assault Service here: https://apps.nhslothian.scot/refhelp/guidelines/sexualreprohealth/sexual-assault-services/ Please note that people can self-refer for support even if they do not want police involvement. More info on useful resources such as PILs and support links included.
East Lothian Rehabilitation Service (ELRS) have updated their SCI gateway referral protocol with new pathways added to the dropdown menu: MSK, domiciliary physio, Falls physio, Community respiratory, Women’s health & Physio-led chronic MSK pain management. https://apps.nhslothian.scot/refhelp/guidelines/rehabilitation/east-lothian-rehabilitation-service-elrs/
Physiotherapy Led Chronic Pain Management service provides a biopsychosocial approach to persistent pain, delivered by a team of specially trained physiotherapists across East and West Lothian. Currently, under review for Edinburgh patients. More info: https://apps.nhslothian.scot/refhelp/guidelines/musculoskeletalphysiotherapy/chronic-msk-pain-local-services/
New pathway for hip fracture initiated in NHSL whereby all patients are offered infusion of zoledronic acid (ZA) which reduces risk of further fractures. 3 years after primary care evaluate the need for ongoing osteoporosis treatment. Detailed info here: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/hip-fracture/
Measles is on the rise in parts of the UK & Europe. Few cases have been confirmed in Scotland. NHS Lothian’s Measles Preparedness Group has issued a guidance for GPs covering symptoms, process for confirmed/suspected cases & ensure right swabs for testing. https://apps.nhslothian.scot/refhelp/guidelines/laboratoryservices/virology/measles/
Refhelp is excited to announce a new page on injectable Anti-Obesity Medication (AOM). This can be found as a subpage on the Weight Management section of our website. This provides details on referral criteria, how to refer via Sci-gateway, and printable self-referral forms.
The MNPI Team is a new & developing service to provide access to supportive psychological interventions for families and staff in NHS Lothian’s maternity and neonatal services. You can access their referral form and PIL under the resources & links tab: https://apps.nhslothian.scot/refhelp/guidelines/mentalhealthadult/perinatalmentalhealth/maternity-and-neonatal-psychological-intervention-team/
Dual-Energy X-ray Absorptiometry (DEXA) is indicated in patients suspected to have Osteoporosis & Repeat DEXA scans are done to monitor response to treatment or progression to Osteopenia. For guidance on indications and intervals between scans please see: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/dexa/
New to RefHelp? Check out our website walkthrough to know more about the website features, navigation and details of the information we offer via a step by step narration! To watch the video please visit our About us page: https://apps.nhslothian.scot/refhelp/about-us/
Specific page for Male Osteoporosis. Check out details on history, examination, investigations, biochemistry, hematology, treatment, and indications for referral here: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/male-osteoporosis/
Muscle twitching & cramps are normal, occasionally may indicate an underlying neurological condition but are nearly always benign. A study showed >50% had muscle fasciculation & 37% muscle cramps in a year. Check primary care management & referral info: https://apps.nhslothian.scot/refhelp/guidelines/neurology/muscle-twitches-and-cramps/
Updated information on Osteopenia here: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/osteopenia/
Clinical evaluation and Indications for secondary care referral of patients who fracture on treatment and who have had a repeat DEXA to assess response are outlined here: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/osteoporosisfracturesontreatment/
Midlothian Wellbeing Service (operated by Thistle Foundation) is based in Midlothian GP surgeries for people aged >18 living with long term health conditions &/or facing challenging life situations. Know more about courses offered & referral criteria here: https://apps.nhslothian.scot/refhelp/midlothian-wellbeing-services/
Check out the updated information on diagnosis, management and referral guidelines for postmenopausal osteoporosis here: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/osteoporosis/post-menopausal-osteoporosis/
Helpful advice on primary care management of Polymyalgia Rheumatica: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/polymyalgiarheumatica/
Patients suspected of having Psoriatic Arthritis should be referred to the Rheumatology service. For key clinical features, tips on examination, advice on investigations and initial management please see: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/psoriaticarthritis/
Check out the scoring criteria for the diagnosis of Rheumatoid Arthritis and possible differential diagnosis. Info on initial management and useful resources included: https://apps.nhslothian.scot/refhelp/guidelines/rheumatology/rheumatoidarthritis/
