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Gold, incentives and meh

Practice nurse shortage could hit drive to cut GPs' workload

GPs face being swamped with workload as the obesity epidemic doubles rates of cardiovascular disease in the middle-aged within two decades, an alarming new study reveals.

Cardiologists and GPs said the crisis would worsen unless the Government focused on anti-obesity public health campaigns and provided funding to allow GPs to prescribe expensive anti-obesity drugs.

The study estimated that in Scotland there had been 73,600 cardiovascular events in middle-aged men and women in the 20 years from 1976. It forecast that based on current obesity rates, this would leap to 157,200 in the 20 years from 1998.

Lead author Professor John McMurray, professor of clinical pharmacology at the University of Glasgow, said: 'The current global obesity epidemic will increase the future burden of cardiovascular disease, with a more than doubling in the number of middle-aged men and women experiencing a cardiovascular event.

'These results support public health strategies to combat obesity and primary preventive approaches to cardiovascular disease in obese individuals.'

In the study, 15,406 men and women were screened for obesity and cardiovascular disease between 1972 and 1976 and followed up for 20 years. In this cohort, 10.7 per cent of men and 15 per cent of women were obese, but by 1998 obesity rates in Scotland had risen to 23 per cent and 31.5 per cent respectively.

The research, presented last week at the European Society for Cardiology congress in Munich, extrapolated forward from 1998 and estimated that over 20 years there would be an extra 106,078 admissions in middle-aged men and 63,273 in women for cardiac problems.

Dr Eugene Hughes, a GP on the Isle of Wight and a member of Primary Care Diabetes Europe, said: 'The obesity epidemic is a real problem GPs have been saddled with and we are spending more and more time dealing with it.

'The big question is whether PCTs will sanction widespread use of anti-obesity drugs and exercise on prescription.'

He said it was unfair that while GPs would earn extra money through the quality and outcomes framework for treating cardiovascular disease, they would not be paid for managing obesity.

By Brian Kelly

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