Volume 20, Number 2

Martin Duerden B Med Sci MRCGP Dip Ther DPH Senior Lecturer, Keele University, General Practitioner and Medical Director, Conwy Local Health Board; Stephanie Wolfe MSc RGN RNCT Dip Asthma and COPD Independent Respiratory Specialist Nurse, Primary Care and Regional Trainer NRTC, Director, Primary Research Ltd, Norwich

The term ‘concordance’ in relation to prescribing and medicine-taking came into common use following a report published by the Royal Pharmaceutical Society of Great Britain in 1997, From compliance to concordance.1 Compliance is the extent to which a person takes or uses a medicine as intended by the prescriber (who may be a doctor, and now, other healthcare professional). Concordance is the partnership between a patient and healthcare professionals in which an agreement is reached about how medicines are to be taken or used.

Brendan Cooper MSc PhD CBiol MI Biol Consultant Clinical Scientist (Clinical Physiology), Lung Investigation Unit, University Hospital Birmingham NHS Trust, Birmingham

The use of lung function services in general practice is increasing across the UK, largely because of the introduction of the British Thoracic Society (BTS) guidelines1 recommending spirometry for the management of chronic obstructive pulmonary disease (COPD). These guidelines place an emphasis on the measurement of forced expiratory volume in one second (FEV1) together with other spirometric indices (forced vital capacity [FVC], vital capacity [VC] and peak expiratory flow [PEF]) as an opportunistic screening test for patients dropping in to the practice.

Philip Ind MA FRCP Senior Lecturer and Honorary Consultant Physician, Hammersmith Hospital, London; Maria Hansson MSc Independent Medical Writer, Ely

Asthma poses one of the greatest challenges to the management of chronic disease in primary care and consumes a large portion of NHS resources. The importance of asthma from a public health perspective is emphasised by its inclusion as one of ten clinical priorities in the new General Medical Services (GMS) contract which came into effect in April 2004.

Hilary Pinnock MB ChB MRCGP Clinical Research Fellow, Division of Community Health Sciences, GP Section, University of Edinburgh and Principal in General Practice, Whitstable Medical Practice, Whitstable; David Price MB BChir MA FRCGP GPIAG Professor of Primary Care Respiratory Medicine, Department of General Practice and Primary Care, University of Aberdeen, Aberdeen

The key role of primary care in the area of respiratory disease, and its growing contribution to research, was recognised in a two-day primary care conference during the 2004 European Respiratory Society (ERS) congress in Glasgow.

Philip Ind, Editor

A recent paper has audited respiratory research activity and examined published output from various countries, and compared this with national disease burden.1 Funding of respiratory research in the UK was also reported. This raises interesting questions regarding research priorities – who should decide them, how they are funded and the breakdown between basic and clinical research.

Nicholas Chanarin MD FRCP Consultant Chest Physician; Prina Ruparelia BSc Hons MRCP Specialist Registrar in Respiratory Medicine, Colchester General Hospital, Colchester

The pleural space is the area between the lung and the chest wall. It is lined by two thin serous membranes, the visceral and parietal pleura. This space is bathed in pleural fluid. If fluid builds up and exceeds 100 ml on one side, then patient is said to have a pleural effusion.