Doctors Lisa and Sara are back with Consultant Neurologist Dr Antonella Macerollo for this episode about Parkinson’s disease. 

We look at a typical case and discuss what Parkinson’s is, the differentials, the need for time to discern between these, and the options for treatment. Links include information on Clinical Trials and Parkinson’s UK which is an active Charity linking resources together for patients and professionals. Thanks to Alison Day at Parkinson’s UK for making the connection between ourselves and Antonella to make these episodes possible.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Resources:

Parkinson’s UK: https://www.parkinsons.org.uk/

The epidemiological link between Essential Tremor and Parkinson’s Disease: https://www.nature.com/articles/s41531-023-00577-y

PD Frontline (clinical trial in Parkinson's disease): https://pdfrontline.com/en

Cure Parkinson’s: https://cureparkinsons.org.uk/

Parkinson’s Europe Charity (good resources): https://parkinsonseurope.org/

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Sara and Lisa discuss the podcast episodes over the year. We talk about our longer term learning points, how the year has gone and what's to come.

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Doctors Lisa and Sara speak to Consultant Neurologist Dr Antonella Macerollo about Essential Tremor (ET). We take a case and go through what ET is, how it might present, differentials and the differences between other conditions, how it might affect people and what management options there are. 

This is the first of two Episodes with Dr Antonella Macerollo, our next one is about Parkinson’s Disease. Thanks to Alison Day at Parkison’s UK for making the connection between ourselves and Antonella to make these episodes possible.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Resources:

More Differentials and details of clinical assessment of Tremors: https://patient.info/doctor/history-examination/tremor-pro?utm_source=gpoptin

Revisiting the assessment of tremor: clinical review. Vijiaratnam N, Wirth T and Morris HR. British Journal of General Practice 2020; 70 (701): 611-614. https://bjgp.org/content/70/701/611

Treatment for essential tremor: a systematic review and Bayesian Model-based Network Meta-analysis of RCTs. Zhang, Junjiao et al. eClinicalMedicine, Volume 77, 102889: https://www.thelancet.com/action/showCitFormats?doi=10.1016%2Fj.eclinm.2024.102889&pii=S2589-5370%2824%2900468-1

Parkinson’s UK: https://www.parkinsons.org.uk/

The epidemiological link between Essential Tremor and Parkinson’s Disease: https://www.nature.com/articles/s41531-023-00577-y 

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

We go through a hypothetical case to illustrate some of the finer points of management that can commonly get missed or might not be appreciated. A really detailed talk full of useful practice enhancing tips for this complex group of patients. 

Disclaimer: This episode was supported by Greater Manchester NHS who received support from Boehringer. 

Resources:

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We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Resources:

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Resources:

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Resources:

Podcast: Infectious Diseases Insight of Two Specialists (ID:IOTS): https://www.britishinfection.org/education-events/idiots-podcast

UK Standards for Microbiology Investigations, The Royal College of Pathologists: https://www.rcpath.org/profession/publications/standards-for-microbiology-investigations.html

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

We’ve got something a little bit different for you today, instead of our summer rewind.

Some people may remember the wonderful episode about dealing with Uncertainty we did way back in 2020 with  GP, Primary Care Educator and Author Dr Avril Danczak. It was such an important episode in our careers and I know helped many others.

We wanted to share the news that Avril is doing brilliant podcasting work with the ever pragmatic Professor James McCormack. Their podcast Contented clinician, people may have already found, but we thought it would be useful to post one here to signpost listeners to their good work.

Welcome to Episode 6 of The Contented Clinician Podcast! Dr Avril Danczak and Professor James McCormack created The Contented Clinician Podcast to help clinicians find more joy and satisfaction in your practice by blending a collective of real-world experience, common sense, and the best available evidence. So, if you’re looking to make your clinical practice more fulfilling and sustainable, join us and our inspiring network of clinicians as we explore new perspectives and effective strategies to reshape the way you think about your work.

The Case:

Dr. Ashville is currently training to become a family physician. One day, they receive a phone call from a frustrated patient named Jane Brown.

Jane had received a message stating: “As your cardiovascular risk is now 10%, it is recommended you take a statin medication.” She is upset because no one had a proper conversation with her about starting a new prescription.

Her main concern is: “How likely am I to actually benefit from this treatment? Is it really worth it?”

Dr. Ashville realizes they had simply been following a protocol and isn't entirely sure how to answer Jane's question. Wanting to better understand how to provide more balanced information, Dr. Ashville decides to discuss the issue with the clinician supervising their medical education.

Resources:

GP Evidence: https://gpevidence.org/

James McCormack: Doing statistics can be difficult but understanding them can be fairly simple: https://www.sensible-med.com/p/doing-statistics-can-be-difficult

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Resources:

Podcast: Infectious Diseases Insight of Two Specialists (ID:IOTS): https://www.britishinfection.org/education-events/idiots-podcast

Antimicrobial Counselling Resources from Public Health Wales: https://phw.nhs.wales/services-and-teams/antibiotics-and-infections/harp-news/eaadwaaw-2021/resources/community-pharmacy-counselling-checklist/

Antimicrobial Counselling RCGP TARGET Resources: https://elearning.rcgp.org.uk/mod/book/view.php?id=12647

The Cynefin Framework for looking at decisions (Simple, complicated, Complex, Chaos): https://thecynefin.co/about-us/about-cynefin-framework/?srsltid=AfmBOopHNprchcOsISLVvXm2C5W-UU-oqHDkty_jo1IAAsupfoMu4_Cx

Shared Decision Making Tool BRAN - Benefits, Risks, Alternatives, Nothing: https://www.england.nhs.uk/personalisedcare/shared-decision-making/decision-support-tools/how-to-use-a-decision-support-tool/#:~:text=Prepare%20patients%20to%20share%20decisions&text=In%20addition%20to%20the%20proactive,Nothing)%20or%20equivalent%20local%20initiatives

World Health Organisation AWaRe Book: Access, Watch, Reserve Antimicrobial Book (can aid in decision making around which antibiotics to use. Accessed May 2025):  https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2022.02

UK Health Security Agency Adaptation of the Access, Watch, Reserve (AWaRe) Guidelines: https://www.gov.uk/government/publications/uk-aware-antibiotic-classification/uk-access-watch-reserve-and-other-classification-for-antibiotics-uk-aware-antibiotic-classification

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

Resources:

Joint asthma guideline: https://www.nice.org.uk/guidance/ng244

GMMMG asthma guidelines: https://gmmmg.nhs.uk/guidance/clinical-guidance-and-pathways/gm-asthma-guideline-2024-for-web/

Asthma and Lung UK: https://www.asthmaandlung.org.uk/

Right Breathe: https://www.rightbreathe.com/

Asthma and Lung UK explainer videos: https://www.asthmaandlung.org.uk/living-with/inhaler-videos

___

We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback

Email us at: [email protected]

___

This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. 

The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it’s release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen.

Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk.

The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.