Beres Joyner, General practitioner and Senior lecturer, Rural Clinical Division, School of Medicine, University of Queensland, Rockhampton, Qld.
This familiar yellow book with the metamorphosing tadpole on the cover has further matured and also experienced an expansion in girth (80 pages in three years). It has been extensively revised.
The book aims to provide 'what a clinician needs to know to manage a patient with a given condition'. For commonly encountered clinical conditions in general practice such as diabetes, obesity, thyroid disorders, osteoporosis, contraception, ovarian replacement therapy and menstrual disorders, the guidelines provide excellent summaries of current management recommendations, including drug therapies. It answers questions that arise in clinical practice. How do you choose between sulfonylureas for a person with diabetes? How do you manage hypoglycaemia in a person on acarbose? How do you monitor and adjust the dose of carbimazole for a person with thyrotoxicosis? How do you interpret bone mineral density results? When should you screen for thrombophilia in a woman who wants the combined oral contraceptive pill? What are the important drug interactions with the combined oral contraceptive pill? How do you overcome the skin irritation when testosterone impregnated adhesive skin patches are used? What happens if a woman with diabetes gets pregnant while on an ACE inhibitor?
These guidelines are well written and easy to read and there are lots of practical points. They are minimally but appropriately referenced with canonical papers. Although the style is definitive, it is not didactic. Where clinical practice is not based on evidence, this is indicated. There are a few minor errors, but these do not detract from the book overall. It represents good value for the money and will be useful for busy practising clinicians, and also medical students. Although time is a valuable resource, I would encourage general practitioners to read through the chapters on conditions they manage frequently.
