Participants

• Dr David McConaghy, Irish College of GPs Clinical Lead in Prevention; Member of HSE Team on Integrated Care Programme for Chronic Disease
• Dr John Maher - Host

Summary

• This conversation reviews the management of hypertension in primary care, in light of recently-published ESC 2024 guidelines. We discuss:
• updated blood pressure targets and the potential implications for blood pressure diagnosis and management in primary care;
• the shift towards first-line combination therapy, for potentially improved patient outcomes;
• the role of risk assessment tools such as QRISK3 to guide management;
• the importance of lifestyle changes.

We also highlight the role of ECG and ABPM monitoring, and criteria for referring patients to secondary care, emphasising a proactive approach to management of hypertension, to reduce morbidity and mortality.

Takeaways

• Hypertension is a leading cause of morbidity and mortality.
• The new target for blood pressure is under 130/80 mmHg.
• Elevated blood pressure is now defined as 120/70 mmHg.
• Combination therapy is preferred over monotherapy for hypertension.
• Audits can improve hypertension management in general practice.
• Lifestyle changes are essential for managing hypertension.
• QRISK3 is a useful tool for cardiovascular risk assessment.
• Annual ECG and ABPM are recommended for patients with established hypertension.
• Referral to secondary care is necessary for resistant hypertension.
• Proactive management can significantly reduce cardiovascular events.

Links

1. Guidelines for the management of elevated blood pressure and hypertension 2024 - European Society of Cardiology

2. Primary prevention of cardiovascular disease in primary care - Forum September 2025, Irish College of GPs

3. HSE Opportunistic case finding - 1st Report

4. Structured Chronic Disease Management Treatment Programme - 3rd Report

5. QRISK3 Online Calculator

6. SCORE2 Online Calculator (MDCalc)

Disclaimer
The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional.

The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs.

Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast.

This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability.

While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented.

By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided.

Subscribe, like and review wherever you get your podcasts.
Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast
Email: podcast@icgp.ie

Participants

Dr Ciara McCarthy - GP Lead in Women's Health, HSE and Irish College of GPs

Dr Laura Cullen - Director of Women's Health, Irish College of GPs

Dr John Maher - Host

Summary

This two-part conversation reviews the provision of Early Medical Abortion (EMA) in primary care Ireland, based on the Irish College of GPs Quick Reference Guide "Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners" which is available on the College website. We will refer to this QRG throughout our conversation.

In today’s episode, which is part two, Ciara and Laura continue their discussion, covering topics including:

• the notification aspect of the legislation in Ireland;
• management of complications, including in the Out of Hours setting;
• an approach to the patient expressing ambivalence;
• contraception considerations;
• training offered by the Irish College of GPs to support GPs who wish to provide an EMA service;
• practice considerations and tips for setting up an EMA service.

Links to Core Irish College of GP Resources referenced during episode

• QRG: Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners

• QRG: Clinical Support for Termination of Pregnancy in General Practice

• Checklist for. GPs preparing to provide a termination of pregnancy service - Appendix 2 of QRG

• Digital Blended Learning: Early Medical Abortion

Links to Other Useful Resources Mentioned

• Health (Regulation of Termination of Pregnancy) Act 2018

• Irish Medical Council Guide to Professional Conduct & Ethics for Registered Medical Practitioners - 9th Edition 2024

• HSE Unplanned Pregnancy Supports (Including My Options)

Disclaimer
The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional.

The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs.

Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast.

This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability.

While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented.

By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided.

Subscribe, like and review wherever you get your podcasts.
Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast
Email: podcast@icgp.ie

Participants

Dr Ciara McCarthy - GP Lead in Women's Health, HSE and Irish College of GPs

Dr Laura Cullen - Director of Women's Health, Irish College of GPs

Dr John Maher - Host

Summary

This two-part conversation reviews the provision of Early Medical Abortion (EMA) in primary care Ireland, based on the Irish College of GPs Quick Reference Guide "Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners" which is available on the College website. We will refer to this QRG throughout our conversation.

In today’s episode, which is part one, Ciara and Laura discuss the legal and ethical framework of EMA provision in primary care in Ireland, resources available through My Options, the three-visit structure in primary care and what takes place at each step, an overview of medications administered, safety, efficacy and follow-up, and the importance of providing care in a patient-centred manner, including considerations for patients living in more remote locations.

Links to Core Irish College of GP Resources referenced during episode

• QRG: Early Medical Abortion: Top Ten Tips for Non-Providing General Practitioners

• QRG: Clinical Support for Termination of Pregnancy in General Practice

• Checklist for. GPs preparing to provide a termination of pregnancy service - Appendix 2 of QRG

• Digital Blended Learning: Early Medical Abortion

Links to Other Useful Resources Mentioned

• Health (Regulation of Termination of Pregnancy) Act 2018

• Irish Medical Council Guide to Professional Conduct & Ethics for Registered Medical Practitioners - 9th Edition 2024
• HSE Unplanned Pregnancy Supports (Including My Options)

Disclaimer
The information provided in this podcast is for educational and informational purposes only. It is not intended to serve as medical advice, diagnosis, or treatment, nor does it replace independent clinical judgment or consultation with a qualified healthcare professional.

The views and opinions expressed by hosts and guests are their own and do not necessarily reflect those of the Irish College of GPs.

Listeners are encouraged to review current clinical guidelines, product labelling, and relevant policies before applying any information discussed in this podcast.

This podcast does not establish a doctor–patient relationship. Healthcare professionals should exercise their own professional judgment in evaluating and applying information to specific clinical situations. Patients or members of the public should seek advice from their own qualified healthcare provider regarding any medical condition or treatment. It may not be possible or appropriate in all circumstances to follow the advice/processes suggested in this podcast, for example due to resource availability.

While efforts are made to ensure accuracy, medicine is a constantly evolving field, and no guarantee is made regarding the completeness, accuracy, or timeliness of the information presented.

By listening to this podcast, you acknowledge and agree that the hosts, guests, producers, affiliated organizations and the Irish College of GPs are not liable for any direct or indirect consequences resulting from the use of the information provided.

Subscribe, like and review wherever you get your podcasts.
Webpage: https://www.irishcollegeofgps.ie/The-GP-Podcast
Email: podcast@icgp.ie