Background. About 30–50% of patients with gastro-oesophageal reflux disease (GORD) experience refractory symptoms despite taking proton pump inhibitors regularly. Epidemiology studies suggest lifestyle risks, but these are under-represented in existing guidelines. The potential for changes to positively impact on symptoms may be underestimated. Lifestyle advice currently appears to be ineffective.

Objectives. To inform the future design of a behaviour change intervention aimed at improving symptoms for patients with GORD, by exploring patient understanding and experiences of lifestyle influences on GORD symptoms.

Methods. We conducted semi-structured interviews with 23 patients (12 women and 11 men) aged 30–86 years, aiming to identify lifestyle influences perceived by patients to affect their symptoms.

Results. Patients reported a wide range of daily influences on their symptoms, including diet, drinking with a meal, body position, alcohol, gaining weight, stress and anxiety. Dietary influences included types of food eaten and eating pattern—including speed of eating and meal size. Many foods were identified as troublesome, but not all foods affected all patients. Eating late and daytime tiredness were not recognized as causes or consequences of night-time reflux.

Conclusions. Patients stated that daily living patterns affected their reflux symptoms, but influences were highly variable between respondents. Lifestyle factors appear to combine in unique patterns for individuals, but GORD patients may not be able to identify potential triggers and make changes for themselves. A behaviour change intervention might prove beneficial to these patients.

Background. Ethnicity is an important dimension in many aspects of psychosis.

Objective. To investigate ethnic differences in the primary care management of patients with psychosis.

Methods. Data were obtained from Lambeth DataNet, a database of computerized general practice case records derived from practices in an inner city London borough. We undertook a cross-sectional survey of patients with psychosis. Outcome measures: health screening, chronic disease management and prescribing data and differences between ethnic groups were expressed as odds ratios (ORs).

Results. One thousand six hundred and ninety-four of 165,911 (1.02%) registered patients had a diagnosis of psychosis; 1090 (64%) had ethnicity recorded; 501 were White and 403 were Black or Black British. There were no significant ethnic differences for blood pressure, cholesterol or HbA1c monitoring or control; cervical or mammography screening; treatment with hypotensives, statins, antidepressants, lithium, antipsychotics or atypical antipsychotics. Depot injectable antipsychotics were more likely to be prescribed to Black patients than other delivery modes: OR 2.10 (95% CI: 1.20–3.67).

Conclusions. Measurable aspects of physical health care of patients with psychosis were similar, regardless of ethnicity. Increased use of the depot antipsychotic medication in black patients needs further exploration.