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Family Practice

Ankie C M Hazen, Dorien L M Zwart, Judith M Poldervaart, Johan J de Gier, Niek J de Wit, Antoinette A de Bont, Marcel L Bouvy
Objective: To evaluate the process of clinical medication review for elderly patients with polypharmacy performed by non-dispensing pharmacists embedded in general practice. The aim was to identify the number and type of drug therapy problems and to assess how and to what extent drug therapy problems were actually solved. Method: An observational cross-sectional study, conducted in nine general practices in the Netherlands between June 2014 and June 2015. On three pre-set dates, the non-dispensing pharmacists completed an online data form about the last 10 patients who completed all stages of clinical medication review...
January 10, 2019: Family Practice
Eglantine Ferrand Devouge, Morgane Biard, Jean Beuzeboc, Marie-Pierre Tavolacci, Matthieu Schuers
Background: Clinical research is mostly conducted among hospitalized patients, which restricts the generalizability of research results. The involvement of GPs in research has been consistently highlighted as a factor associated with successful study recruitment. Objectives: To assess GPs' motivations and willingness to participate in primary care research as investigators and to identify factors associated with their willingness. Methods: We conducted an observational, cross-sectional study in Normandy, France, with a self-questionnaire sent to 3002 GPs...
January 3, 2019: Family Practice
Manuel Morgado, Sarah Pousinho
No abstract text is available yet for this article.
December 31, 2018: Family Practice
Frank Gabel, Ruth Chambers, Tracey Cox, Stefan Listl, Neal Maskrey
Background: The evidence that large pay-for-performance schemes improve the health of populations is mixed-evidence regarding locally implemented schemes is limited. Objective: This study evaluates the effects in Stoke-on-Trent of a local, multifaceted Quality Improvement Framework including pay for performance in general practice introduced in 2009 in the context of the national Quality and Outcomes Framework that operated from 2004. Methods: We compared age-standardized mortality data from all 326 local authorities in England with the rates in Stoke-on-Trent using Difference-in-Differences, estimating a fixed-effects linear regression model with an interaction effect...
December 21, 2018: Family Practice
Christos Lionis, Marilena Anastasaki
No abstract text is available yet for this article.
December 13, 2018: Family Practice
Silvia C Mendonca, Gary A Abel, Carolynn Gildea, Sean McPhail, Michael D Peake, Greg Rubin, Hardeep Singh, Willie Hamilton, Fiona M Walter, Martin O Roland, Georgios Lyratzopoulos
Background: Large variation in measures of diagnostic activity has been described previously between English general practices, but related predictors remain understudied. Objective: To examine associations between general practice population and characteristics, with the use of urgent referrals for suspected cancer, and use of endoscopy. Methods: Cross-sectional observational study of English general practices. We examined practice-level use (/1000 patients/year) of urgent referrals for suspected cancer, gastroscopy, flexible sigmoidoscopy and colonoscopy...
December 12, 2018: Family Practice
Chris O Ifediora, Emmanuel C Azuike
Background: Given the dearth of government-sponsored programmes, preventive lifestyles and practices are the realistic hopes for millions of women in developing countries against cervical cancer. Early interventions for teenage high school girls have been advocated recently, but evidence-base for sustainable activities at this demographic is lacking. This article reduces this gap by determining the impact of two cervical cancer education techniques. Method: This is a 6-month interventional cohort study of 432 female high school students in South-eastern Nigeria...
December 12, 2018: Family Practice
Daisy J M Ermers, Karin J H van Bussel, Marieke Perry, Yvonne Engels, Henk J Schers
Background: Advance care planning (ACP) is a crucial element of palliative care. It improves the quality of end-of-life care and reduces aggressive and needless life-prolonging medical interventions. However, little is known about its application in daily practice. This study aims to examine the application of ACP for patients with cancer in general practice. Methods: We performed a retrospective cohort study in 11 general practices in the Netherlands. Electronic patient records (EPRs) of deceased patients with colorectal or lung cancer were analysed...
December 10, 2018: Family Practice
Yogarabindranath Swarna Nantha, Shamsul Haque, Hemanath Swarna Nantha
Background: There has been a shift in worldwide disease burden from infections to non-communicable diseases, especially type 2 diabetes (T2D). Behavioural change and self-management are key to optimal T2D control. Several universal models of diabetic care have been proposed to help explain the dimensions of T2D self-care such as medication adherence, physical activity, diet and patient-doctor interaction. These models do not allow an objective and quantifiable measurement of the problems faced by patients in terms of medication compliance...
December 10, 2018: Family Practice
Kerstin Maehder, Bernd Löwe, Martin Härter, Daniela Heddaeus, Martin Scherer, Angelika Weigel
Background: Stepped care models comprise a graded treatment intensity and a systematic monitoring. For an effective implementation, stepped care models have to account for the high rates of mental and somatic comorbidity in primary care. Objectives: The aim of the systematic review was to take stock of whether present stepped care models take comorbidities into consideration. A further aim was to give an overview on treatment components and involved health care professionals...
December 7, 2018: Family Practice
Juliana L Torres, Silvia L A da Silva, Fabiane R Ferreira, Liliane P S Mendes, Luciana A Machado
Background: Chronic pain is known to increase health care use in high-income countries, but in Brazil, little is known. Objective: To investigate the association between chronic pain and health care use among Brazilian older adults and explore the relationship between pain severity and health care use. Methods: This cross-sectional study was derived from the population-based study Frailty in Brazilian Older People-FIBRA. Chronic pain, pain intensity and pain-related disability were assessed through additional telephone interviews...
December 5, 2018: Family Practice
Petra Borsje, Peter L B J Lucassen, Hans Bor, Roland B Wetzels, Anne Margriet Pot, Raymond T C M Koopmans
Background: During the course of dementia, most people develop some type of neuropsychiatric symptoms (NPS), which result in lower quality of life, high caregiver burden, psychotropic drug use and a major risk of institutionalization. Studies on NPS in people with dementia have been mainly conducted in clinical centres or psychiatric services. Objectives: To investigate the course of NPS in people with dementia in primary care. Methods: Analysis of (cumulative) prevalence and incidence, persistence and resolution based on data collected during an assessment at home of a prospective naturalistic cohort study in primary care in a sample of 117 people with dementia and their informal caregivers...
December 4, 2018: Family Practice
Hala Samir Abou-ElWafa, Abdel-Hady El-Gilany
Background: Working mothers face unique barriers to breastfeeding, despite the compelling evidence of its benefits. The aim of this study was to describe exclusive breastfeeding (EBF) rate of working mothers and associated factors. Methods: Cross-sectional study was carried out in Mansoura District, Egypt from 1 July to 31 December 2017 among working mothers attending health care facilities for vaccinating their infants aged 6 months. Data were collected using a questionnaire covering sociodemographic and occupational data; breastfeeding supportive workplace facilities; antenatal and natal care; infant's data; and EBF practice...
December 1, 2018: Family Practice
Erika Strazdins, Kathryn Dwan, Melanie Pescud, Lyndall Strazdins
Background: Increasing numbers of GPs are reducing the hours they work in clinical practice. The reasons for and implications of this are not well-understood. Objective: To investigate how the demands of general practice, especially new time pressures, impact GPs' professional and personal lives and work hour choices. Method: Using a grounded theory approach, we conducted 26 in-depth interviews with GPs working in Australia. Results: Time-bound consultation windows, the complexity of patients presenting to general practice and consequent administrative and emotional burdens placed upon GPs combined to increase time pressures and an intensifying clinical load...
December 1, 2018: Family Practice
Elizabeth A Sturgiss, Elizabeth Rieger, Emily Haesler, Matthew J Ridd, Kirsty Douglas, Shelley L Galvin
Background: Relational aspects of primary care are important, but we have no standard measure for assessment. The 'working alliance' incorporates elements of the therapeutic relationship, shared decision-making, goal setting and communication skills. The Working Alliance Inventory (short form) (WAI-SF) has been used in adult psychology, and a high score on the survey is associated with improved outcomes for clients. Objective: To adapt the WAI-SF for use between GPs and patients and to test its concurrent validity with measures of shared decision-making and the doctor-patient relationship and discriminant validity with measures of social desirability...
November 26, 2018: Family Practice
Paul Sebo, Jean Pascal Fournier, Hubert Maisonneuve
Objective: We aimed to compare the number of submissions until acceptance and the time to publication between articles co-authored and articles not co-authored by statisticians. Methods: We randomly selected 781 articles published in 2016 in 18 high impact factor journals of general internal medicine and primary care. For each article, we retrieved its date of submission to the journal and its first publication; we also contacted its corresponding author and asked about the number of submissions necessary from the first submission to a journal until acceptance and whether the article was co-authored by a statistician...
November 26, 2018: Family Practice
Eugene Y H Tang, Christopher Price, Blossom C M Stephan, Louise Robinson, Catherine Exley
Background: Memory and cognitive deficits post stroke are common and associated with increased risk of future dementia. Rehabilitation tends to focus on physical recovery; however, once in the community, it is unclear what happens in the longer term to the stroke-survivor with new memory difficulties. Objective: The aim of this qualitative study was to examine in stroke-survivors what factors influence contact with health professionals. Method: Semi-structured interviews were conducted with stroke-survivors and their family carers where memory difficulties were reported at 6 months post stroke...
November 19, 2018: Family Practice
Peninah Murage, Max O Bachmann, S Michael Crawford, Sean McPhail, Andy Jones
Background: Poor geographical access to health services and routes to a cancer diagnosis such as emergency presentations have previously been associated with worse cancer outcomes. However, the extent to which access to GPs determines the route that patients take to obtain a cancer diagnosis is unknown. Methods: We used a linked dataset of cancer registry and hospital records of patients with a cancer diagnosis between 2006 and 2010 across eight different cancer sites...
November 19, 2018: Family Practice
L Adelyn Cohen, Christine A Limbers
Background: Mothers of children with diabetes are at-risk for experiencing parenting stress and diminished mental/emotional health. To the best of our knowledge, no studies to date have examined whether there are differences in these outcomes between mothers whose diabetic child is managed in a patient-centred medical home or not. Objective: The objective of the present study was to assess whether there were differences in mental health and parenting stress among mothers whose diabetic child was managed in a patient-centred medical home or not...
November 16, 2018: Family Practice
Ngiap Chuan Tan, Agnes Ying Leng Koong, Lok Pui Ng, Pei Lin Hu, Eileen Yi Ling Koh, Kee Tung Tan, Peter Kirm Seng Moey, Mei Xuan Tan, Chia Siong Wong, Thean Yen Tan, Hanley Jian An Ho, Mark I-Cheng Chen
Background: Women with urinary tract infections (UTIs) often present with urinary complaints such as frequency of micturition, dysuria, foul-smelling urine and other non-specific symptoms like fever. Physicians may order urine microscopy to guide empirical antibiotic prescription. However, the performance of this approach has not been assessed. Objectives: This study aimed to determine the accuracy of UTI symptoms and urine microscopy associated with culture-positive UTI in Asian women...
November 15, 2018: Family Practice
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