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Family Practice

Ngiap Chuan Tan, Rong Quan Chew, Reena Chandhini Subramanian, Usha Sankari, Yi Ling Eileen Koh, Li Wei Cho
Introduction: Patients may be symptomatic, resulting in lower quality of life (QOL), despite L-thyroxine (LT4) therapy for hypothyroidism or having normal thyroid function. We hypothesized that their clinical symptoms of hypothyroidism and co-morbidities were associated with QOL. Objective: The study aimed to determine the association between the hypothyroid-related symptoms of Asian patients on LT4 treatment, their co-morbidities and their QOL. Method: A questionnaire survey was conducted from November 2015 to July 2016 on consecutive multi-ethnic Asian patients on LT4 treatment for their hypothyroidism in a public primary care clinic in Singapore...
July 13, 2018: Family Practice
Øystein Hetlevik, Christina H Bjørnå, Ina-Terese Lundring, Sturla Gjesdal
Background: Psychological problems are increasing among adolescents, but little is known about the role of GPs in this area. Objectives: This study aims to investigate the frequency of GP consultations with a psychological diagnosis in adolescence and predictors for such help seeking. Methods: Nationwide longitudinal register-based study investigating GP consultations among adolescents aged 13-17 years (N = 123 516) in Norway. First, all GP consultations within the study population were identified from the national GP claims register for 2006-11...
July 11, 2018: Family Practice
Vida Jeremic Stojkovic, Bojana Matejic, Karel Turza
Background: In prominent international documents and professional position papers, confidentiality was recognized as a necessary condition for effective reproductive healthcare of adolescents. Although legally guaranteed, it is questionable if the right to confidentiality of adolescents is respected in healthcare practice in Serbia. Objectives: To assess primary care physicians' perspectives on the legal right of minors to confidentiality in sexual and reproductive healthcare, as well as their experiences in practice...
July 6, 2018: Family Practice
Annicka G M van der Plas, Mariska G Oosterveld-Vlug, H Roeline Pasman, Bart Schweitzer, Bregje D Onwuteaka-Philipsen
Background: Discharge from hospital to home can be a stressful experience for patients and carers. Contact with the GP is important to ensure continuity of care. Objectives: To investigate timing of contact with the GP and locum after the last hospitalization in the last year of life and to investigate patient and care characteristics related to contact with the GP within 2 days after discharge. Methods: Health insurance data were combined with data from Statistics Netherlands on patients who mainly received care at home in the last 4 months of life...
June 30, 2018: Family Practice
Christine Cohidon, Pascal Wild, Nicolas Senn
Background: In contrast to many studies exploring barriers to preventive care in family medicine, there is less quantitative research regarding the self-perceived role of family physicians (FPs) in prevention and its predictive factors. Moreover, the existing studies considered this attitude as a homogeneous entity. The objective of this study is firstly, to characterize FPs' attitudes towards prevention taking into account nine different prevention themes, and secondly, to explore the factors that could be predictive of this attitude...
June 26, 2018: Family Practice
Janneke van Leeuwen, Eleni-Rosalina Andrinopoulou, Marleen Hamoen, Winifred D Paulis, Jolande van Teeffelen, Kees Kornelisse, Kelly van der Wijst-Ligthart, Bart W Koes, Marienke van Middelkoop
Background: Multidisciplinary intervention programs for overweight and obese children mainly focus on reducing bodyweight and body mass index (BMI), but they may also positively impact blood pressure (BP), and cardiorespiratory fitness (CRF), which is a stronger predictor for all-cause mortality than BMI. Objective: To evaluate whether Kids4Fit, a multidisciplinary weight reduction program, has a positive effect on CRF and BP in overweight and obese children in socially deprived areas...
June 25, 2018: Family Practice
Frederico Rosário, Milica Vasiljevic, Leo Pas, Niamh Fitzgerald, Cristina Ribeiro
Background: Alcohol is one of the most important risk factors contributing to the global burden of disease. Screening and brief interventions in primary care settings are effective in reducing alcohol consumption. However, implementation of such interventions in routine practice has been proven difficult. Most programmes in practice and research have lacked a theoretical rationale for how they would change practitioner behaviour. Objective: To determine whether a theory-based behaviour change intervention delivered to primary care practices significantly increases delivery of alcohol screening...
June 25, 2018: Family Practice
Ildikó Gágyor, Arndt Heßling, Susanne Heim, Andreas Frewer, Friedemann Nauck, Wolfgang Himmel
Background: General practitioners (GPs), nurses and informal caregivers are often jointly involved in healthcare situations in which ethical issues play an important role. Objectives: To describe ethical problems from the perspective of these three groups and to investigate whether there is a common experience of ethical issues in primary care. Methods: We conducted six focus groups with general practitioners, nurses and informal caregivers in Germany...
June 21, 2018: Family Practice
Julie Rotival, Youri Yordanov, Pierre-Clément Thiebaud, Nathalie Pelletier-Fleury, Elsa Jacquet, Erwan Debuc, Dominique Pateron, Diane Naouri
Background: Some studies have demonstrated an association between poor continuity of care, high likelihood of 'inappropriate' use of emergency departments (EDs) and avoidable hospitalization. However, we lack data concerning primary care use after an ED visit. Objective: Identify the determinants of a visit to the general practitioner (GP) after an ED visit. Design: Observational study (single-centre cohort). Setting: One emergency department in Paris, France...
June 21, 2018: Family Practice
Janni Katharina Stuhr, Jesper Lykkegaard, Jette Kolding Kristensen, Jette Brommann Kornum, Malene Plejdrup Hansen
Background: Sore throat is a frequent presentation of acute respiratory tract infections in general practice. Though these infections are often harmless and self-limiting, antibiotics are frequently prescribed. In Denmark, practice nurses manage an increasing part of patients with acute minor illnesses. Objectives: We aimed (i) to investigate Danish practice nurses' and GPs' management of patients presenting with a sore throat and (ii) to explore to what extent management is according to current Danish guidelines...
June 19, 2018: Family Practice
Slawomir Chlabicz, Dorota Rogowska-Szadkowska, Barbara Pytel-Krolczuk, Ludmila Marcinowicz, Anna Justyna Milewska, Julia Strumilo
Background: Requests by patients for antibiotics are known to strongly affect doctors' decisions to prescribe them. Objective. The aim of this study was to establish how frequently patients presenting with respiratory tract infections (RTIs) express their expectation not to be treated with antibiotics, which symptoms and physical findings are related to their perception of antibiotics not being helpful, and to what degree their expectations influence doctors' decisions. Methods: This was a direct observational study set in primary care practices in Bialystok, Poland...
June 15, 2018: Family Practice
Ruben E A Musson, Ayse Y Demir
No abstract text is available yet for this article.
June 12, 2018: Family Practice
Jolien J Glaudemans, Anja E de Jong, Bregje D Onwuteaka Philipsen, Jan Wind, Dick L Willems
Background: Few older people benefit from advance care planning (ACP), due to several barriers related to primary care professionals, such as insufficient knowledge, negative beliefs and a lack of time. Information on overcoming these barriers is limited. We assumed primary care professionals experienced in ACP with older patients are likely to have learned how to overcome these barriers. Objective: To investigate how Dutch primary care professionals experienced in ACP with older patients overcome these barriers...
June 11, 2018: Family Practice
Aileen R Neilson, Gareth T Jones, Gary J Macfarlane, Karen Walker-Bone, Kim Burton, Peter J Heine, Candy S McCabe, Alex McConnachie, Keith T Palmer, David Coggon, Paul McNamee
Background: Arm pain is common, costly to health services and society. Physiotherapy referral is standard management, and while awaiting treatment, advice is often given to rest, but the evidence base is weak. Objective: To assess the cost-effectiveness of advice to remain active (AA) versus advice to rest (AR); and immediate physiotherapy (IP) versus usual care (waiting list) physiotherapy (UCP). Methods: Twenty-six-week within-trial economic evaluation (538 participants aged ≥18 years randomized to usual care, i...
June 6, 2018: Family Practice
Kyoungjin Lee, Hyangkyu Lee, Jeongok Park, Sun Ha Jee
Objectives: The purpose of this study was to examine sex differences in factors associated with metabolic syndrome in Korean adults without diabetes mellitus. Study design: Cross-sectional design. Methods: The dataset of Korea National Health and Nutrition Examination Survey from 2010 to 2013 was used. Among a total of 33552 adults aged ≥30, subjects who (i) were diagnosed or had been treated for diabetes mellitus, (ii) had a fasting blood glucose level of 126 mg/dL or higher or (iii) had a glycosylated haemoglobin level of 6...
June 5, 2018: Family Practice
Belén Muñoz Díaz, Guillermo Molina-Recio, Manuel Romero-Saldaña, Juana Redondo Sánchez, Cristina Aguado Taberné, Carmen Arias Blanco, Rafael Molina-Luque, Jorge Martínez De La Iglesia
Aim: To validate the Mini Nutritional Assessment (MNA) in a Spanish population over 65 years of age with varying degrees of independence. Design: This cross-sectional validation study used the Chang nutritional assessment method as a reference test. Participants: 248 subjects (75.4% female), with a mean age of 83, completed the study. They were classified into three groups: (i) autonomous patients who were able to take part in activities outside their home; (ii) patients who require help with daily self-care; (iii) patients living in a residential health care facility...
June 5, 2018: Family Practice
Amy D Nguyen, Lauren J Frensham, Melissa T Baysari, Jane E Carland, Richard O Day
Background: Chronic disease patients are adopting self-management techniques, such as using mobile health applications (apps). As GPs are the main caregivers of chronic disease patients, obtaining GP perspectives regarding patient use of mobile health apps is vital in understanding longer term value and feasibility of these apps. Objective: The aim was to determine GP perceptions of their current and potential roles in the use of health apps by their patients and how patient-focused apps affect patient management...
June 5, 2018: Family Practice
Julie Khoury, Catherine J Krejany, Roald W Versteeg, Michaela A Lodewyckx, Simone R Pike, Michael S Civil, Moyez Jiwa
Background: Since 1991, the Royal Australian College of General Practitioners' (RACGP) Standards for General Practices (the Standards) have provided a framework for quality care, risk management and best practice in the operation of Australian general practices. The Standards are also linked to incentives for general practice remuneration. These Standards were revised in 2017. Objective: The objective of this study is to describe the process undertaken to develop the fifth edition Standards published in 2017 to inform future standards development both nationally and internationally...
June 2, 2018: Family Practice
Sapana R Patel, Andrea Cole, Virna Little, Natalia A Skritskaya, Elizabeth Lever, Lisa B Dixon, M Katherine Shear
Background: Complicated grief, a syndrome of persistent grief diagnosed >6 months following the loss of someone close is expected to be included in the 11th revision of the International Classification of Diseases as a new diagnosis called prolonged grief disorder. Complicated grief is associated with impaired functioning and health comorbidity and does not respond to treatments for depression. Individuals may seek help in primary care where providers need to be familiar with the syndrome...
June 1, 2018: Family Practice
Marijke Olthof, Feikje Groenhof, Marjolein Y Berger
Background: Continuity of care could reduce health care consumption by patients and reduce the number of referrals to specialist care, but it is unknown if there is a difference in referral rates to specific medical specialties. Aim: We aimed to determine the relationship between continuity of care and both the referral rate (referrals per patient per year) and the medical specialties for which this relationship was strongest. Design and setting: A retrospective cohort study of 19333 patients in primary care in the north of the Netherlands...
May 30, 2018: Family Practice
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