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Family Practice

Kevin Pan, Alan I Blankley, Peter J Hughes
Background: In the USA, opioid overdose accounted for more than 60% of drug overdose deaths in 2015. Of these deaths, 40% were due to use of prescription opioids. Objectives: The aims of the study were to (i) study family medicine physician opioid-prescribing rate and duration of prescription, (ii) study the distribution of prescription by medication potency, (iii) study opioid-prescribing trends in health care shortage areas and (iv) study the association between extreme high prescribing rates and medical board discipline...
September 19, 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
No abstract text is available yet for this article.
September 18, 2018: Family Practice
Kimberly D Campbell-Voytal, Kendra L Schwartz, Hiam Hamade, Florence J Dallo, Anne Victoria Neale
Background: The Arab Muslim and Chaldean Christian American community is unified by language but culturally diverse. Researchers are challenged to engage the Arab/Chaldean community to meet immigrant health needs. Arabs/Chaldeans are identified as white in clinical data sets making it difficult to identify health behaviours and patterns unique to the community. Objectives: To explore the views of members of the Arab/Chaldean community, including researchers and the lay public, regarding health research participation and the role of clinicians, researchers and community leaders in the research process...
September 17, 2018: Family Practice
Thuy N Thai, Thanh C Bui, Mark H Ebell
Background: Determining risk scores for genital high-risk human papillomavirus (HRHPV) infection in women will support more efficient cervical cancer screening strategies. Objective: We developed and validated point scores to predict the likelihood of any genital HRHPV infection in women. Methods: We conducted the cross-sectional analysis in 2017 and used data from the 2005-14 US National Health and Nutrition Examination Survey (7337 women aged 25-59 years; 6300 women aged 30-59 years)...
September 17, 2018: Family Practice
Abigail Moore, Caroline Croxson, Sara McKelvie, Dan Lasserson, Gail Hayward
Background: The world has an ageing population. Infection is common in older adults; serious infection has a high mortality rate and is associated with unplanned admissions. In the UK, general practitioners (GPs) must identify which older patients require admission to hospital and provide appropriate care and support for those staying at home. Objectives: To explore attitudes of UK GPs towards referring older patients with suspected infection to hospital, how they weigh up the decision to admit against the alternatives and how alternatives to admission could be made more effective...
September 14, 2018: Family Practice
Robyn L Shepardson, Jesse D Kosiba, Lee I Bernstein, Jennifer S Funderburk
Background: Although anxiety is prevalent in primary care, the association between anxiety symptoms and suicide risk remains understudied. Objectives: This cross-sectional study aimed to (i) assess the prevalence of suicide risk among Veteran primary care patients with anxiety symptoms and (ii) compare suicide risk between patients with a positive (versus negative) depression screen. Methods: Participants were 182 adult primary care patients (84...
September 14, 2018: Family Practice
Ricardo Batista, Kevin C Pottie, Simone Dahrouge, Douglas G Manuel, Peter Tanuseputro, Amy E Mark, Edward Ng
Objectives: In 2003, Ontario introduced a patient enrolment system as part of health care reforms, aimed at enhancing primary health care services, but it is unclear whether immigrants have benefited from this health care reform. Therefore, we studied whether this reform changed the extent of immigrants' enrolment in primary care services in Ontario between 2003 and 2012. Methods: This is a population-based retrospective cohort study, in which a closed cohort of 9231840 Ontario residents between 1985 and 2003 was created, using linked health administrative and immigration databases...
September 14, 2018: Family Practice
Phui-Nah Chong, Wern Ee Tang
No abstract text is available yet for this article.
September 12, 2018: Family Practice
Makoto Kaneko, Kazuhisa Motomura, Hideki Mori, Ryuichi Ohta, Hiroki Matsuzawa, Akira Shimabukuro, Masato Matsushima
Background: Gatekeeping is important for strong primary care and cost containment. Under Japan's free-access system, patients can access any medical institution without referral, which makes it difficult to evaluate the gatekeeping function of primary care physicians (PCPs). Objectives: To examine the gatekeeping function of PCPs in Japan, we compared the frequencies of visits to primary care clinics, referrals to advanced care and hospitalizations between 14 remote islands and a nationwide survey...
September 8, 2018: Family Practice
E H Bergene, L Holst, T B Rø, A Steinsbekk
Background: Finding appropriate medicinal product formulations and dosage forms for children can be challenging. Knowledge about considerations behind which medicinal product to prescribe or dispense for children is lacking. Objective: To explore considerations of formulation characteristics of medicinal products made by GPs when prescribing and by pharmacists when dispensing medicines for children 0-6 years of age. Method: A qualitative study was performed by conducting three semi-structured focus groups with GPs and three with pharmacists, using nearly identical thematic interview guides...
September 5, 2018: Family Practice
M Blake Berryhill, Anne Halli-Tierney, Nathan Culmer, Nelle Williams, Alex Betancourt, Michael King, Hannah Ruggles
Background: The growing worldwide prevalence of individuals with anxiety disorders has increased needs for mental health services. Due to limited number of mental health providers and community resources, especially in low-income countries, individuals often seek services from primary care settings. Through collaborative care models, services via telemedicine address the mental health provider shortage. While previous reviews show telemedicine effectively treats mental illness, a gap exists for reviews on videoconferencing psychological therapy for anxiety treatment...
September 4, 2018: Family Practice
Sharon Leventhal Perek, Katharine Thomas, Anat Gaver, Andre Matalon, Hanny Yeshua
Background: Depression and anxiety are among the most prevalent disorders in primary care. City dwelling is commonly cited as a risk factor for mental disorders, but epidemiological evidence for this relationship is inconclusive. Objective: To compare the prevalence of antidepressant use, as a proxy for the level of depressive disorders, between patients in Israeli urban and rural communities. Methods: A cross-sectional study, based on data drawn from the registry of the largest health maintenance organization in Israel...
September 3, 2018: Family Practice
Cik Yin Lee, Dianne Goeman, Christine Beanland, Rohan A Elliott
Background: Increasing numbers of older people are receiving home nursing support for medication management to enable them to remain living at home. Home nursing clients frequently experience medication errors and adverse medication events. There has been little study of how medication management processes and interdisciplinary teamwork impact on medication management in the home nursing setting. Objective: To explore medication management processes and describe barriers and challenges from the perspective of community nurses, community pharmacists and GPs involved in the provision of medication management services for home nursing clients...
September 3, 2018: Family Practice
Guillaume Picquendar, Antoine Guedon, Fanny Moulinet, Matthieu Schuers
Background: Burnout is a common occurrence among GPs, decreasing quality of and access to care and impacting both physician and patient health. The link between burnout and low medical density has never been studied. Objectives: This study aimed to assess the prevalence of burnout and its related factors, including low medical density, among GPs. Method: We conducted a cross-sectional survey. A self-administered questionnaire was sent to all of the 1632 GPs in Normandy, France, in September 2015...
September 3, 2018: Family Practice
Lawson B Eksteen, Robert J Mash
Background: Effective primary care is vital for improving health outcomes. Patient-centred consultations are important and one way of assessing this is to evaluate patient satisfaction. The Medical Interview Satisfaction Scale (MISS) has not been used in South Africa. Aim: To test validity and reliability of the MISS and evaluate patient satisfaction with consultations. Setting: Primary care facilities in the Helderberg sub-district, South Africa...
August 30, 2018: Family Practice
Maartje C Meijers, Janneke Noordman, Peter Spreeuwenberga, Tim C Olde Hartman, Sandra van Dulmen
Background: Shared decision-making (SDM) is, largely, espoused as the preferred model for making decisions in everyday health care. Studies exploring the application of SDM in primary care practice are still lacking. Objectives: This study explores how GPs involve their patients in decision-making, if application of SDM has increased over time (2007-15), and what factors are associated with it. Methods: We investigated the application of SDM by Dutch GPs by analysing a random set of real-life video-recorded consultations collected in 2007 (n = 50) and 2015 (n = 50)...
August 30, 2018: Family Practice
Špela Miroševic, Zalika Klemenc-Ketiš, Polona Selic
Background: Due to the expensive and time-consuming diagnostics, most general physicians do not use a standardized psychodiagnostic tool to detect depression and anxiety and often rely on their own judgment. This often leads to inaccuracy of identification of patients with mental disorders. Objective: To systematically review the literature of the 14-item resilience scale (RS-14) and offer directions for future studies. Methods: Fourteen studies that included a translated/validated RS-14 regardless of the sample were included through Medline and CINAHL databases and the following questions were addressed: (i) What are the factor structure, internal consistency and repeatability of the RS-14? (ii) Is RS-14 concordant with other scales for measuring resilience, and what is the concurrent validity of this instrument? (iii) What are the critiques, conclusions and limitations of previous studies? Results: Most factor analyses demonstrated a one-factor solution and confirmed 14-item scale...
August 28, 2018: Family Practice
Kénora Chau, Nicolas Girerd, Faiez Zannad, Patrick Rossignol, Jean-Marc Boivin
Background: Undiagnosed arterial hypertension is frequent. Whether it is associated with gender and the absence of cardiovascular-disease warning signs is unknown. Knowledge of the features of undiagnosed-hypertension subjects may help their identification in primary care. Objective: To examine whether gender, alcohol consumption, smoking status, health status, cardiovascular diseases/diabetes, familial hypertension history, anti-cholesterol treatment, GP-consultation frequency, body mass index (BMI), waist circumference and metabolic measurements were associated with having undiagnosed hypertension among hypertensive subjects...
August 27, 2018: Family Practice
Claire Friedemann Smith, Alice Tompson, Gea A Holtman, Clare Bankhead, Fergus Gleeson, Daniel Lasserson, Brian D Nicholson
Background: One-stop clinics provide comprehensive diagnostic testing in one outpatient appointment. They could benefit patients with conditions, such as cancer, whose outcomes are improved by early diagnosis, and bring efficiency savings for health systems. Objective: To assess the use and outcomes of one-stop clinics for symptoms where cancer is a possible diagnosis. Design and setting: Systematic review of studies reporting use and outcomes of one-stop clinics in primary care patients...
July 20, 2018: 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
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