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Family Practice

Pia Klarskov, Lia E Bang, Peter Schultz-Larsen, Hans Gregers Petersen, David Benee Olsen, Ronan M G Berg, Henrik Abrahamsen, Niels Wiinberg
Objective: To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting. Design: Randomized controlled parallel group trial with 12-month follow-up. Setting: One hundred and ten general practices in all regions of Denmark. Participants: One thousand forty-eight patients with essential hypertension. Intervention: Conventional blood pressure monitoring ('usual group') continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring ('intensive group') supplemented this with frequent home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring...
January 17, 2018: Family Practice
Liselotte A D Raben, Maria E T C van den Muijsenbergh
Background: Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care. Objective: To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women...
January 17, 2018: Family Practice
Leah Ffion Jones, Meredith K D Hawking, Rebecca Owens, Donna Lecky, Nick A Francis, Chris Butler, Micaela Gal, Cliodna A M McNulty
Background: The TARGET (Treat Antibiotics Responsibly; Guidance, Education, Tools) Antibiotics Toolkit aims to improve antimicrobial prescribing in primary care through guidance, interactive workshops with action planning, patient facing educational and audit materials. Objective: To explore GPs', nurses' and other stakeholders' views of TARGET. Design: Mixed methods. Method: In 2014, 40 UK GP staff and 13 stakeholders participated in interviews or focus groups...
December 28, 2017: Family Practice
Traci Po-Yan Leung, Lisa Phillips, Christina Bryant, Kelsey Hegarty
Background: There are few existing studies which have investigated the meanings of 'readiness' and 'preparedness' among family doctors working with female patients who experience intimate partner abuse (IPA). Objectives: We aimed to explore how doctors perceived the concepts of readiness and preparedness to identify and respond to IPA against female patients. Methods: We adopted purposive sampling and conducted individual semi-structured interviews with 19 doctors (11 females and 8 males) practising in primary care...
December 28, 2017: Family Practice
Louise H Hall, Judith Johnson, Jane Heyhoe, Ian Watt, Kevin Anderson, Daryl B O'Connor
Background: Primary care physicians are particularly prone to high levels of burnout and poor well-being. Despite this, no qualitative studies have specifically investigated the best ways to improve well-being and prevent burnout in primary care physicians. Previous interventions within primary care have been person-oriented and mainly focused on mindfulness, but there has been no prior research on whether general practitioners (GPs) deem this to be the best approach. Objectives: To explore strategies that could improve GP well-being and reduce or prevent burnout, based on GP perceptions of the workplace factors that affect their levels of well-being and burnout...
December 22, 2017: Family Practice
Aline De Vleminck, David Batteauw, Tijs Demeyere, Peter Pype
Background: Research about advance care planning (ACP) has often targeted those with serious illness and limited prognosis, thereby not addressing the preferences of healthy adults or adults with a stable condition. Aims: (i) To describe to what extent patients aged 50 and older who are relatively stable or in good health are thinking about the end of life (EOL) and willing to discuss this with their family physician (FP) and (ii) to explore whether patients and FPs indicate the same topics as triggers for ACP discussions in family practice...
December 20, 2017: Family Practice
Fredrik M Plat, Yvonne A S Peters, Feike J Loots, Corline J A de Groot, Thomas Eckhardt, Ellen Keizer, Paul Giesen
Background: Patients with life-threatening conditions who contact out-of-hours primary care either receive a home visit from a GP of a GP cooperative (GPC) or are handed over to the ambulance service. Objective: The objective of this study was to determine whether highly urgent visits, after a call to the GPC, are delivered by the most appropriate healthcare provider: GPC or ambulance service. Methods: We performed a cross-sectional study using patient record data from a GPC and ambulance service in an urban district in The Netherlands...
December 20, 2017: Family Practice
Kurt Kroenke
No abstract text is available yet for this article.
December 18, 2017: Family Practice
Michel Rossignol, Michel Labrecque, Michel Cauchon, Marie-Claude Breton, Paul Poirier
Background: Number of patients needed to treat (NNT) with a statin in primary prevention of coronary heart disease (CHD) is often misinterpreted because this single statistic averages results from heterogeneous studies. Objective: To provide estimates of the number of individuals needed to be prescribed a statin to prevent one CHD event accounting for their level of CHD risk and for persistence to treatment. Methods: A post hoc analysis was conducted based on a Cochrane review on statins for the primary prevention of cardiovascular diseases...
December 18, 2017: Family Practice
Cornelia Straßner, Jost Steinhäuser, Tobias Freund, Joachim Szecsenyi, Michel Wensing
Background: Key recommendations for the management of patients with polypharmacy are structured medication counselling (SMC), medication lists and systematic medication reviews. Objective: The aim of this study was to identify determinants (hindering and facilitating factors) for the implementation of the recommendations in general practice. Methods: This study was linked to a tailored intervention aimed at improving the implementation of the recommendations in German general practice...
December 16, 2017: Family Practice
Christopher P Price, Ian Smith, Ann Van den Bruel
Background: It is suggested that new models of primary care should have better access to test results through the use of point-of-care testing (POCT). Objective: To determine whether quality management of POCT leads to better results. Methods: A comprehensive search of the literature on quality management of POCT in primary care, where the impact of participation in quality management programmes had been investigated with relevant outcome measures...
December 15, 2017: Family Practice
Carl Llor, Lars Bjerrum
No abstract text is available yet for this article.
December 13, 2017: Family Practice
Dorte E Jarbøl, Sanne Rasmussen, Rikke P Svendsen, Kirubakaran Balasubramaniam, Peter F Haastrup, Maja S Petersen, Mojib Fallah, Sandra Elnegaard
Background: A prerequisite for general practitioners (GPs) being able to refer patients with cancer alarm symptoms for further investigations is that individuals present to the GP. Knowledge of barriers to help-seeking is, however, sparse. Objectives. The aim of this study was to analyse associations between the experience of recent-onset alarm symptom of colorectal cancer and four different barriers towards GP contact. Methods: A nationwide web-based cohort survey was conducted in 100000 individuals aged 20 years or above, randomly selected from the Danish Civil Registration System...
December 12, 2017: Family Practice
Alexander Singer, Sergio Fanella, Leanne Kosowan, Jamie Falk, Brenden Dufault, Kevin Hamilton, Ashley Walus
Background: Antimicrobial stewardship (AS) programs promote the optimal use of antimicrobials and safe patient care. With most antimicrobials prescribed in the ambulatory setting, establishing benchmark data is imperative to gauge the impact of future AS initiatives. Objectives: To determine the frequency of potentially inappropriate antimicrobial prescribing in primary care practices in Manitoba, Canada and to assess the association between potentially inappropriate antimicrobial prescribing and patient, prescriber and practice-related factors...
December 10, 2017: Family Practice
Melissa Desmedt, Sonja Vertriest, Mirko Petrovic, Jochen Bergs, Hubertus Vrijhoef, Ezra Dessers, Johan Hellings, Dominique Vandijck
Background: Most well-developed healthcare systems are facing the challenge of managing the increasing prevalence of patients with chronic diseases. Comprehensive frameworks, such as the chronic care model (CCM), receive widespread acceptance for improving care processes, clinical outcomes and costs. Objective: The purpose of this study was to explore chronic patients' perceptions of the quality of chronic care and the alignment with the CCM. Since previous research indicated that a patient's assessment may depend on socio-demographic or disease-related characteristics, the relationship between the mean Patient Assessment of Chronic Illness Care (PACIC) score and possible aforementioned predictors was also explored...
December 10, 2017: Family Practice
Carolyn Wayne, Luis A Guerra, Jiefei Yao, Mélise A Keays, Michael P Leonard
Background: Many primary care physicians order an ultrasound (US) before referral to specialist care for suspected undescended testis; however, the value of this practice is questionable. Objective: To determine the proportion of boys referred for suspected undescended testis who had accompanying US, the cost of this practice and the accuracy of US for testis localization when compared with physical examination by a pediatric urologist. Methods: This was a retrospective chart review at a pediatric urology service, including all patients referred for suspected undescended testis from 2008 to 2012...
December 10, 2017: Family Practice
Deirdre A Shires, Daphna Stroumsa, Kim D Jaffee, Michael R Woodford
Background: Most transgender individuals either use or are interested in using gender-affirming hormone therapy (HT). Making gender-affirming HT available in primary care is critical for quality care to this vulnerable population. The barriers that transgender patients experience to accessing this treatment may be exacerbated if primary care providers (PCPs) will not provide it. Little is known about PCPs' willingness to administer HT to transgender patients. Objective: To examine whether PCPs are willing to continue prescribing HT for transgender patients and the factors that predict such willingness...
December 9, 2017: Family Practice
Chyi-Feng Jan, Tai-Yuan Chiu, Ching-Yu Chen, Fei-Ran Guo, Meng-Chih Lee
Objective: Taiwan has launched a Family Practice Integrated Care Project (FPICP) to develop an accountable family doctor system since March 2003. We aim to report the effectiveness of this nationwide demonstration programme over a 10-year period. Methods: Papers and reports related to the FPICP published both in English and in Chinese from 2003 to 2015 were collected systematically based on keywords including 'family doctor', 'primary care', 'integrated care' and 'Taiwan'...
November 29, 2017: Family Practice
Ka-Fai Chung, Chit-Tat Lee, Wing-Fai Yeung, Man-Sum Chan, Emily Wing-Yue Chung, Wai-Ling Lin
Background: Sleep hygiene education (SHE) is commonly used as a treatment of insomnia in general practice. Whether SHE or cognitive-behavioural therapy for insomnia (CBT-I), a treatment with stronger evidence base, should be provided first remains unclear. Objective: To review the efficacy of SHE for poor sleep or insomnia. Methods: We systematically searched six key electronic databases up until May 2017. Two researchers independently selected relevant publications, extracted data and evaluated methodological quality according to the Cochrane criteria...
November 29, 2017: Family Practice
Beth A Clark, Jaimie F Veale, Devon Greyson, Elizabeth Saewyc
Objective: To examine the issues of primary care access and foregone health care among transgender adolescents and young adults. Methods: This cross-sectional analysis of data from the Canadian Trans Youth Health Survey was conducted online during 2013-2014. Participants included 923 youth aged 14-25 (323 adolescents aged 14-18 and 600 young adults aged 19-25). Main outcome measures were self-reported general and mental health status, comfort discussing transgender identity and health care needs with general practitioners, and types of and reasons for self-identified foregone health care...
November 21, 2017: Family Practice
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