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Family Practice

Clare J Taylor, Ronan Ryan, Linda Nichols, Nicola Gale, F D Richard Hobbs, Tom Marshall
No abstract text is available yet for this article.
August 1, 2017: Family Practice
(no author information available yet)
No abstract text is available yet for this article.
August 1, 2017: Family Practice
Isaraporn Thepwongsa, Radhakrishnan Muthukumar, Pattapong Kessomboon
Background: Motivational interviewing (MI) is an effective tool to help clinicians with facilitating behavioural changes in many diseases and conditions. However, different forms of MI are required in different health care settings and for different clinicians. Although general practitioners (GPs) play a major role in Type 2 diabetes management, the effects of MI delivered by GPs intended to change the behaviours of their Type 2 diabetes patients and GP outcomes, defined as GP knowledge, satisfaction and practice behaviours, have not been systematically reviewed...
August 1, 2017: Family Practice
Leif I Solberg
No abstract text is available yet for this article.
August 1, 2017: Family Practice
Paul Forsyth
No abstract text is available yet for this article.
August 1, 2017: Family Practice
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods: We performed a cluster randomised controlled trial in 22 Dutch general practices...
August 1, 2017: Family Practice
Achim Mortsiefer, Attila Altiner, Annette Ernst, Hanna Kadusziewicz, Alice Krahe, Christine Mellert, Ingmar Schäfer, Carl-Otto Stolzenbach, Birgitt Wiese, Christin Löffler
Background: Little is known about the quality of general practice care received by patients suffering from multimorbidity. Objectives: To assess how patients with multimorbidity evaluate their General Practitioners (GPs') performance and to identify factors associated with high patient satisfaction levels. Methods: Cross-sectional study in Germany using the EUROPEP questionnaire consisting of 23 items with a five-point Likert scale and covering two dimensions: clinical performance of the GP and organisation of care...
August 1, 2017: Family Practice
Hannah V Thornton, Alastair D Hay, Niamh M Redmond, Sophie L Turnbull, Hannah Christensen, Tim J Peters, John P Leeming, Andrew Lovering, Barry Vipond, Peter Muir, Peter S Blair
Background and objectives: Diagnostic uncertainty over respiratory tract infections (RTIs) in primary care contributes to over-prescribing of antibiotics and drives antibiotic resistance. If symptoms and signs predict respiratory tract microbiology, they could help clinicians target antibiotics to bacterial infection. This study aimed to determine relationships between symptoms and signs in children presenting to primary care and microbes from throat swabs. Methods: Cross-sectional study of children ≥3 months to <16 years presenting with acute cough and RTI, with subset follow-up...
August 1, 2017: Family Practice
Derek Stewart, Breda Anthony, Clare Morrison, Yvonne MacRae, Lucy Dixon, Emer Friel, Evelyn Yoong, Scott Cunningham, Katie MacLure
Background: The Highlands and the Western Isles are the two most remote and rural areas of Scotland, with many medical practices in areas where pharmacies would not be viable. Recent regulations state that that dispensing medical practices in these areas must receive pharmacist support for patients who would benefit. Objective: This study aimed to evaluate pilot services, which centred on the provision of patient centred pharmaceutical care. Methods: A realist type evaluation was conducted by an independent research team comprising collecting quantitative data around what occurred during the consultation followed by interviews with purposive samples of staff (n = 14) and patients (n = 18)...
August 1, 2017: Family Practice
Toby O Smith, Máire C McKenna, Charlotte Salter, Wendy Hardeman, Kathryn Richardson, Melvyn Hillsdon, Carly A Hughes, Nicholas Steel, Andy P Jones
Background: Primary care is an ideal setting for physical activity interventions to prevent and manage common long-term conditions. To identify those who can benefit from such interventions and to deliver tailored support, primary care professionals (e.g. GPs, practice nurses, physiotherapists, health care assistants) need reliable and valid tools to assess physical activity. However, there is uncertainty about the best-performing tool. Objective: To identify the tools used in the literature to assess the physical activity in primary care and describe their psychometric properties...
August 1, 2017: Family Practice
Saskia Hullegie, Mandy Wootton, Theo J M Verheij, Emma Thomas-Jones, Janine Bates, Kerenza Hood, Micaela Gal, Nick A Francis, Paul Little, Michael Moore, Carl Llor, Timothy Pickles, David Gillespie, Nigel Kirby, Curt Brugman, Christopher C Butler
Background: Urine culture at the point of care minimises delay between obtaining the sample and agar inoculation in a microbiology laboratory, and quantification and sensitivity results can be available more rapidly in primary care. Objective: To identify the degree to which clinicians' interpretations of a point-of-care-test (POCT) urine culture (Flexicult™ SSI-Urinary Kit) agrees with laboratory culture in women presenting to primary care with symptoms of uncomplicated urinary tract infections (UTI)...
August 1, 2017: Family Practice
Sally Bailes, Catherine S Fichten, Dorrie Rizzo, Marc Baltzan, Roland Grad, Alan Pavilanis, Laura Creti, Rhonda Amsel, Eva Libman
Purpose: The purpose of this study was to examine the sleep characteristics, metabolic syndrome disease and likelihood of obstructive sleep apnea in a sample of older, family medicine patients previously unsuspected for sleep apnea. Methods: A total of 295 participants, minimum age 45, 58.7% women, were recruited from two family medicine clinics. None previously had been referred for sleep apnea testing. All participants completed a sleep symptom questionnaire and were offered an overnight polysomnography study, regardless of questionnaire results...
August 1, 2017: Family Practice
Farrukh M Koraishy, Denise Hooks-Anderson, Joanne Salas, Jeffrey F Scherrer
Introduction: Late nephrology referral is associated with adverse outcomes especially among minorities. Research on the association of the rate of chronic kidney disease (CKD) progression with nephrology referral in white versus black patients is lacking. Objectives: Compute the odds of nephrology referral in primary care and their associations with race and the rate of CKD progression. Methods: Electronic health record data were obtained from 2170 patients in primary care clinics in the Saint Louis metropolitan area with at least two estimated glomerular filtration rate (eGFR) values over a 7-year observation period...
August 1, 2017: Family Practice
Coralie Wenger-Bonny, Adjua Alexandra N'goran, Jérôme Pasquier, Charles Dvorak, Dagmar M Haller, Lilli Herzig
Background: Systematic screening for excessive alcohol use among young people is recommended but rarely implemented. Family practitioners tend to select patients for screening, based on their preliminary subjective opinions, which may be biased. Objective: To evaluate the ability of family practitioners to identify excessive alcohol use among young people prior to screening them. Methods: This prospective study was conducted through Sentinella, an epidemiological network involving 150 family practitioners across Switzerland...
August 1, 2017: Family Practice
Carola van Dipten, Saskia van Berkel, Vincent A van Gelder, Jack F M Wetzels, Reinier P Akkermans, Wim J C de Grauw, Marion C J Biermans, Nynke D Scherpbier-de Haan, Willem J J Assendelft
Background: GPs insufficiently follow guidelines regarding consultation and referral for chronic kidney disease (CKD). Objective: To identify patient characteristics and quality of care (QoC) in CKD patients with whom consultation and referral recommendations were not followed. Method: A 14 month prospective observational cohort study of primary care patients with CKD stage 3-5. 47 practices participated, serving 207469 people. 2547 CKD patients fulfilled consultation criteria, 225 fulfilled referral criteria...
August 1, 2017: Family Practice
Vincent A van Gelder, Nynke D Scherpbier-de Haan, Saskia van Berkel, Reinier P Akkermans, Inge S de Grauw, Eddy M Adang, Pim J Assendelft, Wim J C de Grauw, Marion C J Biermans, Jack F M Wetzels
Background: Consultation of a nephrologist is important in aligning care for patients with chronic kidney disease (CKD) at the primary-secondary care interface. However, current consultation methods come with practical difficulties that can lead to postponed consultation or patient referral instead. Objective: This study aimed to investigate whether a web-based consultation platform, telenephrology, led to a lower referral rate of indicated patients. Furthermore, we assessed consultation rate, quality of care, costs and general practitioner (GPs') experiences with telenephrology...
August 1, 2017: Family Practice
Ineke C Nugteren, Laura A M Duineveld, Thijs Wieldraaijer, Henk C P M van Weert, Irma M Verdonck-de Leeuw, Cornelia F van Uden-Kraan, Jan Wind
Background: As colon cancer is increasingly becoming a chronic illness with a broad range of symptoms, there is a need for individually tailored care for these patients. Objective: To investigate patients' opinions about GP involvement in survivorship care and the use of eHealth applications, such as Oncokompas2.0, to support self-management. Oncokompas2.0 is an interactive website that monitors quality of life via participant-reported outcomes and provides feedback and personalized supportive care...
August 1, 2017: Family Practice
Sarah Dennis, Helen K Reddel, Sandy Middleton, Iqbal Hasan, Oshana Hermiz, Rosemary Phillips, Alan J Crockett, Sanjyot Vagholkar, Guy B Marks, Nicholas Zwar
Background: Chronic obstructive pulmonary disease (COPD) is commonly managed in primary care but there is poor awareness of evidence-based guidelines and the quality and interpretation of spirometry is suboptimal. Objectives: The aims of this qualitative study were to explore how an intervention involving case finding and management of COPD was implemented, and the extent to which the GPs and practice nurses (PNs) worked in partnership to diagnose and manage COPD...
August 1, 2017: Family Practice
Tabitha Tonsaker, Susan Law, Ilja Ormel, Cecilia Nease, Gillian Bartlett
Background: Informal or family caregivers are important contributors to health and health care and require support to sustain their role and address particular challenges. An experience-based health website may be an accessible, effective way to offer caregivers peer support and ultimately better equip them to care for themselves and their loved ones. Objectives: This study investigated how caregivers access and use information on the Internet about caregiving and their perspectives on the design and features of a new personal health experiences (PHEx) website...
August 1, 2017: Family Practice
Jeremy Howick, Patrick M Bossuyt, Jochen W L Cals
No abstract text is available yet for this article.
August 1, 2017: Family Practice
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