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British Journal of General Practice: the Journal of the Royal College of General Practitioners

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https://www.readbyqxmd.com/read/29440017/patient-involvement-in-diagnosing-cancer-in-primary-care-a-systematic-review-of-current-interventions
#1
Jane Heyhoe, Caroline Reynolds, Alice Dunning, Olivia Johnson, Alex Howat, Rebecca Lawton
BACKGROUND: Patients can play a role in achieving an earlier diagnosis of cancer by monitoring and re-appraising symptoms after initially presenting to primary care. It is not clear what interventions exist, or what the components of an intervention to engage patients at this diagnostic stage are. AIM: The review had two aims: 1) to identify interventions that involve patients, and 2) to establish key components for engaging patients in the diagnosis of cancer in primary care at the post-presentation stage...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29440016/reducing-inappropriate-antibiotic-prescribing-for-children-in-primary-care-a-cluster-randomised-controlled-trial-of-two-interventions
#2
Marieke B Lemiengre, Jan Y Verbakel, Roos Colman, Tine De Burghgraeve, Frank Buntinx, Bert Aertgeerts, Frans De Baets, An De Sutter
BACKGROUND: Antibiotics are overprescribed for non-severe acute infections in children in primary care. AIM: To explore two different interventions that may reduce inappropriate antibiotic prescribing for non-severe acute infections. DESIGN AND SETTING: A cluster randomised, factorial controlled trial in primary care, in Flanders, Belgium. METHOD: Family physicians (FPs) enrolled children with non-severe acute infections into this study...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29440015/self-rated-worry-in-acute-care-telephone-triage-a-mixed-methods-study
#3
Hejdi Gamst-Jensen, Linda Huibers, Kristoffer Pedersen, Erika F Christensen, Annette K Ersbøll, Freddy K Lippert, Ingrid Egerod
BACKGROUND: Telephone triage is used to assess acute illness or injury. Clinical decision making is often assisted by triage tools that lack callers' perspectives. This study analysed callers' perception of urgency, defined as degree of worry in acute care telephone calls. AIM: To explore the caller's ability to quantify their degree of worry, the association between degree of worry and variables related to the caller, the effect of degree of worry on triage outcome, and the thematic content of the caller's worry...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29440014/presenting-the-primary-care-team-to-the-public-a-qualitative-exploration-of-general-practice-websites
#4
Helen Anderson, Joy Adamson, Yvonne Birks
BACKGROUND: Increasing demand and expanded primary care provision, coupled with a reduced GP workforce, present challenges for primary care. New workforce models aim to reduce GP workload by directing patients to a variety of alternative clinicians. Concurrently, the principle of patient choice in relation to healthcare providers has gained prominence. It is, therefore, necessary to provide patients with sufficient information to negotiate access to appropriate primary healthcare professionals...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29440013/the-impact-of-new-forms-of-large-scale-general-practice-provider-collaborations-on-england-s-nhs-a-systematic-review
#5
Luisa M Pettigrew, Stephanie Kumpunen, Nicholas Mays, Rebecca Rosen, Rachel Posaner
BACKGROUND: Over the past decade, collaboration between general practices in England to form new provider networks and large-scale organisations has been driven largely by grassroots action among GPs. However, it is now being increasingly advocated for by national policymakers. Expectations of what scaling up general practice in England will achieve are significant. AIM: To review the evidence of the impact of new forms of large-scale general practice provider collaborations in England...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29440012/patterns-of-regional-variation-of-opioid-prescribing-in-primary-care-in-england-a-retrospective-observational-study
#6
Luke Mordecai, Carl Reynolds, Liam J Donaldson, Amanda C de C Williams
BACKGROUND: Opioids are a widely prescribed class of drug with potentially harmful short-term and long-term side effects. There are concerns about the amounts of these drugs being prescribed in England given that they are increasingly considered ineffective in the context of long-term non-cancer pain, which is one of the major reasons for their prescription. AIM: To assess the amount and type of opioids prescribed in primary care in England, and patterns of regional variation in prescribing...
February 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29378699/use-of-primary-care-data-to-predict-those-most-vulnerable-to-cold-weather-a-case-crossover-analysis
#7
Peter Tammes, Claudio Sartini, Ian Preston, Alastair D Hay, Daniel Lasserson, Richard W Morris
BACKGROUND: The National Institute for Health and Care Excellence (NICE) recommends that GPs use routinely available data to identify patients most at risk of death and ill health from living in cold homes. AIM: To investigate whether sociodemographic characteristics, clinical factors, and house energy efficiency characteristics could predict cold-related mortality. DESIGN AND SETTING: A case-crossover analysis was conducted on 34 777 patients aged ≥65 years from the Clinical Practice Research Datalink who died between April 2012 and March 2014...
January 29, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29378698/sexual-orientation-disclosure-in-health-care-a-systematic-review
#8
Hannah Brooks, Carrie D Llewellyn, Tom Nadarzynski, Fernando Castilho Pelloso, Felipe De Souza Guilherme, Alex Pollard, Christina J Jones
BACKGROUND: Significant health disparities between sexual minority individuals (that is, lesbian, gay, bisexual, or transgender [LGBT]) and heterosexual individuals have been demonstrated. AIM: To understand the barriers and facilitators to sexual orientation (SO) disclosure experienced by LGBT adults in healthcare settings. DESIGN AND SETTING: Mixed methods systematic review, including qualitative, quantitative, and mixed methods papers following PRISMA guidelines...
January 29, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29378697/alternatives-to-the-face-to-face-consultation-in-general-practice-focused-ethnographic-case-study
#9
Helen Atherton, Heather Brant, Sue Ziebland, Annemieke Bikker, John Campbell, Andy Gibson, Brian McKinstry, Tania Porqueddu, Chris Salisbury
BACKGROUND: NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives. AIM: To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice...
January 29, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29335329/relocating-patients-from-a-specialist-homeless-healthcare-centre-to-general-practices-a-multi-perspective-study
#10
Kathrine Gibson Smith, Vibhu Paudyal, Katie MacLure, Katrina Forbes-McKay, Carol Buchanan, Liz Wilson, Joan MacLeod, Ann Smith, Derek Stewart
BACKGROUND: The relocation of formerly homeless patients eligible to transfer from a specialist homeless healthcare centre (SHHC) to mainstream general practices is key to patient integration in the local community. Failure to transition patients conferring eligibility for relocation may also negatively impact on SHHC service delivery. AIM: To explore barriers and facilitators of relocation from the perspectives of formerly homeless patients and healthcare staff involved in their care...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29335328/walking-prescription-of-10-000-steps-per-day-in-patients-with-type-2-diabetes-mellitus-a-randomised-trial-in-nigerian-general-practice
#11
Ayorinde F Fayehun, Olufemi O Olowookere, Adetola M Ogunbode, Adedotun A Adetunji, Arinola Esan
BACKGROUND: In clinical practice, translating the benefits of a sustained physically active lifestyle on glycaemic control in patients with type 2 diabetes mellitus (T2DM) is difficult. A walking prescription may be an effective alternative. AIM: To examine the effect of a 10 000 steps per day prescription on glycaemic control of patients with T2DM. DESIGN AND SETTING: Forty-six adults with T2DM attending a general outpatient clinic were randomised into two equal groups...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29335327/gps-experiences-of-diagnosing-and-managing-childhood-eczema-a-qualitative-study-in-primary-care
#12
Emma Le Roux, Kingsley Powell, Jonathan P Banks, Matthew J Ridd
BACKGROUND: Eczema is common among children, and in the UK the majority are managed by GPs. The most common cause of poor disease control is incorrect use of topical treatments. There is a lack of research into the challenges faced by GPs in diagnosing and managing this condition. AIM: To explore the experiences of GPs in assessing and managing children with eczema. DESIGN AND SETTING: Qualitative study in primary care in England. METHOD: Semi-structured interviews with 15 GPs were audiorecorded, transcribed verbatim, and analysed thematically using the framework method...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29335326/attendance-of-routine-childcare-visits-in-primary-care-for-children-of-mothers-with-depression-a-nationwide-population-based-cohort-study
#13
Bente Kjær Lyngsøe, Claus Høstrup Vestergaard, Dorte Rytter, Mogens Vestergaard, Trine Munk-Olsen, Bodil Hammer Bech
BACKGROUND: Depression is a common and potentially debilitating illness worldwide. Attendance to routine childcare appointments is a key point of interest in the effort to improve the health and care for families facing depression. AIM: To evaluate the association between maternal depression and offspring non-attendance to the Danish childcare and vaccination programme (CCP) for children from 0-5 years of age. The CCP consists of seven separate visits and several vaccinations...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29335325/population-and-patient-factors-affecting-emergency-department-attendance-in-london-retrospective-cohort-analysis-of-linked-primary-and-secondary-care-records
#14
Sally A Hull, Kate Homer, Kambiz Boomla, John Robson, Mark Ashworth
BACKGROUND: Population factors, including social deprivation and morbidity, predict the use of emergency departments (EDs). AIM: To link patient-level primary and secondary care data to determine whether the association between deprivation and ED attendance is explained by multimorbidity and other clinical factors in the GP record. DESIGN AND SETTING: Retrospective cohort study based in East London. METHOD: Primary care demographic, consultation, diagnostic, and clinical data were linked with ED attendance data...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29335322/identifying-patterns-of-communication-in-patients-attending-memory-clinics-a-systematic-review-of-observations-and-signs-with-potential-diagnostic-utility
#15
Cate Bailey, Norman Poole, Daniel J Blackburn
BACKGROUND: Subjective cognitive complaints are commonly encountered in primary care and often result in memory clinic referral. However, meta-analyses have shown that such concerns do not consistently correspond to objective memory impairment or predict future dementia. Memory clinic referrals are increasing, with greater proportions of patients attending who do not have dementia. Studies of interaction during memory clinic assessments have identified conversational profiles that can differentiate between dementia and functional disorders of memory...
January 15, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29255111/diagnosing-cancer-in-primary-care-results-from-the-national-cancer-diagnosis-audit
#16
Ruth Swann, Sean McPhail, Jana Witt, Brian Shand, Gary A Abel, Sara Hiom, Jem Rashbass, Georgios Lyratzopoulos, Greg Rubin
BACKGROUND: Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. AIM: To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. DESIGN AND SETTING: Clinical audit of cancer diagnosis in general practices in England. METHOD: Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices...
December 18, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29255110/gps-perceptions-of-advance-care-planning-with-frail-and-older-people-a-qualitative-study
#17
Tim Sharp, Alexandra Malyon, Stephen Barclay
BACKGROUND: Frail and older people are estimated to account for 40% of deaths. Despite conversations about end-of-life care being an important component of the national End of Life Care Strategy, there is a marked disparity between the majority who would like to discuss advance care plans, and the minority who currently have this opportunity. AIM: To investigate the attitudes of GPs to advance care planning (ACP) discussions with frail and older individuals. DESIGN AND SETTING: Focus group study with GPs in Cambridgeshire between September 2015 and January 2016...
December 18, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29255109/psyscan-e-tool-to-support-diagnosis-and-management-of-psychological-problems-in-general-practice-a-randomised-controlled-trial
#18
Luc G Gidding, Mark Spigt, Bjorn Winkens, Odette Herijgers, Geert-Jan Dinant
BACKGROUND: GPs are crucial in adequately diagnosing and initiating appropriate management for patients with psychological problems, but face many challenges and require support. AIM: To determine the effects of the e-tool PsyScan. DESIGN AND SETTING: A randomised controlled trial with a 1-year follow-up, comparing care using PsyScan with usual care for psychological problems, was undertaken in 10 multidisciplinary primary healthcare centres in Eindhoven, the Netherlands...
December 18, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29255108/associations-between-diagnostic-activity-and-measures-of-patient-experience-in-primary-care-a-cross-sectional-ecological-study-of-english-general-practices
#19
Georgios Lyratzopoulos, Silvia C Mendonca, Carolynn Gildea, Sean McPhail, Michael D Peake, Greg Rubin, Hardeep Singh, William Hamilton, Fiona M Walter, Martin Roland, Gary A Abel
BACKGROUND: Lower use of endoscopies and urgent referrals for suspected cancer has been linked to poorer outcomes for patients with cancer; it is important to examine potential predictors of variable use. AIM: To examine the associations between general practice measures of patient experience and practice use of endoscopies or urgent referrals for suspected cancer. DESIGN AND SETTING: Cross-sectional ecological analysis in English general practices...
December 18, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29203683/possible-missed-opportunities-for-diagnosing-colorectal-cancer-in-dutch-primary-care-a-multimethods-approach
#20
Daan Brandenbarg, Feikje Groenhof, Ilse M Siewers, Anna van der Voort, Fiona M Walter, Annette J Berendsen
BACKGROUND: Early detection of colorectal cancer (CRC) is important to achieve better survival. Discriminating symptoms suggestive of CRC from benign conditions is a challenge for GPs because most known 'alarm symptoms' have low predictive values. AIM: To further understand the diagnostic process of CRC in general practice in terms of healthcare use and by analysing factors related to diagnostic intervals. DESIGN AND SETTING: A multimethod approach comprising a historical, prospective registry study and qualitative content analysis...
December 4, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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