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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/28396369/the-one-in-a-million-study-creating-a-database-of-uk-primary-care-consultations
#1
Marcus Jepson, Chris Salisbury, Matthew J Ridd, Chris Metcalfe, Ludivine Garside, Rebecca K Barnes
BACKGROUND: Around 1 million primary care consultations happen in England every day. Despite this, much of what happens in these visits remains a 'black box'.Aim To create an archive of videotaped consultations and linked data based on a large sample of routine face-to-face doctor-patient consultations with consent for use in future research and training.Design and setting Cross-sectional study in 12 general practices in the west of England, UK. METHOD: Up to two GPs from each practice took part in the study...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28396368/individual-utilisation-thresholds-and-exploring-how-gps-knowledge-of-their-patients-affects-diagnosis-a-qualitative-study-in-primary-care
#2
Matthias Michiels-Corsten, Stefan Bösner, Norbert Donner-Banzhoff
BACKGROUND: One of the tenets of general practice is that continuity of care has a beneficial effect on patient care. However, little is known about how continuity can have an impact on the diagnostic reasoning of GPs.Aim To explore GPs' diagnostic strategies by examining GPs' reflections on their patients' individual thresholds for seeking medical attention, how they arrive at their estimations, and which conclusions they draw.Design and setting Qualitative study with 12 GPs in urban and rural practices in Germany...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28396367/lyme-disease-and-bell-s-palsy-an-epidemiological-study-of-diagnosis-and-risk-in-england
#3
Lilli Cooper, Michael Branagan-Harris, Richard Tuson, Charles Nduka
BACKGROUND: Lyme disease is caused by a tick-borne spirochaete of the Borrelia species. It is associated with facial palsy, is increasingly common in England, and may be misdiagnosed as Bell's palsy.Aim To produce an accurate map of Lyme disease diagnosis in England and to identify patients at risk of developing associated facial nerve palsy, to enable prevention, early diagnosis, and effective treatment.Design and setting Hospital episode statistics (HES) data in England from the Health and Social Care Information Centre were interrogated from April 2011 to March 2015 for International Classification of Diseases 10th revision (ICD-10) codes A69...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28396366/comorbidity-and-polypharmacy-in-chronic-heart-failure-a-large-cross-sectional-study-in-primary-care
#4
Bosco Baron-Franco, Gary McLean, Frances S Mair, Veronique L Roger, Bruce Guthrie, Stewart W Mercer
BACKGROUND: Comorbidity is common in heart failure, but previous prevalence estimates have been based on a limited number of conditions using mainly non-primary care data sources.Aim To compare prevalence rates of comorbidity and polypharmacy in those with and without chronic heart failure due to left ventricular systolic dysfunction (LVSD).Design and setting A cross-sectional study of 1.4 million patients in primary care in Scotland. METHOD: Data on the presence of LVSD, 31 other physical, and seven mental health comorbidities, and prescriptions were extracted from a database of 1 424 378 adults...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28347987/outcome-prioritisation-tool-for-medication-review-in-older-patients-with-multimorbidity-a-pilot-study-in-general-practice
#5
Jojanneke Jgt van Summeren, Jan Schuling, Flora M Haaijer-Ruskamp, Petra Denig
BACKGROUND: Several methods have been developed to conduct and support medication reviews in older persons with multimorbidity. Assessing the patient's priorities for achieving specific health outcomes can guide the medication review process. Little is known about the impact of conducting such assessments. AIM: This pilot study aimed to determine proposed and observed medication changes when using an outcome prioritisation tool (OPT) during a medication review in general practice...
March 27, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28347986/evaluation-of-a-complex-intervention-to-improve-primary-care-prescribing-a-phase-iv-segmented-regression-interrupted-time-series-analysis
#6
Sean MacBride-Stewart, Charis Marwick, Neil Houston, Iain Watt, Andrea Patton, Bruce Guthrie
BACKGROUND: It is uncertain whether improvements in primary care high-risk prescribing seen in research trials can be realised in the real-world setting. AIM: To evaluate the impact of a 1-year system-wide phase IV prescribing safety improvement initiative, which included education, feedback, support to identify patients to review, and small financial incentives. DESIGN AND SETTING: An interrupted time series analysis of targeted high-risk prescribing in all 56 general practices in NHS Forth Valley, Scotland, was performed...
March 27, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28347985/clinical-features-of-bowel-disease-in-patients-aged-50-years-in-primary-care-a-large-case-control-study
#7
Sally A Stapley, Greg P Rubin, Deborah Alsina, Elizabeth A Shephard, Matthew D Rutter, William T Hamilton
BACKGROUND: Incidences of colorectal cancer (CRC) and inflammatory bowel disease (IBD) are increasing in those aged <50 years. AIM: To identify and quantify clinical features in primary care of CRC/IBD in those aged <50 years. This study considered the two conditions together and aimed to determine which younger patients, presenting in primary care with symptoms, would benefit from investigation for potentially serious colorectal disease. DESIGN AND SETTING: Matched case-control study using primary care records from the Clinical Practice Research Datalink, UK...
March 27, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28347984/trends-in-the-diagnosis-and-management-of-hypertension-repeated-primary-care-survey-in-south-west-england
#8
Natasha Mejzner, Christopher E Clark, Lindsay Fp Smith, John L Campbell
BACKGROUND: Previous surveys identified a shift to nurse-led care in hypertension in 2010. In 2011 the National Institute for Health and Care Excellence (NICE) recommended ambulatory (ABPM) or home (HBPM) blood pressure (BP) monitoring for diagnosis of hypertension. AIM: To survey the organisation of hypertension care in 2016 to identify changes, and to assess uptake of NICE diagnostic guidelines. DESIGN AND SETTING: Questionnaires were distributed to all 305 general practices in South West England...
March 27, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28289016/gambling-problems-among-patients-in-primary-care-a-cross-sectional-study-of-general-practices
#9
Sean Cowlishaw, Lone Gale, Alison Gregory, Jim McCambridge, David Kessler
BACKGROUND: Primary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems. AIM: To indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability. DESIGN AND SETTING: Cross-sectional study of patients attending 11 general practices in Bristol, South West England...
March 13, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28289015/trends-in-attractiveness-of-general-practice-as-a-career-surveys-of-views-of-uk-trained-doctors
#10
Trevor W Lambert, Fay Smith, Michael J Goldacre
BACKGROUND: It is current UK policy to expand the numbers of newly qualified doctors entering training to become GPs, to meet increased demand. AIM: To report on trends in young doctors' views on the attractiveness of general practice as a career, compared with hospital practice. DESIGN AND SETTING: Questionnaire surveys in the UK. METHOD: Surveys of doctors, 3 years after graduation, conducted in successive year-of-qualification cohorts between 1999 and 2015...
March 13, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28289014/addressing-the-crisis-of-gp-recruitment-and-retention-a-systematic-review
#11
Catherine Marchand, Stephen Peckham
BACKGROUND: The numbers of GPs and training places in general practice are declining, and retaining GPs in their practices is an increasing problem. AIM: To identify evidence on different approaches to retention and recruitment of GPs, such as intrinsic versus extrinsic motivational determinants. DESIGN AND SETTING: Synthesis of qualitative and quantitative research using seven electronic databases from 1990 onwards (Medline, Embase, Cochrane Library, Health Management Information Consortium [HMIC], Cumulative Index to Nursing and Allied Health Literature (Cinahl), PsycINFO, and the Turning Research Into Practice [TRIP] database)...
March 13, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28289013/prescription-rates-of-adrenaline-auto-injectors-for-children-in-uk-general-practice-a-retrospective-cohort-study
#12
Lavanya Diwakar, Carole Cummins, Ronan Ryan, Tom Marshall, Tracy Roberts
BACKGROUND: Adrenaline auto-injectors (AAI) should be provided to individuals considered to be at high risk of anaphylaxis. There is some evidence that the rate of AAI prescription is increasing, but the true extent has not been previously quantified. AIM: To estimate the trends in annual GP-issued prescriptions for AAI among UK children between 2000 and 2012. DESIGN AND SETTING: Retrospective cohort study using data from primary care practices that contributed to The Health Improvement Network (THIN) database...
March 13, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28246099/developing-and-testing-of-a-screening-tool-to-predict-people-without-ige-mediated-allergy-a-quantitative-analysis-of-the-predictive-value-of-a-screening-tool
#13
Victoria S Hammersley, Jessica Harris, Aziz Sheikh, Emma Davidson, Samantha Walker
BACKGROUND: Consultations in primary care for allergies are common. It can be difficult to differentiate between IgE-mediated (atopic) symptoms - which respond to allergen-specific interventions - and those that are non-atopic, without performing objective tests that are largely unavailable in UK general practice. AIM: To develop and test a screening tool that can accurately discriminate between atopic and non-atopic individuals. DESIGN AND SETTING: A validation study that took place in 2012 in adult volunteers aged >16 years in Scotland...
February 28, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28246098/opiate-addiction-and-overdose-experiences-attitudes-and-appetite-for-community-naloxone-provision
#14
Tomás Barry, Jan Klimas, Helen Tobin, Mairead Egan, Gerard Bury
BACKGROUND: More than 200 opiate overdose deaths occur annually in Ireland. Overdose prevention and management, including naloxone prescription, should be a priority for healthcare services. Naloxone is an effective overdose treatment and is now being considered for wider lay use. AIM: To establish GPs' views and experiences of opiate addiction, overdose care, and naloxone provision. DESIGN AND SETTING: An anonymous postal survey to GPs affiliated with the Department of Academic General Practice, University College Dublin, Ireland...
February 28, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28246097/exposure-of-undergraduates-to-authentic-gp-teaching-and-subsequent-entry-to-gp-training-a-quantitative-study-of-uk-medical-schools
#15
Hugh Alberti, Hannah L Randles, Alex Harding, Robert K McKinley
BACKGROUND: It has been suggested that the quantity of exposure to general practice teaching at medical school is associated with future choice of a career as a GP. AIM: To examine the relationship between general practice exposure at medical school and the percentage of each school's graduates appointed to a general practice training programme after foundation training (postgraduate years 1 and 2). DESIGN AND SETTING: A quantitative study of 29 UK medical schools...
February 28, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28193617/prescribing-tamoxifen-in-primary-care-for-the-prevention-of-breast-cancer-a-national-online-survey-of-gps-attitudes
#16
Samuel G Smith, Robbie Foy, Jennifer A McGowan, Lindsay C Kobayashi, Andrea DeCensi, Karen Brown, Lucy Side, Jack Cuzick
BACKGROUND: The cancer strategy for England (2015-2020) recommends GPs prescribe tamoxifen for breast cancer primary prevention among women at increased risk. AIM: To investigate GPs' attitudes towards prescribing tamoxifen. DESIGN AND SETTING: In an online survey, GPs in England, Northern Ireland, and Wales (n = 928) were randomised using a 2 × 2 between-subjects design to read one of four vignettes describing a healthy patient seeking a tamoxifen prescription...
February 13, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28137783/juggling-confidentiality-and-safety-a-qualitative-study-of-how-general-practice-clinicians-document-domestic-violence-in-families-with-children
#17
Jessica Drinkwater, Nicky Stanley, Eszter Szilassy, Cath Larkins, Marianne Hester, Gene Feder
BACKGROUND: Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. AIM: To explore how and why general practice clinicians document DVA in families with children...
January 30, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28360074/predicting-the-onset-of-hazardous-alcohol-drinking-in-primary-care-development-and-validation-of-a-simple-risk-algorithm
#18
Juan Ángel Bellón, Juan de Dios Luna, Michael King, Irwin Nazareth, Emma Motrico, María Josefa GildeGómez-Barragán, Francisco Torres-González, Carmen Montón-Franco, Marta Sánchez-Celaya, Miguel Ángel Díaz-Barreiros, Catalina Vicens, Patricia Moreno-Peral
BACKGROUND: Little is known about the risk of progressing to hazardous alcohol use in abstinent or low-risk drinkers. AIM: To develop and validate a simple brief risk algorithm for the onset of hazardous alcohol drinking (HAD) over 12 months for use in primary care. DESIGN AND SETTING: Prospective cohort study in 32 health centres from six Spanish provinces, with evaluations at baseline, 6 months, and 12 months. METHOD: Forty-one risk factors were measured and multilevel logistic regression and inverse probability weighting were used to build the risk algorithm...
April 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28360073/patient-participation-in-general-practice-based-undergraduate-teaching-a-focus-group-study-of-patient-perspectives
#19
Sophie E Park, Caroline Allfrey, Melvyn M Jones, Jasprit Chana, Ciara Abbott, Sofia Faircloth, Nicola Higgins, Laila Abdullah
BACKGROUND: Patients make a crucial contribution to undergraduate medical education. Although a national resource is available for patients participating in research, none is as yet available for education. AIM: This study aimed to explore what information patients would like about participation in general practice based undergraduate medical education, and how they would like to obtain this information. DESIGN AND SETTING: Two focus groups were conducted in London-based practices involved in both undergraduate and postgraduate teaching...
April 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28360072/attitudes-of-newly-qualified-doctors-towards-a-career-in-general-practice-a-qualitative-focus-group-study
#20
Alexandra Merrett, Daniel Jones, Kim Sein, Trish Green, Una Macleod
BACKGROUND: A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. AIM: To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment...
April 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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