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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/27919938/outcomes-and-inequalities-in-diabetes-from-2004-2005-to-2011-2012-english-longitudinal-study
#1
Robert Fleetcroft, Miqdad Asaria, Shehzad Ali, Richard Cookson
BACKGROUND: Outcomes of diabetes care are unequal and the NHS has a duty to consider reducing inequality in healthcare outcomes. AIM: To quantify trends in socioeconomic inequality and diabetes outcomes. DESIGN AND SETTING: Whole-population longitudinal study of 32 482 neighbourhoods (Lower Layer Super Output Areas [LSOAs]) in England between 2004/2005 and 2011/2012. METHOD: Slope indices of inequality (SIIs) between neighbourhoods of great and little deprivation were measured annually for: glycated haemoglobin control in people with diabetes; emergency hospitalisation for diabetes; and amenable mortality from diabetes...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27919937/primary-care-referral-for-echocardiogram-refer-in-heart-failure-a-diagnostic-accuracy-study
#2
Clare J Taylor, Andrea K Roalfe, Rachel Iles, Fd Richard Hobbs, Pelham Barton, Martin R Cowie, Russell C Davis, Jon Deeks, Jonathan Mant, Deborah McCahon, Theresa McDonagh, George Sutton, Lynda Tait
BACKGROUND: Symptoms of breathlessness, fatigue, and ankle swelling are common in general practice but deciding which patients are likely to have heart failure is challenging. AIM: To evaluate the performance of a clinical decision rule (CDR), with or without N-Terminal pro-B type natriuretic peptide (NT-proBNP) assay, for identifying heart failure. DESIGN AND SETTING: Prospective, observational, diagnostic validation study of patients aged >55 years, presenting with shortness of breath, lethargy, or ankle oedema, from 28 general practices in England...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27919936/smoking-cessation-interventions-for-patients-with-coronary-heart-disease-and-comorbidities-an-observational-cross-sectional-study-in-primary-care
#3
David N Blane, Daniel Mackay, Bruce Guthrie, Stewart W Mercer
BACKGROUND: Little is known about how smoking cessation practices in primary care differ for patients with coronary heart disease (CHD) who have different comorbidities. AIM: To determine the association between different patterns of comorbidity and smoking rates and smoking cessation interventions in primary care for patients with CHD. DESIGN AND SETTING: Cross-sectional study of 81 456 adults with CHD in primary care in Scotland. METHOD: Details of eight concordant physical comorbidities, 23 discordant physical comorbidities, and eight mental health comorbidities were extracted from electronic health records between April 2006 and March 2007...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27919935/secondary-prevention-lifestyle-interventions-initiated-within-90-days-after-tia-or-minor-stroke-a-systematic-review-and-meta-analysis-of-rehabilitation-programmes
#4
Neil Heron, Frank Kee, Christopher Cardwell, Mark A Tully, Michael Donnelly, Margaret E Cupples
BACKGROUND: Strokes are often preceded by a transient ischaemic attack (TIA) or 'minor' stroke. The immediate period after a TIA/minor stroke is a crucial time to initiate secondary prevention. However, the optimal approach to prevention, including non-pharmacological measures, after TIA is not clear. AIM: To systematically review evidence about the effectiveness of delivering secondary prevention, with lifestyle interventions, in comprehensive rehabilitation programmes, initiated within 90 days of a TIA/minor stroke...
December 5, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27872085/population-health-needs-as-predictors-of-variations-in-nhs-practice-payments-a-cross-sectional-study-of-english-general-practices-in-2013-2014-and-2014-2015
#5
Louis S Levene, Richard Baker, Andrew Wilson, Nicola Walker, Kambiz Boomla, M John G Bankart
BACKGROUND: NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. AIM: To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. DESIGN AND SETTING: Cross-sectional study of all practices in England, in financial years 2013-2014 and 2014-2015...
November 21, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27872084/patient-perspectives-on-delays-in-diagnosis-and-treatment-of-cancer-a-qualitative-analysis-of-free-text-data
#6
Rachel K Parsonage, Julia Hiscock, Rebecca-Jane Law, Richard D Neal
BACKGROUND: Earlier cancer diagnosis is crucial in improving cancer survival. The International Cancer Benchmarking Partnership Module 4 (ICBP4) is a quantitative survey study that explores the reasons for delays in diagnosis and treatment of breast, colorectal, lung, and ovarian cancer. To further understand the associated diagnostic processes, it is also important to explore the patient perspectives expressed in the free-text comments. AIM: To use the free-text data provided by patients completing the ICBP4 survey to augment the understanding of patients' perspectives of their diagnostic journey...
November 21, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27821672/predicting-clinical-deterioration-after-initial-assessment-in-out-of-hours-primary-care-a-retrospective-service-evaluation
#7
Gail N Hayward, Charles Vincent, Daniel S Lasserson
BACKGROUND: Accurate assessment of the need for admission is challenging in out-of-hours (OOH) primary care. Understanding more about patient contacts where the decision to continue care in the community may have been incorrect could assist clinicians in assessing clinical risk. AIM: To define the population contacting OOH primary care who are at higher risk of re-presenting to this service and requiring urgent transfer to secondary care within 3 days of their initial contact...
November 7, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27821671/cost-effectiveness-of-case-finding-strategies-for-primary-prevention-of-cardiovascular-disease-a-modelling-study
#8
Catriona Crossan, Joanne Lord, Ronan Ryan, Leo Nherera, Tom Marshall
BACKGROUND: Policies of active case finding for cardiovascular disease (CVD) prevention in healthy adults are common, but economic evaluation has not investigated targeting such strategies at those who are most likely to benefit. AIM: To assess the cost effectiveness of targeted case finding for CVD prevention. DESIGN AND SETTING: Cost-effectiveness modelling in an English primary care population. METHOD: A cohort of 10 000 individuals aged 30-74 years and without existing CVD or diabetes was sampled from The Health Improvement Network database, a large primary care database...
November 7, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27821670/identification-of-patients-with-non-metastatic-colorectal-cancer-in-primary-care-a-case-control-study
#9
Marcela Ewing, Peter Naredi, Chenyang Zhang, Jörgen Månsson
BACKGROUND: Colorectal cancer is the third most common cancer worldwide and second most common in Europe. Despite screening, it is often diagnosed at an unfavourable stage. AIM: To identify and quantify features of non-metastatic colorectal cancer in primary care to enable earlier diagnosis by GPs. DESIGN AND SETTING: A case-control study was conducted using diagnostic codes from national and regional healthcare databases in Sweden. METHOD: A total of 542 patients diagnosed with non-metastatic colorectal cancer in 2011 and 2139 matched controls were selected from the Swedish Cancer Register (SCR) and a regional healthcare database respectively...
November 7, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27777232/cytology-in-the-diagnosis-of-cervical-cancer-in-symptomatic-young-women-a-retrospective-review
#10
Anita Ww Lim, Rebecca Landy, Alejandra Castanon, Antony Hollingworth, Willie Hamilton, Nick Dudding, Peter Sasieni
BACKGROUND: Cervical cancer in young women presents a diagnostic challenge because gynaecological symptoms are common but underlying disease is rare. AIM: To explore the potential for using cytology as a diagnostic aid for cervical cancer in young women. DESIGN AND SETTING: Retrospective review of primary care records and cytology data from the national cervical screening database and national audit of cervical cancers. METHOD: Four datasets of women aged 20-29 years in England were examined: primary care records and national screening data from an in-depth study of cervical cancers; cytology from the national audit of cervical cancers; whole-population cytology from the national screening database; and general-population primary care records from the Clinical Practice Research Datalink...
October 24, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27777231/investigating-the-relationship-between-consultation-length-and-patient-experience-a-cross-sectional-study-in-primary-care
#11
Natasha Elmore, Jenni Burt, Gary Abel, Frances A Maratos, Jane Montague, John Campbell, Martin Roland
BACKGROUND: Longer consultations in primary care have been linked with better quality of care and improved health-related outcomes. However, there is little evidence of any potential association between consultation length and patient experience. AIM: To examine the relationship between consultation length and patient-reported communication, trust and confidence in the doctor, and overall satisfaction. DESIGN AND SETTING: Analysis of 440 videorecorded consultations and associated patient experience questionnaires from 13 primary care practices in England...
October 24, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27777230/opportunities-for-primary-care-to-reduce-hospital-admissions-a-cross-sectional-study-of-geographical-variation
#12
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK. Substantial interpractice variation in admission rates for ambulatory care sensitive conditions (ACSC) suggests that decreases might be possible. AIM: To identify the clinical areas and patient subgroups where the greatest opportunities exist for GPs to improve ACSC care. DESIGN AND SETTING: Cross-sectional study using routine hospital data from patients registered at 8123 English GP practices during 2011 and 2012...
October 24, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27672140/impact-of-a-primary-care-national-policy-on-hiv-screening-in-france-a-longitudinal-analysis-between-2006-and-2013
#13
Jonathan Sicsic, Olivier Saint-Lary, Elisabeth Rouveix, Nathalie Pelletier-Fleury
BACKGROUND: Early diagnosis of HIV infection is a major public health issue worldwide. In 2009, the French National Authority for Health (Haute Autorité de Santé) developed specific guidelines and recommended mass screening of 15-70-year-olds across the general population. The guidelines were supported by communication directed at healthcare professionals, especially GPs. AIM: To assess the impact of the national mass screening policy on HIV testing. DESIGN AND SETTING: The study used data from the French National Health Insurance Fund database, from January 2006 to December 2013...
September 26, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27621293/best-practice-for-hrt-unpicking-the-evidence
#14
Louise R Newson
No abstract text is available yet for this article.
September 12, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27884918/patients-beliefs-on-the-impediments-to-good-diabetes-control-a-mixed-methods-study-of-patients-in-general-practice
#15
Amanda Jane Elliott, Fiona Harris, Sandra G Laird
BACKGROUND: Most people with diabetes are not attaining desirable levels of HbA1c (glycated haemoglobin), or of blood pressure and cholesterol, leaving them at risk of developing complications. AIM: To identify ways of improving diabetes control by gaining insight into patients' attitudes/beliefs. DESIGN AND SETTING: Questionnaires were offered to patients attending for a diabetes review in the 24 GP practices of North East Hampshire and Farnham Clinical Commissioning Group...
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27884917/managing-barriers-to-empathy-in-the-clinical-encounter-a-qualitative-interview-study-with-gps
#16
Frans Awm Derksen, Tim C Olde Hartman, Jozien M Bensing, Antoine Lm Lagro-Janssen
BACKGROUND: Current daily general practice has become increasingly technical and somatically oriented (where attention to patients' feelings is decreased) due to an increase in protocol-based guidelines. Priorities in GP-patient communication have shifted from a focus on listening and empathy to task-oriented communication. AIM: To explore what barriers GPs experience when applying empathy in daily practice, and how these barriers are managed. DESIGN AND SETTING: Thirty Dutch GPs with sufficient heterogeneity in sex, age, type of practice, and rural or urban setting were interviewed...
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27884916/usual-medical-treatments-or-levonorgestrel-ius-for-women-with-heavy-menstrual-bleeding-long-term-randomised-pragmatic-trial-in-primary-care
#17
Joe Kai, Lee Middleton, Jane Daniels, Helen Pattison, Konstantinos Tryposkiadis, Janesh Gupta
BACKGROUND: Heavy menstrual bleeding (HMB) is a common, chronic problem affecting women and health services. However, long-term evidence on treatment in primary care is lacking. AIM: To assess the effectiveness of commencing the levonorgestrel-releasing intrauterine system (LNG-IUS) or usual medical treatments for women presenting with HMB in general practice. DESIGN AND SETTING: A pragmatic, multicentre, parallel, open-label, long term, randomised controlled trial in 63 primary care practices across the English Midlands...
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27884915/a-case-of-congenital-rubella-syndrome-and-infection-in-south-east-london-in-2015-prevention-diagnosis-and-the-public-health-response
#18
Elizabeth Marchant, Louise Bishop, Debbie Flaxman, Jenni Jagodzinski, Mahesh Nanjundappa, Prasanna Muniyappa, Rebecca Cordery
No abstract text is available yet for this article.
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27884914/red-eyes-in-children-red-flags-and-a-case-to-learn-from
#19
Paul G Rainsbury, Kate Cambridge, Stephen Selby, Jonathan Lochhead
No abstract text is available yet for this article.
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27884913/reducing-the-risk-of-type-2-diabetes-mellitus-in-primary-care-after-gestational-diabetes-a-role-for-mobile-technology-to-improve-current-care
#20
Brian McMillan, Reem Abdelgalil, Priya Madhuvrata, Katherine Easton, Caroline Mitchell
No abstract text is available yet for this article.
December 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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