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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/29686134/responsibility-for-follow-up-during-the-diagnostic-process-in-primary-care-a-secondary-analysis-of-international-cancer-benchmarking-partnership-data
#1
Brian D Nicholson, Clare R Goyder, Clare R Bankhead, Berit S Toftegaard, Peter W Rose, Hans Thulesius, Peter Vedsted, Rafael Perera
BACKGROUND: It is unclear to what extent primary care practitioners (PCPs) should retain responsibility for follow-up to ensure that patients are monitored until their symptoms or signs are explained. AIM: To explore the extent to which PCPs retain responsibility for diagnostic follow-up actions across 11 international jurisdictions. DESIGN AND SETTING: A secondary analysis of survey data from the International Cancer Benchmarking Partnership...
April 23, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29686133/improving-long-term-adherence-to-statin-therapy-a-qualitative-study-of-gps-experiences-in-primary-care
#2
Karen Krüger, Niklas Leppkes, Sabine Gehrke-Beck, Wolfram Herrmann, Engi A Algharably, Reinhold Kreutz, Christoph Heintze, Iris Filler
BACKGROUND: Statins substantially reduce the risk of cardiovascular disease when taken regularly. Though statins are generally well tolerated, current studies show that one-third of patients discontinue use of statins within 2 years. A qualitative approach may improve the understanding of attitudes and behaviours towards statins, the mechanisms related to discontinuation, and how they are managed in primary care. AIM: To identify factors related to statin discontinuation and approaches for long-term statin adherence...
April 23, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29686132/application-of-prescribing-recommendations-in-older-people-with-reduced-kidney-function-a-cross-sectional-study-in-general-practice
#3
Su Wood, Duncan Petty, Liz Glidewell, Dk Theo Raynor
BACKGROUND: Kidney function reduces with age, increasing the risk of harm from increased blood levels of many medicines. Although estimated glomerular filtration rate (eGFR) is reported for prescribing decisions in those aged ≥65 years, creatinine clearance (Cockcroft-Gault) gives a more accurate estimate of kidney function. AIM: To explore the extent of prescribing outside recommendations for people aged ≥65 years with reduced kidney function in primary care and to assess the impact of using eGFR instead of creatinine clearance to calculate kidney function...
April 23, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29686131/gps-views-of-health-policy-changes-a-qualitative-netnography-study-of-uk-general-practice-online-magazine-commentary
#4
Rebecca Elvey, Jennifer Voorhees, Simon Bailey, Taylor Burns, Damian Hodgson
BACKGROUND: Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. AIM: To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine...
April 23, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29686130/factors-associated-with-consultation-rates-in-general-practice-in-england-2013-2014-a-cross-sectional-study
#5
Toqir K Mukhtar, Clare Bankhead, Sarah Stevens, Rafael Perera, Tim A Holt, Chris Salisbury, Fd Richard Hobbs
BACKGROUND: Workload in general practice has risen during the last decade, but the factors associated with this increase are unclear. AIM: To examine factors associated with consultation rates in general practice. DESIGN AND SETTING: A cross-sectional study examining a sample of 304 937 patients registered at 316 English practices between 2013 and 2014, drawn from the Clinical Practice Research Datalink. METHOD: Age, sex, ethnicity, smoking status, and deprivation measures were linked with practice-level data on staffing, rurality, training practice status, and Quality and Outcomes Framework performance...
April 23, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29632005/development-of-a-prediction-tool-for-patients-presenting-with-acute-cough-in-primary-care-a-prognostic-study-spanning-six-european-countries
#6
Robin Bruyndonckx, Niel Hens, Theo Jm Verheij, Marc Aerts, Margareta Ieven, Christopher C Butler, Paul Little, Herman Goossens, Samuel Coenen
BACKGROUND: Accurate prediction of the course of an acute cough episode could curb antibiotic overprescribing, but is still a major challenge in primary care. AIM: The authors set out to develop a new prediction rule for poor outcome (re-consultation with new or worsened symptoms, or hospital admission) in adults presenting to primary care with acute cough. DESIGN AND SETTING: Data were collected from 2604 adults presenting to primary care with acute cough or symptoms suggestive of lower respiratory tract infection (LRTI) within the Genomics to combat Resistance against Antibiotics in Community-acquired LRTI in Europe (GRACE; www...
April 9, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29632004/weight-loss-as-a-predictor-of-cancer-in-primary-care-a-systematic-review-and-meta-analysis
#7
Brian D Nicholson, William Hamilton, Jack O'Sullivan, Paul Aveyard, Fd Richard Hobbs
BACKGROUND: Weight loss is a non-specific cancer symptom for which there are no clinical guidelines about investigation in primary care. AIM: To summarise the available evidence on weight loss as a clinical feature of cancer in patients presenting to primary care. DESIGN AND SETTING: A diagnostic test accuracy review and meta-analysis. METHOD: Studies reporting 2 × 2 diagnostic accuracy data for weight loss (index test) in adults presenting to primary care and a subsequent diagnosis of cancer (reference standard) were included...
April 9, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29632003/abdominal-symptoms-and-cancer-in-the-abdomen-prospective-cohort-study-in-european-primary-care
#8
Knut Holtedahl, Peter Hjertholm, Lars Borgquist, Gé A Donker, Frank Buntinx, David Weller, Tonje Braaten, Jörgen Månsson, Eva Lena Strandberg, Christine Campbell, Joke C Korevaar, Ranjan Parajuli
BACKGROUND: Different abdominal symptoms may signal cancer, but their role is unclear. AIM: To examine associations between abdominal symptoms and subsequent cancer diagnosed in the abdominal region. DESIGN AND SETTING: Prospective cohort study comprising 493 GPs from surgeries in Norway, Denmark, Sweden, Scotland, Belgium, and the Netherlands. METHOD: Over a 10-day period, the GPs recorded consecutive consultations and noted: patients who presented with abdominal symptoms pre-specified on the registration form; additional data on non-specific symptoms; and features of the consultation...
April 9, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29581130/primary-care-outcomes-questionnaire-psychometric-testing-of-a-new-instrument
#9
Mairead Murphy, Sandra Hollinghurst, Sean Cowlishaw, Chris Salisbury
BACKGROUND: Patients attend primary care for many reasons and to achieve a range of possible outcomes. There is currently no Patient Reported Outcome Measure (PROM) designed to capture these diverse outcomes, and trials of interventions in primary care may thus fail to detect beneficial effects. AIM: This study describes the psychometric testing of the Primary Care Outcomes Questionnaire (PCOQ), which was designed to capture a broad range of outcomes relevant to primary care...
March 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29581129/computer-screening-for-palliative-care-needs-in-primary-care-a-mixed-methods-study
#10
Bruce Mason, Kirsty Boyd, John Steyn, Marilyn Kendall, Stella Macpherson, Scott A Murray
BACKGROUND: Though the majority of people could benefit from palliative care before they die, most do not receive this approach, especially those with multimorbidity and frailty. GPs find it difficult to identify such patients. AIM: To refine and evaluate the utility of a computer application (AnticiPal) to help primary care teams screen their registered patients for people who could benefit from palliative care. DESIGN AND SETTING: A mixed-methods study of eight GP practices in Scotland, conducted in 2016-2017...
March 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29581128/improving-palliative-care-provision-in-primary-care-a-pre-and-post-survey-evaluation-among-patz-groups
#11
Annicka Gm van der Plas, H Roeline W Pasman, Bart Schweitzer, Bregje D Onwuteaka-Philipsen
BACKGROUND: In PaTz (PAlliatieve Thuis Zorg, palliative care at home), modelled after the Gold Standards Framework, GPs and community nurses meet on a regular basis to identify patients with palliative care needs (the PaTz register), and to discuss care for these patients. AIM: To study the effects of the implementation of PaTz, and provide additional analyses on two important elements: the PaTz register and patient discussions. DESIGN AND SETTING: A pre- and post-evaluation among Dutch GPs ( n = 195 before the start of PaTz; n = 166, 1 year after the start of PaTz)...
March 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29581127/acceptability-of-text-messages-for-safety-netting-patients-with-low-risk-cancer-symptoms-a-qualitative-study
#12
Yasemin Hirst, Anita Wey Wey Lim
BACKGROUND: Safety netting is an important diagnostic strategy for patients presenting to primary care with potential (low-risk) cancer symptoms. Typically, this involves asking patients to return if symptoms persist. However, this relies on patients re-appraising their symptoms and making follow-up appointments, which could contribute to delays in diagnosis. Text messaging is increasingly used in primary care to communicate with patients, and could be used to improve safety netting. AIM: To explore the acceptability and feasibility of using text messages to safety net patients presenting with low-risk cancer symptoms in GP primary care (txt-netting)...
March 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29530921/impact-of-issuing-longer-versus-shorter-duration-prescriptions-a-systematic-review
#13
Sarah King, Céline Miani, Josephine Exley, Jody Larkin, Anne Kirtley, Rupert A Payne
BACKGROUND: Long-term conditions place a substantial burden on primary care services, with drug therapy being a core aspect of clinical management. However, the ideal frequency for issuing repeat prescriptions for these medications is unknown. AIM: To examine the impact of longer-duration (2-4 months) versus shorter-duration (28-day) prescriptions. DESIGN AND SETTING: Systematic review of primary care studies. METHOD: Scientific and grey literature databases were searched from inception until 21 October 2015...
March 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29530920/behaviour-change-opportunities-at-mother-and-baby-checks-in-primary-care-a-qualitative-investigation-of-the-experiences-of-gps
#14
Hannah Talbot, Emily Strong, Sarah Peters, Debbie M Smith
BACKGROUND: Pregnancy is widely recognised as a 'teachable moment' for healthy behaviour change and the postnatal period has been identified as the opportune time to initiate this change. In the UK, all women are offered a routine health check at 6-8 weeks postpartum with their GP. This provides a potential opportunity to facilitate long-term behaviour change discussions. AIM: To explore GPs' views and experiences of using the postnatal check as a health-related behaviour change opportunity...
March 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29530919/using-the-electronic-health-record-to-build-a-culture-of-practice-safety-evaluating-the-implementation-of-trigger-tools-in-one-general-practice
#15
Tom Margham, Natalie Symes, Sally A Hull
BACKGROUND: Identifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations. AIM: This study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety. DESIGN AND SETTING: Mixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice...
March 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29530918/the-epidemiology-of-multimorbidity-in-primary-care-a-retrospective-cohort-study
#16
Anna Cassell, Duncan Edwards, Amelia Harshfield, Kirsty Rhodes, James Brimicombe, Rupert Payne, Simon Griffin
BACKGROUND: Multimorbidity places a substantial burden on patients and the healthcare system, but few contemporary epidemiological data are available. AIM: To describe the epidemiology of multimorbidity in adults in England, and quantify associations between multimorbidity and health service utilisation. DESIGN AND SETTING: Retrospective cohort study, undertaken in England. METHOD: The study used a random sample of 403 985 adult patients (aged ≥18 years), who were registered with a general practice on 1 January 2012 and included in the Clinical Practice Research Datalink...
March 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29483078/point-of-care-urine-culture-for-managing-urinary-tract-infection-in-primary-care-a-randomised-controlled-trial-of-clinical-and-cost-effectiveness
#17
Christopher C Butler, Nick A Francis, Emma Thomas-Jones, Mirella Longo, Mandy Wootton, Carl Llor, Paul Little, Michael Moore, Janine Bates, Timothy Pickles, Nigel Kirby, David Gillespie, Kate Rumsby, Curt Brugman, Micaela Gal, Kerenza Hood, Theo Verheij
BACKGROUND: The effectiveness of using point-of-care (POC) urine culture in primary care on appropriate antibiotic use is unknown. AIM: To assess whether use of the Flexicult™ SSI-Urinary Kit, which quantifies bacterial growth and determines antibiotic susceptibility at the point of care, achieves antibiotic use that is more often concordant with laboratory culture results, when compared with standard care. DESIGN AND SETTING: Individually randomised trial of females with uncomplicated urinary tract infection (UTI) in primary care research networks (PCRNs) in England, the Netherlands, Spain, and Wales...
February 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29483077/reducing-risk-of-type-2-diabetes-after-gestational-diabetes-a-qualitative-study-to-explore-the-potential-of-technology-in-primary-care
#18
Brian McMillan, Katherine Easton, Elizabeth Goyder, Brigitte Delaney, Priya Madhuvrata, Reem Abdelgalil, Caroline Mitchell
BACKGROUND: Despite the seven-fold increased risk of type 2 diabetes mellitus (T2DM) among females previously diagnosed with gestational diabetes (GD), annual rates of follow-up in primary care are low. There is a need to consider how to reduce the incidence of progression to T2DM among this high-risk group. AIM: To examine the views of females diagnosed with GD to ascertain how to improve primary care support postnatally, and the potential role of technology in reducing the risk of progression to T2DM...
February 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29483076/factors-influencing-recording-of-drug-misuse-in-primary-care-a-qualitative-study-of-gps-in-england
#19
Hilary Davies-Kershaw, Irene Petersen, Irwin Nazareth, Fiona Stevenson
BACKGROUND: Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. AIM: To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies...
February 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29440017/patient-involvement-in-diagnosing-cancer-in-primary-care-a-systematic-review-of-current-interventions
#20
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
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