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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/28993307/improving-access-to-allied-health-professionals-through-the-champlain-base-%C3%A2-econsult-service-a-cross-sectional-study-in-canada
#1
Fanny McKellips, Erin Keely, Amir Afkham, Clare Liddy
BACKGROUND: Allied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs). AIM: To assess the eConsult service's ability to improve access to advice from AHPs. DESIGN AND SETTING: A cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016...
October 9, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28993306/experiences-with-online-consultation-systems-in-primary-care-case-study-of-one-early-adopter-site
#2
Michael Casey, Sara Shaw, Deborah Swinglehurst
BACKGROUND: There is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care. AIM: To explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices. DESIGN AND SETTING: Mixed methods case study in an inner-city general practice...
October 9, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28993305/effectiveness-of-uk-provider-financial-incentives-on-quality-of-care-a-systematic-review
#3
Rishi Mandavia, Nishchay Mehta, Anne Schilder, Elias Mossialos
BACKGROUND: Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. AIM: To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. DESIGN AND SETTING: Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations...
October 9, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28993304/barriers-and-facilitators-to-integration-of-physician-associates-into-the-general-practice-workforce-a-grounded-theory-approach
#4
Ben Jackson, Michelle Marshall, Susie Schofield
BACKGROUND: Physician associates (PAs) are described as one solution to workforce capacity in primary care in the UK. Despite new investment in the role, how effective this will be in addressing unmet primary care needs is unclear. AIM: To investigate the barriers and facilitators to the integration of PAs into the general practice workforce. DESIGN AND SETTING: A modified grounded theory study in a region unfamiliar with the PA role. METHOD: No a priori themes were assumed...
October 9, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28947622/use-of-the-electronic-frailty-index-to-identify-vulnerable-patients-a-pilot-study-in-primary-care
#5
Lynn N Lansbury, Helen Clare Roberts, Esther Clift, Annie Herklots, Nicola Robinson, Avan A Sayer
BACKGROUND: Identifying frailty is key to providing appropriate treatment for older people at high risk of adverse health outcomes. Screening tools proposed for primary care often involve additional workload. The electronic Frailty Index (eFI) has the potential to overcome this issue. AIM: To assess the feasibility and acceptability of using the eFI in primary care. DESIGN AND SETTING: Pilot study in one suburban primary care practice in southern England in 2016...
September 25, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28947621/the-role-of-the-quality-and-outcomes-framework-in-the-care-of-long-term-conditions-a-systematic-review
#6
Lindsay Jl Forbes, Catherine Marchand, Tim Doran, Stephen Peckham
BACKGROUND: Improving care for people with long-term conditions is central to NHS policy. It has been suggested that the Quality and Outcomes Framework (QOF), a primary care pay-for-performance scheme that rewards practices for delivering effective interventions in long-term conditions, does not encourage high-quality care for this group of patients. AIM: To examine the evidence that the QOF has improved quality of care for patients with long-term conditions. DESIGN AND SETTING: This was a systematic review of research on the effectiveness of the QOF in the UK...
September 25, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28947620/use-of-text-messaging-in-general-practice-a-mixed-methods-investigation-on-gps-and-patients-views
#7
Dorothy Leahy, Aoife Lyons, Matthias Dahm, Diarmuid Quinlan, Colin Bradley
BACKGROUND: Text messaging has become more prevalent in general practice as a tool with which to communicate with patients. AIM: The main objectives were to assess the extent, growth, and perceived risks and benefits of text messaging by GPs to communicate with patients, and assess patients' attitudes towards receiving text messages from their GP. DESIGN AND SETTING: A mixed methods study, using surveys, a review, and a focus group, was conducted in both urban and rural practices in the south-west of Ireland...
September 25, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28947619/impact-of-primary-care-funding-on-secondary-care-utilisation-and-patient-outcomes-a-retrospective-cross-sectional-study-of-english-general-practice
#8
Veline L'Esperance, Matt Sutton, Peter Schofield, Thomas Round, Umer Malik, Patrick White, Mark Ashworth
BACKGROUND: In international studies, greater investment in primary health care is associated with improved population health outcomes. AIM: To determine whether investment in general practice is associated with secondary care utilisation, patient satisfaction, and clinical outcomes. DESIGN AND SETTING: Retrospective cross-sectional study of general practices in England, 2014-2015. METHOD: Practice-level data were stratified into three groups according to GP contract type: national General Medical Services (GMS) contracts, with or without the capitation supplement (mean practice income guarantee), or local Personal Medical Services (PMS) contracts...
September 25, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28893768/building-managed-primary-care-practice-networks-to-deliver-better-clinical-care-a-qualitative-semi-structured-interview-study
#9
Jasmine Pawa, John Robson, Sally Hull
BACKGROUND: Primary care practices are increasingly working in larger groups. In 2009, all 36 primary care practices in the London borough of Tower Hamlets were grouped geographically into eight managed practice networks to improve the quality of care they delivered. Quantitative evaluation has shown improved clinical outcomes. AIM: To provide insight into the process of network implementation, including the aims, facilitating factors, and barriers, from both the clinical and managerial perspectives...
September 11, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28893767/gps-perceptions-of-resilience-training-a-qualitative-study
#10
Anna Cheshire, John Hughes, George Lewith, Maria Panagioti, David Peters, Chantal Simon, Damien Ridge
BACKGROUND: GPs are reporting increasing levels of burnout, stress, and job dissatisfaction, and there is a looming GP shortage. Promoting resilience is a key strategy for enhancing the sustainability of the healthcare workforce and improving patient care. AIM: To explore GPs' perspectives on the content, context, and acceptability of resilience training programmes in general practice, in order to build more effective GP resilience programmes. DESIGN AND SETTING: This was a qualitative study of the perspectives of GPs currently practising in England...
September 11, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28893766/barriers-facilitators-and-survival-strategies-for-gps-seeking-treatment-for-distress-a-qualitative-study
#11
Johanna Spiers, Marta Buszewicz, Carolyn A Chew-Graham, Clare Gerada, David Kessler, Nick Leggett, Chris Manning, Anna Kathryn Taylor, Gail Thornton, Ruth Riley
BACKGROUND: GPs are under increasing pressure due to a lack of resources, a diminishing workforce, and rising patient demand. As a result, they may feel stressed, burnt out, anxious, or depressed. AIM: To establish what might help or hinder GPs experiencing mental distress as they consider seeking help for their symptoms, and to explore potential survival strategies. DESIGN AND SETTING: The authors recruited 47 GP participants via e-mails to doctors attending a specialist service, adverts to local medical committees (LMCs) nationally and in GP publications, social media, and snowballing...
September 11, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28893765/requirement-for-cystatin-c-testing-in-chronic-kidney-disease-a-retrospective-population-based-study
#12
Daniel S Lasserson, Brian Shine, Christopher A O'Callaghan, Tim James
BACKGROUND: Creatinine-based estimated glomerular filtration rate (eGFR) determines chronic kidney disease (CKD) stage, but underestimates renal function. The 2014 updated guidance from the National Institute for Health and Care Excellence (NICE) recommends that GPs reduce overdiagnosis of CKD stage 3a (eGFR 45-60 ml/min/1.73 m(2)) by using the renal biomarker cystatin C. AIM: To determine the population requirement for cystatin C testing, compared with current national availability of the assay...
September 11, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28855163/does-aerobic-exercise-reduce-postpartum-depressive-symptoms-a-systematic-review-and-meta-analysis
#13
Ruth Victoria Pritchett, Amanda J Daley, Kate Jolly
BACKGROUND: There is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent. AIM: To assess the effectiveness of aerobic exercise on postpartum depressive symptoms. DESIGN AND SETTING: Systematic review and meta-analysis. There was no restriction to study site or setting. METHOD: The databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, Clinical Trials...
August 30, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28847775/epidemiology-of-adult-overweight-recording-and-management-by-uk-gps-a-systematic-review
#14
Joanna C McLaughlin, Kathryn Hamilton, Ruth Kipping
BACKGROUND: Primary care guidelines for managing adult overweight/obesity recommend routine measurement of body mass index (BMI) and the offer of weight management interventions. Many studies state that this is rarely done, but the extent to which overweight/obesity is recognised, considered, and documented in routine care has not been determined. AIM: To identify the epidemiology of adult overweight documentation and management by UK GPs. DESIGN AND SETTING: A systematic review of studies since 2006 from eight electronic databases and grey literature...
August 28, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28808077/gps-knowledge-use-and-confidence-in-national-physical-activity-and-health-guidelines-and-tools-a-questionnaire-based-survey-of-general-practice-in-england
#15
Robin Chatterjee, Tim Chapman, Mike Gt Brannan, Justin Varney
BACKGROUND: Physical activity (PA) brief advice in health care is effective at getting individuals active. It has been suggested that one in four people would be more active if advised by a GP or nurse, but as many as 72% of GPs do not discuss the benefits of physical activity with patients. AIM: To assess the knowledge, use, and confidence in national PA and Chief Medical Officer (CMO) health guidelines and tools among GPs in England. DESIGN AND SETTING: Online questionnaire-based survey of selfselecting GPs in England that took place over a 10-day period in March 2016...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28808075/does-aerobic-exercise-reduce-postpartum-depressive-symptoms-a-systematic-review-and-meta-analysis
#16
Ruth Victoria Pritchett, Amanda J Daley, Kate Jolly
BACKGROUND: There is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent. AIM: To assess the effectiveness of aerobic exercise on postpartum depressive symptoms. DESIGN AND SETTING: Systematic review and meta-analysis. There was no restriction to study site or setting. METHOD: The databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, Clinical Trials...
August 14, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28760741/application-of-the-2014-nice-cholesterol-guidelines-in-the-english-population-a-cross-sectional-analysis
#17
Peter Ueda, Thomas Wai-Chun Lung, Philip Clarke, Goodarz Danaei
BACKGROUND: The 2014 guidelines on cardiovascular risk assessment and lipid modification from the National Institute for Health and Care Excellence (NICE) recommend statin therapy for adults with prevalent cardiovascular disease (CVD), and for adults with a 10-year CVD risk of ≥10%, estimated using the QRISK2 algorithm. AIM: To determine risk factor levels required to exceed the risk threshold for statin therapy, and to estimate the number of adults in England who would require statin therapy under the guidelines...
July 31, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28760740/impact-of-initial-medication-non-adherence-on-use-of-healthcare-services-and-sick-leave-a-longitudinal-study-in-a-large-primary-care-cohort-in-spain
#18
Ignacio Aznar-Lou, Ana Fernández, Montserrat Gil-Girbau, Ramón Sabés-Figuera, Marta Fajó-Pascual, María Teresa Peñarrubia-María, Antoni Serrano-Blanco, Patricia Moreno-Peral, Albert Sánchez-Niubó, Marian March-Pujol, Maria Rubio-Valera
BACKGROUND: Initial medication non-adherence is highly prevalent in primary care but no previous studies have evaluated its impact on the use of healthcare services and/or days on sick leave. AIM: To estimate the impact of initial medication non-adherence on the use of healthcare services, days of sick leave, and costs overall and in specific medication groups. DESIGN AND SETTING: A 3-year longitudinal register-based study of all primary care patients (a cohort of 1...
July 31, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28760739/comparison-between-treatment-effects-in-a-randomised-controlled-trial-and-an-observational-study-using-propensity-scores-in-primary-care
#19
Beth L Stuart, Louise En Grebel, Christopher C Butler, Kerenza Hood, Theo J M Verheij, Paul Little
BACKGROUND: Although randomised controlled trials (RCTs) are considered 'gold standard' evidence, they are not always feasible or appropriate, and may represent a select population. Observational studies provide a useful alternative to enhance applicability, but results can be biased due to confounding. AIM: To explore the utility of propensity scores for causal inference in an observational study. DESIGN AND SETTING: Comparison of the effect of amoxicillin on key outcomes in an international RCT and observational study of lower respiratory tract infections...
July 31, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28760738/characteristics-associated-with-joint-replacement-in-early-symptomatic-knee-or-hip-osteoarthritis-6-year-results-from-a-nationwide-prospective-cohort-study-check
#20
Alex N Bastick, Jurgen Damen, Rintje Agricola, Reinoud W Brouwer, Patrick Je Bindels, Sita Ma Bierma-Zeinstra
BACKGROUND: Many patients with osteoarthritis (OA) of the knee and/or hip undergo total joint replacement (TJR) because of severely progressed symptoms. AIM: To determine patient and disease characteristics associated with undergoing TJR in participants with recent-onset knee and/or hip OA. DESIGN AND SETTING: Participants with hip or knee pain from the nationwide prospective Cohort Hip and Cohort Knee (CHECK) study were included. METHOD: The outcome measure was total hip arthroplasty (THA) or total knee arthroplasty (TKA) during 6 years of follow-up...
July 31, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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