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BMC Family Practice

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https://www.readbyqxmd.com/read/28903746/correlation-between-patients-reasons-for-encounters-health-problems-and-population-density-in-japan-a-systematic-review-of-observational-studies-coded-by-the-international-classification-of-health-problems-in-primary-care-ichppc-and-the-international-classification
#1
Makoto Kaneko, Ryuichi Ohta, Naoki Nago, Motoharu Fukushi, Masato Matsushima
BACKGROUND: The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system...
September 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28893200/an-after-hours-gp-clinic-in-regional-australia-appropriateness-of-presentations-and-impact-on-local-emergency-department-presentations
#2
Kristy Payne, Tegan Dutton, Kate Weal, Maree Earle, Ross Wilson, Jannine Bailey
BACKGROUND: After hours general practice clinics provide medical attention for clients with non-emergency situations but are seeking immediate treatment and unable to wait for a general practitioner during routine opening hours. Evidence on the impact that after hours clinics have on emergency department presentations is equivocal. This study explored outcomes of the Bathurst After Hours General Practice Clinic (BAHGPC). Specifically it examined: clients' perceived urgency of, and satisfaction with their presentation to the BAHGPC; general practitioners' perception of the appropriateness of presentations to the BAHGPC; and whether the frequency of non-urgent and semi-urgent emergency department presentations at Bathurst Base Hospital has changed since the opening of the BAHGPC...
September 11, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28882108/general-practitioners-perspectives-on-a-proposed-new-model-of-service-delivery-for-primary-care-management-of-knee-osteoarthritis-a-qualitative-study
#3
Thorlene Egerton, Rachel Nelligan, Jenny Setchell, Lou Atkins, Kim L Bennell
BACKGROUND: Effective management of people with knee osteoarthritis (OA) requires development of new models of care, and successful implementation relies on engagement of general practitioners (GPs). This study used a qualitative methodology to identify potential factors influencing GPs' engagement with a proposed new model of service delivery to provide evidence-based care for patients with knee OA and achieve better patient outcomes. METHODS: Semi-structured telephone interviews with 11 GPs were conducted...
September 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28874124/telephone-counselling-by-nurses-in-norwegian-primary-care-out-of-hours-services-a-cross-sectional-study
#4
Vivian Midtbø, Guttorm Raknes, Steinar Hunskaar
BACKGROUND: The primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly staffed by registered nurses. When assessment by a medical doctor is not required, the nurse often handles the contact solely by nurse telephone counselling. Little is known about this group of contacts. Thus, the aim of this study was to investigate characteristics of encounters with the OOH services that are handled solely by nurse telephone counselling...
September 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28841849/the-diagnostic-pathway-of-parkinson-s-disease-a-cross-sectional-survey-study-of-factors-influencing-patient-dissatisfaction
#5
Annette O A Plouvier, Tim C Olde Hartman, Olga A de Bont, Sjoerd Maandag, Bastiaan R Bloem, Chris van Weel, Antoine L M Lagro-Janssen
BACKGROUND: The diagnostic pathway of Parkinson's disease (PD) is often complicated. Experiences during this pathway can affect patients' satisfaction and their confidence and trust in healthcare providers. Although healthcare providers cannot influence the impact of the diagnosis, they can influence how patients experience the pathway. This study, therefore, aims to provide insight into PD patients' dissatisfaction with the diagnostic pathway and to describe the factors that influence it...
August 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28836941/reasons-for-missed-appointments-linked-to-a-public-sector-intervention-targeting-patients-with-stable-chronic-conditions-in-south-africa-results-from-in-depth-interviews-and-a-retrospective-review-of-medical-records
#6
Bvudzai P Magadzire, Thubelihle Mathole, Kim Ward
BACKGROUND: Missed appointments serve as a key indicator for adherence to therapy and as such, identifying patient reasons for this inconsistency could assist in developing programmes to improve health outcomes. In this article, we explore the reasons for missed appointments linked to a centralised dispensing system in South Africa. This system dispenses pre-packed, patient-specific medication parcels for clinically stable patients to health facilities. However, at least 8%-12% of about 300,000 parcels are not collected each month...
August 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28830385/strengthening-general-practice-family-medicine-in-europe-advice-from-professionals-from-30-european-countries
#7
Natalia Zarbailov, Stefan Wilm, Howard Tandeter, Francesco Carelli, Mette Brekke
BACKGROUND: Substantial variations are still to be found in the strength of general practice/family medicine (GP/FM) across Europe regarding governance, workforce competence and performance, as well as academic development and position. Governments are encouraged by the WHO to secure high quality primary health care to their population, a necessity for reaching the goal "Health for all". The present study aimed at investigating the opinions of council members of the European Academy of Teachers in General Practice (EURACT) on necessary actions to strengthen the position of GP/FM in their country...
August 22, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28830380/primary-care-physician-referral-patterns-in-ontario-canada-a-descriptive-analysis-of-self-reported-referral-data
#8
Clare Liddy, Sadaf Arbab-Tafti, Isabella Moroz, Erin Keely
BACKGROUND: In many countries, the referral-consultation process faces a number of challenges from inefficiencies and rising demand, resulting in excessive wait times for many specialties. We collected referral data from a sample of family doctors across the province of Ontario, Canada as part of a larger program of research. The purpose of this study is to describe referral patterns from primary care to specialist and allied health services from the primary care perspective. METHODS: We conducted a prospective study of patient referral data submitted by primary care providers (PCP) from 20 clinics across Ontario between June 2014 and January 2016...
August 22, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28784088/managing-diagnostic-uncertainty-in-primary-care-a-systematic-critical-review
#9
Rahul Alam, Sudeh Cheraghi-Sohi, Maria Panagioti, Aneez Esmail, Stephen Campbell, Efharis Panagopoulou
BACKGROUND: Diagnostic uncertainty is one of the largest contributory factors to the occurrence of diagnostic errors across most specialties in medicine and arguably uncertainty is greatest in primary care due to the undifferentiated symptoms primary care physicians are often presented with. Physicians can respond to diagnostic uncertainty in various ways through the interplay of a series of cognitive, emotional and ethical reactions. The consequences of such uncertainty however can impact negatively upon the primary care practitioner, their patients and the wider healthcare system...
August 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28774265/prevalence-of-anal-symptoms-in-general-practice-a-prospective-study
#10
Géraldine Tournu, Laurent Abramowitz, Camille Couffignal, Frédéric Juguet, Agnès Sénéjoux, Stéphane Berger, Anne-Laure Wiart, Marc Bernard, Françoise Provost, Hélène Pillant-Le Moult, Dominique Bouchard, Jean-Pierre Aubert
BACKGROUND: Anal disorders are largely underestimated in general practice. Studies have shown patients conceal anal symptoms leading to late diagnosis and treatment. Management by general practitioners is poorly described. The aim of this study is to assess the prevalence of anal symptoms and their management in general practice. METHODS: In this prospective, observational, national study set in France, all adult patients consulting their general practitioner during 2 days of consultation were included...
August 3, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28701184/developing-a-community-based-psycho-social-intervention-with-older-people-and-third-sector-workers-for-anxiety-and-depression-a-qualitative-study
#11
Tom Kingstone, Heather Burroughs, Bernadette Bartlam, Mo Ray, Janine Proctor, Thomas Shepherd, Peter Bullock, Carolyn Anne Chew-Graham
BACKGROUND: One-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited...
July 12, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28697791/blood-transfusion-in-elderly-patients-with-chronic-anemia-a-qualitative-analysis-of-the-general-practitioners-attitudes
#12
Sylvain Le Calvé, Dominique Somme, Joaquim Prud'homm, Aline Corvol
BACKGROUND: Blood transfusion in chronic anemia is not covered by guidelines specific to older adults. When they consider that this treatment is necessary in elderly patients, French general practitioners (GPs) contact a hospital specialist to plan a transfusion. METHODS: Twenty French GPs were questioned individually regarding their approach to blood transfusion using semi-structured interviews. Each interview was recorded, typed up verbatim and then coded using an inductive procedure by theme, in a cross-over design (two researchers) in two phases: analysis and summary, followed by grouping of the recorded comments...
July 11, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28662639/equitable-resourcing-of-primary-health-care-in-remote-communities-in-australia-s-northern-territory-a-pilot-study
#13
John Wakerman, Lisa Sparrow, Susan L Thomas, John S Humphreys, Mike Jones
BACKGROUND: Improved Primary Health Care (PHC) utilisation is central to reducing the unacceptable morbidity and mortality rates characterising populations living in remote communities. Despite poorer health, significant inequity characterises the funding of PHC services in Australia's most remote areas. This pilot study sought to ascertain what funding is required to ensure equitable access to sustainable, high quality primary health care irrespective of geographical remoteness of communities...
June 29, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28633627/effectiveness-of-a-motivational-intervention-on-overweight-obese-patients-in-the-primary-healthcare-a-cluster-randomized-trial
#14
Juan Jose Rodriguez-Cristobal, Carlos Alonso-Villaverde, Jose Ma Panisello, Pere Travé-Mercade, Francisca Rodriguez-Cortés, Josep Ramon Marsal, Esther Peña
BACKGROUND: Overweight and obesity are common health problems which increase the risk of developing several serious health conditions. The main difficulty in the management of weight-loss lies in its maintenance, once it is achieved. The aim of this study was to investigate whether a motivational intervention, together with current clinical practice, was more efficient than a traditional intervention, in the treatment of overweight and obesity and whether this intervention reduces cardiovascular risk factors associated with overweight and obesity...
June 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28623911/moderate-mental-illness-as-a-predictor-of-chronic-disease-prevention-and-screening
#15
Ginetta Salvalaggio, Christopher Meaney, Rahim Moineddin, Eva Grunfeld, Donna Manca
BACKGROUND: Primary care plays a pivotal role in the provision of both mental health care and chronic disease prevention and screening (CDPS). Unfortunately, moderate mental illness (MMI) is associated with poorer general health outcomes. Part of this burden of illness may be due to reduced CDPS uptake. The Building on the Existing Tools to Improve Chronic Disease Prevention in Primary Care (BETTER) trial recruited 777 participants ages 40-65 from 32 family practice panels, of whom 135 (18...
June 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28623894/-doing-the-right-thing-factors-influencing-gp-prescribing-of-antidepressants-and-prescribed-doses
#16
Chris F Johnson, Brian Williams, Stephen A MacGillivray, Nadine J Dougall, Margaret Maxwell
BACKGROUND: Antidepressant prescribing continues to increase, with 5-16% of adults receiving antidepressants annually. Total prescribing growth is due in part to increased long-term use, greater selective serotonin re-uptake inhibitor (SSRI) use and the use of higher SSRI doses. Evidence does not support routine use of higher SSRI doses for depression treatment, and factors influencing the use of such doses are not well known. The aim of this study was to explore factors influencing GPs' use of antidepressants and their doses to treat depression...
June 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28599626/factors-associated-with-general-practitioners-awareness-of-depression-in-primary-care-patients-with-heart-failure-baseline-results-from-the-observational-recode-hf-study
#17
Marion Eisele, Anja Rakebrandt, Sigrid Boczor, Agata Kazek, Nadine Pohontsch, Magdalena Okolo-Kulak, Eva Blozik, Jens-Martin Träder, Stefan Störk, Christoph Herrmann-Lingen, Martin Scherer
BACKGROUND: Depression is more prevalent in patients with heart failure (HF) than in those without, but its detection is complicated by the symptom overlap between the two diseases. General practitioners (GPs) are the first point of contact for patients with HF. Therefore, this study aims to investigate GPs' awareness of depression in their HF patients and factors associated with this awareness. METHODS: In this cross-sectional, observational study 3224 primary care patients with HF were screened for depressive symptomatology using an algorithm based on the Hospital Anxiety and Depression Scale, the 9-item subscale on Depression of the Patient Health Questionnaire, and selected items from the PROMIS Depression and Anxiety scales...
June 9, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28587644/current-and-future-perspectives-on-the-management-of-polypharmacy
#18
Mariam Molokhia, Azeem Majeed
BACKGROUND: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death...
June 6, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28549460/learning-to-use-electronic-health-records-can-we-stay-patient-centered-a-pre-post-intervention-study-with-family-medicine-residents
#19
Cédric Lanier, Melissa Dominicé Dao, Patricia Hudelson, Bernard Cerutti, Noëlle Junod Perron
BACKGROUND: The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the "patient-centered" use of the EHR have been published. However, the impact of training to improve EHR use during clinical encounters is not well known. The aim of this study was to assess the impact of training on residents' EHR-related communication skills and explore whether they varied according to the content of the consultation...
May 26, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28545412/how-do-population-general-practice-and-hospital-factors-influence-ambulatory-care-sensitive-admissions-a-cross-sectional-study
#20
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK and other healthcare systems, however it remains uncertain how this can be achieved. This paper explores the relationship between unplanned ambulatory care sensitive condition (ACSC) admission rates and population, general practice and hospital characteristics. Additionally, we investigated if these factors had a differential impact across 28 conditions. METHODS: We used the English Hospital Episode Statistics to calculate the number of unplanned ACSC hospital admissions for 28 conditions at 8,029 general practices during 2011/12...
May 25, 2017: BMC Family Practice
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