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BMC Family Practice

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https://www.readbyqxmd.com/read/28438124/effectiveness-of-an-individual-online-e-learning-program-about-sexually-transmitted-infections-a-prospective-cohort-study
#1
Linda H A Bos-Bonnie, Jan E A M van Bergen, Ellen Te Pas, Michael A Kijser, Nynke van Dijk
BACKGROUND: Primary health-care professionals play an important role in the treatment and prevention of Sexually Transmitted Infections (STI). Continuing Medical Education (CME)-courses can influence the knowledge and behavior of health-care professionals concerning STI. We performed a prospective cohort study to evaluate if the individual and online e-learning program "The STI-consultation", which uses the Commitment-to-Change (CtC)-method, is able to improve the knowledge, attitude and behavior of Dutch General Practitioners (GPs), concerning the STI-consultation...
April 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28431526/recognition-of-depression-by-primary-care-clinicians-in-rural-ethiopia
#2
Abebaw Fekadu, Girmay Medhin, Medhin Selamu, Tedla W Giorgis, Crick Lund, Atalay Alem, Martin Prince, Charlotte Hanlon
BACKGROUND: Depression is a common health condition affecting up to a third of patients attending primary care, where most of the care for people with depression is provided. Adequate recognition of depression is the critical step in the path to effective care, particularly in low income countries. As part of the Programme for Improving Mental healthcare (PRIME), a project supporting the implementation of integrated mental healthcare in primary care, we evaluated the level of recognition of depression by clinicians working in primary care in rural Ethiopia prior to in service training...
April 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28427338/-working-is-out-of-the-question-a-qualitative-text-analysis-of-medical-certificates-of-disability
#3
Guri Aarseth, Bård Natvig, Eivind Engebretsen, Anne Kveim Lie
BACKGROUND: Medical certificates influence the distribution of economic benefits in welfare states; however, the qualitative aspects of these texts remain largely unexplored. The present study is the first systematic investigation done of these texts. Our aim was to investigate how GPs select and mediate information about their patients' health and how they support their conclusions about illness, functioning and fitness for work in medical certificates. METHODS: We performed a textual analysis of thirty-three medical certificates produced by general practitioners (GP) in Norway at the request of the Norwegian Labour and Welfare Administration (NAV)...
April 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28407754/effect-of-audit-and-feedback-with-peer-review-on-general-practitioners-prescribing-and-test-ordering-performance-a-cluster-randomized-controlled-trial
#4
J Trietsch, B van Steenkiste, R Grol, B Winkens, H Ulenkate, J Metsemakers, T van der Weijden
BACKGROUND: Much research worldwide is focussed on cost containment and better adherence to guidelines in healthcare. The research focussing on professional behaviour is often performed in a well-controlled research setting. In this study a large-scale implementation of a peer review strategy was tested on both test ordering and prescribing behaviour in primary care in the normal quality improvement setting. METHODS: We planned a cluster-RCT in existing local quality improvement collaboratives (LQICs) in primary care...
April 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28381260/multimorbidity-clinical-decision-making-and-health-care-delivery-in-new-zealand-primary-care-a-qualitative-study
#5
Tim Stokes, Emma Tumilty, Fiona Doolan-Noble, Robin Gauld
BACKGROUND: Multimorbidity is a major issue for primary care. We aimed to explore primary care professionals' accounts of managing multimorbidity and its impact on clinical decision making and regional health care delivery. METHODS: Qualitative interviews with 12 General Practitioners and 4 Primary Care Nurses in New Zealand's Otago region. Thematic analysis was conducted using the constant comparative method. RESULTS: Primary care professionals encountered challenges in providing care to patients with multimorbidity with respect to both clinical decision making and health care delivery...
April 5, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28381243/internists-career-choice-towards-primary-care-a-cross-sectional-survey
#6
Nathalie Scherz, Stefan Markun, Vera Aemissegger, Thomas Rosemann, Ryan Tandjung
BACKGROUND: Swiss primary care (PC) is facing workforce shortage. Up to 2011 this workforce was supplied by two board certifications: general medicine and internal medicine. To strengthen them against subspecialties, they were unified into one: general internal medicine. However, since unification general practitioners' career options are no longer restrained by early commitment to PC. This may lead to a decrease of future primary care physicians (PCPs). METHODS: To gain insights in timing and factors influencing career choice of internists, we addressed a cross sectional survey to all board certified internists in the years 2000-2010 (n = 1462)...
April 5, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28376802/understanding-type-2-diabetes-mellitus-screening-practices-among-primary-care-physicians-a-qualitative-chart-stimulated-recall-study
#7
Dina Hafez, Daniel B Nelson, Evan G Martin, Alicia J Cohen, Rebecca Northway, Jeffrey T Kullgren
BACKGROUND: Early diagnosis and treatment of prediabetes and type 2 diabetes mellitus (T2DM) can prevent future health problems, yet many individuals with these conditions are undiagnosed. This could be due, in part, to primary care physicians' (PCP) screening practices, about which little is known. The objectives of this study were to identify factors that influence PCPs' decisions to screen patients for T2DM and to characterize their interpretation and communication of screening test results to patients...
April 4, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28347294/from-good-health-to-illness-with-post-infectious-fatigue-syndrome-a-qualitative-study-of-adults-experiences-of-the-illness-trajectory
#8
Eva Stormorken, Leonard A Jason, Marit Kirkevold
BACKGROUND: Municipal drinking water contaminated with the parasite Giardia lamblia in Bergen, Norway, in 2004 caused an outbreak of gastrointestinal infection in 2500 people, according to the Norwegian Prescription Database. In the aftermath a minor group subsequently developed post-infectious fatigue syndrome (PIFS). Persons in this minor group had laboratory-confirmed parasites in their stool samples, and their enteritis had been cured by one or more courses of antibiotic treatment...
March 27, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28403822/provider-and-patient-perspectives-on-opioids-and-alternative-treatments-for-managing-chronic-pain-a-qualitative-study
#9
Lauren S Penney, Cheryl Ritenbaugh, Lynn L DeBar, Charles Elder, Richard A Deyo
BACKGROUND: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues. METHODS: Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14)...
March 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28340559/association-of-general-psychological-factors-with-frequent-attendance-in-primary-care-a-population-based-cross-sectional-observational-study
#10
André Hajek, Jens-Oliver Bock, Hans-Helmut König
BACKGROUND: Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors. METHODS: Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446)...
March 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28340553/promoting-independence-health-and-well-being-for-older-people-a-feasibility-study-of-computer-aided-health-and-social-risk-appraisal-system-in-primary-care
#11
Kate Walters, Kalpa Kharicha, Claire Goodman, Melanie Handley, Jill Manthorpe, Mima Cattan, Steve Morris, Caroline S Clarke, Jeff Round, Steve Iliffe
BACKGROUND: With population ageing, research is needed into new low-cost, scalable methods of effective promotion of health and wellbeing for older people. We aimed to assess feasibility, reach and costs of implementing a new tailored computer-aided health and social risk appraisal system in primary care. METHODS: Design: Feasibility study. SETTING: Five General Practices in London (Ealing) and Hertfordshire, United Kingdom (UK) Participants: Random sample of patients aged 65 + years...
March 24, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28330457/exercising-alcohol-patients-don-t-lack-motivation-but-struggle-with-structures-emotions-and-social-context-a-qualitative-dropout-study
#12
Sengül Sari, Ashley Elizabeth Muller, Kirsten K Roessler
BACKGROUND: Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants' experiences and suggestions...
March 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28330453/a-systematic-review-of-primary-care-models-for-non-communicable-disease-interventions-in-sub-saharan-africa
#13
Jennifer Kane, Megan Landes, Christopher Carroll, Amy Nolen, Sumeet Sodhi
BACKGROUND: Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed. METHODS: A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA...
March 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327100/impact-of-a-continuing-medical-education-meeting-on-the-use-and-timing-of-urgent-cancer-referrals-among-general-practitioners-a-before-after-study
#14
Berit Skjødeberg Toftegaard, Flemming Bro, Alina Zalounina Falborg, Peter Vedsted
BACKGROUND: Detection of cancer in general practice is challenging because symptoms are diverse. Even so-called alarm symptoms have low positive predictive values of cancer. Nevertheless, appropriate referral is crucial. As 85% of cancer patients initiate their cancer diagnostic pathway in general practice, a Continuing Medical Education meeting (CME-M) in early cancer diagnosis was launched in Denmark in 2012. We aimed to investigate the effect of the CME-M on the primary care interval, patient contacts with general practice and use of urgent cancer referrals...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327096/exploring-why-a-complex-intervention-piloted-in-general-practices-did-not-result-in-an-increase-in-chlamydia-screening-and-diagnosis-a-qualitative-evaluation-using-the-fidelity-of-implementation-model
#15
R Allison, D M Lecky, K Town, C Rugman, E J Ricketts, N Ockendon-Powell, K A Folkard, J K Dunbar, C A M McNulty
BACKGROUND: Chlamydia trachomatis (chlamydia) is the most commonly diagnosed sexually transmitted infection (STI) in England; approximately 70% of diagnoses are in sexually active young adults aged under 25. To facilitate opportunistic chlamydia screening in general practice, a complex intervention, based on a previously successful Chlamydia Intervention Randomised Trial (CIRT), was piloted in England. The modified intervention (3Cs and HIV) aimed to encourage general practice staff to routinely offer chlamydia testing to all 15-24 year olds regardless of the type of consultation...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28327082/out-of-hours-care-in-germany-high-utilization-by-adult-patients-with-minor-ailments
#16
R Leutgeb, P Engeser, S Berger, J Szecsenyi, G Laux
BACKGROUND: Family practitioners (FPs) who work in Out-Of-Hours Care (OOHC) - especially in rural areas - complain about high workload related to low urgency and potentially unnecessary patient presentations with minor ailments. The aim of this study was to describe Reasons for Encounter (RFEs) in primary OOHC taken into account the doctor's perspective in the context of high workload without knowing patients' motives for visiting an OOHC-centre. METHODS: Within this descriptive study, OOHC data from 2012 were evaluated from a German statutory health insurance company in the federal state of Baden-Wuerttemberg...
March 21, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28320337/barriers-and-facilitators-to-use-of-non-pharmacological-treatments-in-chronic-pain
#17
William C Becker, Lindsey Dorflinger, Sara N Edmond, Leila Islam, Alicia A Heapy, Liana Fraenkel
BACKGROUND: Consensus guidelines recommend multi-modal chronic pain treatment with increased uptake of non-pharmacological pain treatment modalities (NPMs). We aimed to identify the barriers and facilitators to uptake of evidence-based NPMs from the perspectives of patients, nurses and primary care providers (PCPs). METHODS: We convened eight separate groups and engaged each in a Nominal Group Technique (NGT) in which participants: (1) created an individual list of barriers (and, in a subsequent round, facilitators) to uptake of NPMs; (2) compiled a group list from the individual lists; and (3) anonymously voted on the top three most important barriers and facilitators...
March 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28320330/self-monitoring-of-health-data-by-patients-with-a-chronic-disease-does-disease-controllability-matter
#18
Martine W J Huygens, Ilse C S Swinkels, Judith D de Jong, Monique J W M Heijmans, Roland D Friele, Onno C P van Schayck, Luc P de Witte
BACKGROUND: There is a growing emphasis on self-monitoring applications that allow patients to measure their own physical health parameters. A prerequisite for achieving positive effects is patients' willingness to self-monitor. The controllability of disease types, patients' perceived self-efficacy and health problems could play an essential role in this. The purpose of this study is to investigate the relationship between patients' willingness to self-monitor and a range of disease and patient specific variables including controllability of disease type, patients' perceived self-efficacy and health problems...
March 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28320325/-was-that-a-success-or-not-a-success-a-qualitative-study-of-health-professionals-perspectives-on-support-for-people-with-long-term-conditions
#19
John Owens, Vikki A Entwistle, Alan Cribb, Zoë C Skea, Simon Christmas, Heather Morgan, Ian S Watt
BACKGROUND: Support for self-management (SSM) is a prominent strand of health policy internationally, particularly for primary care. It is often discussed and evaluated in terms of patients' knowledge, skills and confidence, health-related behaviours, disease control or risk reduction, and service use and costs. However, these goals are limited, both as guides to professional practice and as indicators of its quality. In order to better understand what it means to support self-management well, we examined health professionals' views of success in their work with people with long-term conditions...
March 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28302060/heart-failure-labelled-patients-with-missing-ejection-fraction-in-primary-care-prognosis-and-determinants
#20
Miguel-Angel Muñoz, Xavier Mundet-Tuduri, Jordi Real, José-Luis Del Val, Mar Domingo, Ernest Vinyoles, Ester Calero, Caterina Checa, Nuria Soldevila-Bacardit, José-María Verdú-Rotellar
BACKGROUND: It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it registered, and (ii) the causes contributing to the differences in the availability of EF in EMR. METHODS: Retrospective cohort analyses based on clinical records of HF and attended at 52 primary healthcare centres of Barcelona (Spain)...
March 17, 2017: BMC Family Practice
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