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BMC Family Practice

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https://www.readbyqxmd.com/read/29047331/-i-can-t-bend-it-and-it-hurts-like-mad-direct-observation-of-gout-consultations-in-routine-primary-health-care
#1
Anthony Dowell, Caroline Morris, Lindsay Macdonald, Maria Stubbe
BACKGROUND: Gout is the most common form of inflammatory arthritis and is associated with considerable co-morbidity. It is usually managed in the primary care setting with a combination of lifestyle modification and pharmacological therapy. This study describes patterns of communication about gout observed in interactions between patients and primary care practitioners during routine consultations. METHODS: Secondary analysis of video-recordings of individual healthcare consultations between patients and a range of primary care practitioners (including general practitioners, practice nurses, podiatrists and dietitians) from an archived database...
October 18, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29041908/a-qualitative-study-of-employees-opinions-on-establishing-a-generic-call-centre
#2
Hilde Carin Storhaug, Sara Bjune Mead, Aslak Steinsbekk
BACKGROUND: To investigate opinions among employees at an Out-of-Hours general practitioner (OOH-GP) service and a safety alarm service about the establishment of a generic call-centre. METHODS: Qualitative study using individual and group interviews with 14 employees and managers involved in preparation of a merge into a new generic call-centre. They were asked about their opinions towards establishing a generic call-centre where all contact about unplanned health inquiries from the public had to be done by telephone and how to solve more requests on the phone...
October 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28969592/external-validation-study-of-a-clinical-decision-aid-to-reduce-unnecessary-antibiotic-prescriptions-in-women-with-acute-cystitis
#3
Warren J McIsaac, Rahim Moineddin, Ildikó Gágyor, Tony Mazzulli
BACKGROUND: Empirical prescribing of antibiotics to women with symptoms of acute cystitis prior to culture results is common, but subsequent culture results are often negative. A clinical decision aid for prescribing decisions in acute cystitis was previously developed that could reduce these unnecessary antibiotic prescriptions but has not been validated. This study sought to validate this decision aid for empirical antibiotic prescribing decisions in a new cohort of women with suspected acute cystitis...
October 2, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28962555/family-centered-depression-treatment-for-older-men-in-primary-care-a-qualitative-study-of-stakeholder-perspectives
#4
Ladson Hinton, Andrés F Sciolla, Jürgen Unützer, Edward Elizarraras, Richard L Kravitz, Ester Carolina Apesoa-Varano
BACKGROUND: Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men's depression treatment and potential strategies to overcome those challenges...
September 29, 2017: BMC Family Practice
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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