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BMC Family Practice

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https://www.readbyqxmd.com/read/28784088/managing-diagnostic-uncertainty-in-primary-care-a-systematic-critical-review
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28545402/regional-variations-of-perceived-problems-in-ambulatory-care-from-the-perspective-of-general-practitioners-and-their-patients-an-exploratory-focus-group-study-in-urban-and-rural-regions-of-northern-germany
#13
H Hansen, N J Pohontsch, L Bole, I Schäfer, M Scherer
BACKGROUND: Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients. METHODS: We conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28532475/-we-re-certainly-not-in-our-comfort-zone-a-qualitative-study-of-gps-dementia-care-educational-needs
#14
Tony Foley, Siobhán Boyle, Aisling Jennings, W Henry Smithson
BACKGROUND: Rising dementia prevalence rates rise combined with the policy objective of enabling people with dementia to remain living at home, means that there will be a growing demand for dementia care in the community setting. However, GPs are challenged by dementia care and have identified it as an area in which further training is needed. Previous studies of GPs dementia care educational needs have explored the views of GPs alone, without taking the perspectives of people with dementia and family carers into account...
May 22, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28532428/practices-of-lyme-disease-diagnosis-and-treatment-by-general-practitioners-in-quebec-2008-2015
#15
Salima Gasmi, Nicholas H Ogden, Patrick A Leighton, Ariane Adam-Poupart, François Milord, L Robbin Lindsay, Sapha Barkati, Karine Thivierge
BACKGROUND: Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described...
May 22, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28499356/erratum-to-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
No abstract text is available yet for this article.
May 12, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28499354/patient-and-care-characteristics-of-self-referrals-treated-by-the-general-practitioner-cooperative-at-emergency-care-access-points-in-the-netherlands
#17
Martijn Rutten, Fieke Vrielink, Marleen Smits, Paul Giesen
BACKGROUND: In the Netherlands, out-of-hours primary care is provided in general practitioner-cooperatives (GPCs). These are increasingly located on site and in collaboration with emergency departments of hospitals (ED). At such sites, also called emergency-care-access-points (ECAP), the GPC is generally responsible for the triage and treatment of self-referrals who used to attend the ED. To evaluate the effects and safety of this novel organisation, we studied the characteristics and the quality of care given by GPCs to self-referrals at ECAPs...
May 12, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28499346/occupational-burnout-and-empathy-influence-blood-pressure-control-in-primary-care-physicians
#18
Oriol Yuguero, Josep Ramon Marsal, Montserrat Esquerda, Jorge Soler-González
BACKGROUND: Good physician-patient communication can favor the adoption of healthy lifestyle habits, which is essential in high blood pressure (BP) management. More empathic physicians tend to have lower burnout and better communication skills. We analyzed the association between burnout and empathy among primary care physicians and nurses and investigated the influence on BP control performance. METHODS: Descriptive study conducted in 2014 investigating burnout and empathy levels in 267 primary care physicians and nurses and BP control data for 301,657 patients under their care...
May 12, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28490357/erratum-to-impact-of-medication-adherence-on-renal-function-in-comorbid-patients-with-type-2-diabetes-and-depression-protocol-for-a-cohort-study
#19
Hiroto Ito, Tosiya Sato, Noriko Satoh-Asahara, Mitsuhiko Noda
No abstract text is available yet for this article.
May 10, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28476151/health-care-resource-use-by-patients-before-and-after-a-diagnosis-of-chronic-fatigue-syndrome-cfs-me-a-clinical-practice-research-datalink-study
#20
Simon M Collin, Inger J Bakken, Irwin Nazareth, Esther Crawley, Peter D White
BACKGROUND: Our aim was to investigate patterns of health care resource use by patients before and after a diagnosis of CFS/ME, as recorded by Clinical Practice Research Datalink (CPRD) GP practices in the UK. METHODS: We used a case-control study design in which patients who had a first recorded diagnosis of CFS/ME during the period 01/01/2001 to 31/12/2013 were matched 1:1 with controls by age, sex, and GP practice. We compared rates of GP consultations, diagnostic tests, prescriptions, referrals, and symptoms between the two groups from 15 years (in adults) or 10 years (in children) before diagnosis to 10 years after diagnosis...
May 5, 2017: BMC Family Practice
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