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BMC Family Practice

Sietske M Grol, Gerard R M Molleman, Anne Kuijpers, Rob van der Sande, Gerdine A J Fransen, Willem J J Assendelft, Henk J Schers
BACKGROUND: In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Our aim for this study was to unravel how GPs can play a successful role in elderly care, in particular in multidisciplinary teams, and to define key concepts for success. METHODS: A mixed qualitative research model in four multidisciplinary teams for elderly care in the Netherlands was used...
March 10, 2018: BMC Family Practice
Éva Marjorie Couture, Maud-Christine Chouinard, Martin Fortin, Catherine Hudon
BACKGROUND: Frequent users of healthcare services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. Healthcare systems should offer interventions tailored to their needs and to their level of health literacy, including strategies to promote activation. The relationship between health literacy and patient activation remains to be explored. The aim of this study was to examine the association between health literacy and patient activation in a population of frequent users of healthcare services with chronic diseases...
March 9, 2018: BMC Family Practice
Zahirah Tharek, Anis Safura Ramli, David Leonard Whitford, Zaliha Ismail, Maryam Mohd Zulkifli, Siti Khuzaimah Ahmad Sharoni, Asrul Akmal Shafie, Thevaraajan Jayaraman
BACKGROUND: Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control...
March 9, 2018: BMC Family Practice
Ivo Kim Joore, Jan E A M van Bergen, Gerben Ter Riet, A van der Maat, N van Dijk
BACKGROUND: In the Netherlands, a substantial proportion of newly diagnosed HIV patients present late for care, therefore, we investigated the effectiveness of a blended educational programme for trainers of GPs designed to stimulate proactive HIV testing. METHODS: GP trainers at the Academic Medical Center in Amsterdam were invited to participate in a two days training programme incorporating evidence-based practice guidelines and multiple teaching strategies, including interactive lectures, discussion groups, e-learning and quality improvement targets...
March 7, 2018: BMC Family Practice
Francis-Xavier Andoh-Adjei, Eric Nsiah-Boateng, Felix Ankomah Asante, Ernst Spaan, Koos van der Velden
BACKGROUND: Ghana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care. This paper assesses National Health Insurance Scheme subscribers and care providers' perception of quality of care under the capitation payment method. METHODS: This is a cross-sectional survey of subscribers and care providers perception of quality of care in three administrative regions of Ghana using a 5-point Likert scale for the assessment based on a set of quality of care measures...
March 7, 2018: BMC Family Practice
Rimke Cathelijne Vos, Marise Jeannine Kasteleyn, Monique Johanna Heijmans, Elke de Leeuw, François Georges Schellevis, Mieke Rijken, Guy Emile Rutten
BACKGROUND: Chronically ill patients such as people with type 2 diabetes develop perceptions of their illness, which will influence their coping behaviour. Perceptions are formed once a health threat has been recognised. Many people with type 2 diabetes suffer from multimorbidity, for example the combination with cardiovascular disease. Perceptions of one illness may influence perceptions of the other condition. The aim of the current study was to evaluate the effect of an intervention in type 2 diabetes patients with a first acute coronary event on change in illness perceptions and whether this mediates the intervention effect on health status...
March 2, 2018: BMC Family Practice
Tina Drud Due, Håkon Sandholdt, Volkert Dirk Siersma, Frans Boch Waldorff
BACKGROUND: Social relationships are important to people and affect their quality of life, morbidity and mortality. The aim of this study was to examine the correlation between elderly patients' descriptions of their social relations and feelings of loneliness, and their general practitioners' assessments of these. METHODS: Cross-sectional study in 12 general practices in the Capital Region of Denmark. During a three-week period each practice asked their patients aged 65 and older to fill out a questionnaire regarding health, social relations and loneliness; the general practitioner (GP) filled out a matching questionnaire regarding their perception of the patient's social relations and loneliness...
February 26, 2018: BMC Family Practice
Stefan Bösner, Sonja Schwarm, Paula Grevenrath, Laura Schmidt, Kaja Hörner, Dominik Beidatsch, Milena Bergmann, Annika Viniol, Annette Becker, Jörg Haasenritter
BACKGROUND: Dizziness is a common reason for consulting a general practitioner and there is a broad range of possible underlying aetiologies. There are few evidence-based data about prevalence, aetiology and prognosis in primary care. We aimed to conduct a systematic review of symptom-evaluating studies on prevalence, aetiology or prognosis of dizziness in primary care. METHODS: We systematically searched MEDLINE and EMBASE. Two independent researchers screened titles and abstracts according to predefined criteria...
February 20, 2018: BMC Family Practice
Margreet G Franken, Isaac Corro Ramos, Jeanine Los, Maiwenn J Al
BACKGROUND: In an ageing population, it is inevitable to improve the management of care for community-dwelling elderly with incontinence. A previous study showed that implementation of the Optimum Continence Service Specification (OCSS) for urinary incontinence in community-dwelling elderly with four or more chronic diseases results in a reduction of urinary incontinence, an improved quality of life, and lower healthcare and lower societal costs. The aim of this study was to explore future consequences of the OCSS strategy of various healthcare policy scenarios in an ageing population...
February 17, 2018: BMC Family Practice
Pia Kirkegaard, Adrian Edwards, Trine Laura Overgaard Nielsen, Torben Falck Ørntoft, Karina Dalsgaard Sørensen, Michael Borre, Flemming Bro
BACKGROUND: Most health authorities do not recommend screening for prostate cancer with PSA tests in asymptomatic patients who are not at increased risk. However, opportunistic screening for prostate cancer is still wanted by many patients and it is widely used in primary care clinics, with potential for overdiagnosis and overtreatment. Better tools for risk assessment have been called for, to better target such opportunistic screening. Our aim was to explore perceptions about prostate cancer risk and subsequent opportunistic screening among patients who were not at increased risk of prostate cancer after a first PSA test plus a genetic lifetime risk assessment...
February 17, 2018: BMC Family Practice
Khic-Houy Prang, Rachel Canaway, Marie Bismark, David Dunt, Margaret Kelaher
BACKGROUND: Public performance reporting (PPR) of hospital data aims to improve quality of care in hospitals and to inform consumer choice. In Australia, general practitioners (GPs) are gatekeepers to secondary care with patients requiring their referral for non-emergency access. Despite their intermediary role, GPs have been generally overlooked as potential users of PPR of hospital data, with the majority of the PPR research focussing on consumers, surgeons and hospitals. METHODS: We examined the use of PPR of hospital data by GPs when referring patients to hospitals...
February 12, 2018: BMC Family Practice
Andrew O'Regan, Walter Cullen, Louise Hickey, David Meagher, Ailish Hannigan
BACKGROUND: The pattern of alcohol consumption in Ireland has serious societal and health consequences. General practice is well placed to screen for problem alcohol use and to carry out brief interventions. The aims of this study were to investigate the prevalence of documentation of problem alcohol use in patient records in Irish general practice, and to describe the documentation of its diagnosis and treatment. METHODS: General practitioners (GPs) affiliated with an Irish medical school were invited to participate in the study...
February 12, 2018: BMC Family Practice
Cecilia Björkelund, Irene Svenningsson, Dominique Hange, Camilla Udo, Eva-Lisa Petersson, Nashmil Ariai, Shabnam Nejati, Catrin Wessman, Carl Wikberg, Malin André, Lars Wallin, Jeanette Westman
BACKGROUND: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden. METHODS: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged ≥ 18 years with a new (< 1 month) depression diagnosis...
February 9, 2018: BMC Family Practice
Christine Cohidon, Pascal Wild, Nicolas Senn
BACKGROUND: Good patient experience is recognized as an important component of a strong primary care system. Among the dimensions related to experience in family medicine, the ability to cope better with health problems is considered to be a measure of the quality of a consultation with a family physician (FP). The objective is to identify factors related to patients, physicians and practice, associated with patients' ability to cope better with their health problems after a family medicine consultation...
February 7, 2018: BMC Family Practice
Mark Porcheret, Chris Main, Peter Croft, Krysia Dziedzic
BACKGROUND: Professionally-focussed behaviour change intervention (BCI) workshops were utilised in the Management of OsteoArthritis in Consultations (MOSAICS) trial investigating the feasibility of implementing the National Institute for Health and Care Excellence (NICE) Osteoarthritis (OA) Guideline in general practice. The workshops aimed to implement the general practitioner (GP) component of the trial intervention: an enhanced consultation for patients presenting with possible OA...
February 6, 2018: BMC Family Practice
Sophie Turnbull, Patricia J Lucas, Niamh M Redmond, Hannah Christensen, Hannah Thornton, Christie Cabral, Peter S Blair, Brendan C Delaney, Matthew Thompson, Paul Little, Tim J Peters, Alastair D Hay
BACKGROUND: The objectives were to identify 1) the clinician and child characteristics associated with; 2) clinical management decisions following from, and; 3) the prognostic value of; a clinician's 'gut feeling something is wrong' for children presenting to primary care with acute cough and respiratory tract infection (RTI). METHODS: Multicentre prospective cohort study where 518 primary care clinicians across 244 general practices in England assessed 8394 children aged ≥3 months and < 16 years for acute cough and RTI...
February 5, 2018: BMC Family Practice
Klaus B von Pressentin, Robert J Mash, Laurel Baldwin-Ragaven, Roelf Petrus Gerhardus Botha, Indiran Govender, Wilhelm Johannes Steinberg, Tonya M Esterhuizen
BACKGROUND: Evidence from first world contexts support the notion that strong primary health care teams contain family physicians (FPs). African leaders are looking for evidence from their own context. The roles and scope of practice of FPs are also contextually defined. The South African family medicine discipline has agreed on six roles. These roles were incorporated into a family physician impact assessment tool, previously validated in the Western Cape Province. METHODS: A cross-sectional study design was used to assess the perceived impact of family physicians across seven South African provinces...
February 5, 2018: BMC Family Practice
Agnieszka Sowińska, Sławomir Czachowski
BACKGROUND: Patients with medically unexplained symptoms (MUS) are common in primary care, and pose a communicative and therapeutic challenge to GPs. Although much has been written about GPs' frustration and difficulties while dealing with these patients, research presenting the patients' perspectives on MUS still seems to be scarce. Existing studies have demonstrated the patients' desire to make sense of symptoms, addressed the necessity for appropriate and acceptable explanation of MUS, and revealed stigmatization of patients with symptoms of mental origin...
February 2, 2018: BMC Family Practice
Cath Quinn, Katie Denman, Philippa Smithson, Christabel Owens, Rod Sheaff, John Campbell, Ian Porter, Jill Annison, Richard Byng
BACKGROUND: Offenders frequently have substantial healthcare needs and, like many other socially marginalised groups, often receive healthcare in inverse proportion to their needs. Improved continuity of healthcare over time could contribute to addressing these needs. General Practitioners need to be able to support people with complex social and medical problems, even in systems that are not specifically designed to manage individuals with such degrees of complexity. We aimed to examine offenders' perspectives on factors that contributed to, or worked against, creating and sustaining their access to healthcare...
February 2, 2018: BMC Family Practice
Sameer Al-Ghamdi, Gulfam Ahmad, Ali Hassan Ali, Nasraddin Bahakim, Salman Alomran, Waleed Alhowikan, Salman Almutairi, Tariq Basalem, Faisal Aljuaid
BACKGROUND: Illness perception questionnaires for various medical conditions have become more useful in recent years. However, very few have addressed this issue for Type 2 diabetes in Saudi Arabia. METHODS: A self-administered questionnaire was distributed to Type 2 diabetic patients attendees of primary health care centers and Al Kharj Military Industries Corporation Hospital in Al Kharj, Saudi Arabia, from November 24th 2016 to April 24th, 2017. RESULTS: Overall, 383 of the 500 distributed questionnaires were returned, and 187 were males (48...
February 2, 2018: BMC Family Practice
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