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BMC Family Practice

Katja Krug, René Alexander Ballhausen, Regine Bölter, Peter Engeser, Michel Wensing, Joachim Szecsenyi, Frank Peters-Klimm
BACKGROUND: Family caregivers (FCGs) of patients at the end of life (EoL) cared for at home receive support from professional and non-professional care providers. Healthcare providers in general practice play an important role as they coordinate care and establish contacts between the parties concerned. To identify potential intervention targets, this study deals with the challenges healthcare providers in general practice face in EoL care situations including patients, caregivers and networks...
July 13, 2018: BMC Family Practice
Anja Rieckert, Christina Sommerauer, Anja Krumeich, Andreas Sönnichsen
BACKGROUND: Within the EU-funded project PRIMA-eDS (Polypharmacy in chronic diseases: Reduction of Inappropriate Medication and Adverse drug events in older populations by electronic Decision Support) an electronic decision support tool (the "PRIMA-eDS-tool") was developed for general practitioners (GPs) to reduce inappropriate medication in their older polypharmacy patients. After entering patient data relevant to prescribing in an electronic case report form the physician received a comprehensive medication review (CMR) on his/her screen displaying recommendations regarding missing indications, necessary laboratory tests, evidence-base of current medication, dose adjustments for renal malfunction, potentially harmful drug-drug interactions, contra-indications, and possible adverse drug events...
July 9, 2018: BMC Family Practice
Christina Sandlund, Kimberly Kane, Mirjam Ekstedt, Jeanette Westman
BACKGROUND: The majority of patients who seek help for insomnia do so in primary health care. Nurse-led group treatment in primary care based on cognitive behavioral therapy for insomnia (CBT-I) can lead to improvements in both day- and nighttime symptoms. This study aimed to explore patients' experiences of nurse-led group treatment for insomnia in primary health care. METHODS: Seventeen patients who had participated in the group treatment program were interviewed in five focus groups...
July 9, 2018: BMC Family Practice
Christine P Kowalski, Miranda Veeser, Michele Heisler
BACKGROUND: Understanding the many factors that influence implementation of new programs, in addition to their success or failure, is extraordinarily complex. This qualitative study examines the implementation and adaptation process of two linked clinical programs within Primary Care, diabetes shared medical appointments (SMAs) and a reciprocal Peer-to-Peer (P2P) support program for patients with poorly controlled diabetes, through the lens of the Consolidated Framework for Implementation Research (CFIR)...
July 7, 2018: BMC Family Practice
Karleen F Giannitrapani, Peter A Glassman, Derek Vang, Jeremiah C McKelvey, R Thomas Day, Steven K Dobscha, Karl A Lorenz
BACKGROUND: Facilitating appropriate and safe prescribing of opioid medications for chronic pain management in primary care is a pressing public health concern. Interdisciplinary team-based models of primary care are exploring the expansion of clinical pharmacist roles to support disease management for chronic conditions, e.g. pain. Our study aims to 1) identify roles clinical pharmacists can assume in primary care team based chronic pain care processes and 2) understand the barriers to assuming these expanded roles...
July 3, 2018: BMC Family Practice
Concepción Violán, Albert Roso-Llorach, Quintí Foguet-Boreu, Marina Guisado-Clavero, Mariona Pons-Vigués, Enriqueta Pujol-Ribera, Jose M Valderas
BACKGROUND: The purpose of this study was to ascertain multimorbidity patterns using a non-hierarchical cluster analysis in adult primary patients with multimorbidity attended in primary care centers in Catalonia. METHODS: Cross-sectional study using electronic health records from 523,656 patients, aged 45-64 years in 274 primary health care teams in 2010 in Catalonia, Spain. Data were provided by the Information System for the Development of Research in Primary Care (SIDIAP), a population database...
July 3, 2018: BMC Family Practice
Debbie Cavers, Natalia Calanzani, Sheina Orbell, Gabriele Vojt, Robert J C Steele, Linda Brownlee, Steve Smith, Julietta Patnick, David Weller, Christine Campbell
BACKGROUND: Bowel cancer is the third most common cause of cancer death worldwide. Bowel screening has been shown to reduce mortality and primary care interventions have been successful in increasing uptake of screening. Using evidence-based theory to inform the development of such interventions has been shown to increase their effectiveness. This study aimed to develop and refine a brief evidence-based intervention for eligible individuals whom have not responded to their last bowel screening invitation (non-responders), for opportunistic use by primary care providers during routine consultations...
June 30, 2018: BMC Family Practice
Marie Claire Van Hout, Des Crowley, Aoife McBride, Ide Delargy
BACKGROUND: Treatment for opioid dependence in Ireland is provided predominantly by general practitioners (GP) who have undergone additional training in opioid agonist treatment (OAT) and substance misuse. The National Methadone Treatment Programme (MTP) was introduced in 1998, and was designed to treat the opioid dependent population and to regulate the prescribing regimes at the time. The past two decades have seen the increased prescribing of methadone in primary care and changes in type of opioid abused, in particular, the increased use of over the counter (OTC) and prescription medications...
June 30, 2018: BMC Family Practice
Muna Habib Al Lawati, Sarah Dennis, Stephanie D Short, Nadia Noor Abdulhadi
BACKGROUND: Patient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East. METHODS: A systematic review of the literature...
June 30, 2018: BMC Family Practice
Noémi Gede, Diána Reményi Kiss, István Kiss
BACKGROUND: This study aims to survey the level of awareness of colorectal cancer and screening and to identify sources of information among the population under investigation. METHODS: A cross-sectional study was conducted among 1150 adults between the ages of 40 and 70 using quota sampling. Data were collected through self-made questionnaires to be completed by respondents. RESULTS: 32.7% of the participants correctly identified the recommended beginning of colorectal cancer screening, these participants were more likely to see their physician more frequently in the past years than those answering to the qusetion incorrectly (p = 0...
June 30, 2018: BMC Family Practice
Ariëtte R J Sanders, Jozien M Bensing, Tessa Magnée, Peter Verhaak, Niek J de Wit
BACKGROUND: Although the recovery of patients suffering from low back pain is highly context dependent, patient preferences about treatment options are seldom incorporated into the therapeutic plan. Shared decision-making (SDM) offers a tool to overcome this deficiency. The reinforcement by the general practitioner (GP) of a 'shared' chosen therapy might increase patients' expectations of favourable outcomes and thus contribute to recovery. METHODS: In the Netherlands, a clustered randomised controlled trial was performed to assess the effectiveness of shared decision-making followed by positive reinforcement of the chosen therapy (SDM&PR) on patient-related clinical outcomes...
June 28, 2018: BMC Family Practice
Franziska D Welzel, Janine Stein, Alexander Pabst, Melanie Luppa, Anette Kersting, Matthias Blüher, Claudia Luck-Sikorski, Hans-Helmut König, Steffi G Riedel-Heller
BACKGROUND: Obesity is one of the most prevalent health problems in western societies. However, it seems not effectively managed in the healthcare system at present. Originating from smoking cessation a tool called the 5As for obesity management has been drafted and adapted by the Canadian Obesity Network (CON) to improve weight counseling and provider-patient-interaction. This paper describes the rationale and design of the INTERACT study. The objective of the INTERACT study is to evaluate the effectiveness and intervention costs of a 5As eLearning program for obesity management aimed specifically at general practitioners (GPs)...
June 23, 2018: BMC Family Practice
Bernhard Riedl, Simon Kehrer, Christoph U Werner, Antonius Schneider, Klaus Linde
BACKGROUND: Even in practices with a comprehensive appointment system a minority of patients walks in without prior notice, sometimes causing problems for practice service quality. We aimed to explore differences between patients consulting primary care practices with and without appointment. METHODS: Consecutive patients visiting five primary care practices without an appointment and following patients with an appointment were asked to fill in a four-page questionnaire addressing socio-demographic characteristics, the reason for encounter, urgency of seeing a physician, depressive, somatic and anxiety symptoms, personality traits, and satisfaction with the practice...
June 23, 2018: BMC Family Practice
Henny Sinnema, Berend Terluin, Daniëlle Volker, Michel Wensing, Anton van Balkom
BACKGROUND: Adequate recognition of anxiety and depression by general practitioners (GPs) can be improved. Research on factors that are associated with recognition is limited and shows mixed results. The aim of this study was to explore which patient and GP characteristics are associated with recognition of anxiety and depression. METHODS: We performed a secondary analysis on data from 444 patients who were recruited for a randomized trial. Recognition of anxiety and depression was defined in terms of information in the medical records, in patients who screened positive on the extended Kessler 10 (EK-10)...
June 23, 2018: BMC Family Practice
Jana Malhotra, Eric Wong, Amardeep Thind
BACKGROUND: To explore the determinants of job satisfaction and work-life balance satisfaction of family physicians in Canada. METHODS: This is a secondary analysis of the Canadian 2013 National Physician's Survey using descriptive statistics and binomial logistic regression. An estimated 34,753 family physicians practicing in Canada at the time of survey administration in 2013 were eligible for the survey. The main outcome measures were respondent satisfaction with professional life and satisfaction with work-life balance...
June 23, 2018: BMC Family Practice
Ranita Hisham, Chirk Jenn Ng, Su May Liew, Pauline Siew Mei Lai, Yook Chin Chia, Ee Ming Khoo, Nik Sherina Hanafi, Sajaratulnisah Othman, Ping Yein Lee, Khatijah Lim Abdullah, Karuthan Chinna
BACKGROUND: Evidence-Based Medicine (EBM) integrates best available evidence from literature and patients' values, which then informs clinical decision making. However, there is a lack of validated instruments to assess the knowledge, practice and barriers of primary care physicians in the implementation of EBM. This study aimed to develop and validate an Evidence-Based Medicine Questionnaire (EBMQ) in Malaysia. METHODS: The EBMQ was developed based on a qualitative study, literature review and an expert panel...
June 23, 2018: BMC Family Practice
Traci D Yates, Marion E Davis, Yhenneko J Taylor, Lisa Davidson, Crystal D Connor, Katherine Buehler, Melanie D Spencer
BACKGROUND: Inappropriate prescribing of antibiotics poses an urgent public health threat. Limited research has examined factors associated with antibiotic prescribing practices in outpatient settings. The goals of this study were to explore elements influencing provider decisions to prescribe antibiotics, identify provider recommendations for interventions to reduce inappropriate antibiotic use, and inform the clinical management of patients in the outpatient environment for infections that do not require antibiotics...
June 23, 2018: BMC Family Practice
R Leutgeb, J Frankenhauser-Mannuß, M Scheuer, J Szecsenyi, Katja Goetz
BACKGROUND: Challenging work environment, high workload, and increasing physician shortages characterize current rural general practice in Germany and in most European Countries. These factors extend into Out-Of-Hours Care (OOHC). However, little research about potential stressors for general practitioners (GPs) in OOHC settings is available. This pilot study aimed to evaluate workload, different elements of job satisfaction and stressors for GPs in OOHC and to analyze whether these aspects are associated with overall job satisfaction...
June 22, 2018: BMC Family Practice
Maaike C M Ronda, Lioe-Ting Dijkhorst-Oei, Rimke C Vos, Guy E H M Rutten
BACKGROUND: To gain insight into the opinions and working methods of diabetes care providers after using a diabetes web portal for 4 years in order to understand the role of the provider in patients' web portal use. METHODS: Survey among physicians and nurses from general practices and an outpatient clinic, correlated with data from the common web portal. RESULTS: One hundred twenty-eight questionnaires were analysed (response rate 56.6%)...
June 21, 2018: BMC Family Practice
Kirsti Malterud, Aase Aamland, Kristina Riis Iden
BACKGROUND: Research often fails to impose substantial shifts in clinical practice. Evidence-based health care requires implementation of documented interventions, with implementation research as a science-informed strategy to identify core experiences from the process and share preconditions for achievement. Evidence developed in hospital contexts is often neither relevant nor feasible for primary care. Different evidence types may constitute a point of departure, stretching and testing the transferability of the intervention by piloting it in primary care...
June 21, 2018: BMC Family Practice
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