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BMC Family Practice

Olivia Braillard, Anbreen Slama-Chaudhry, Catherine Joly, Nicolas Perone, David Beran
BACKGROUND: Patient-centeredness and therapeutic relationship are widely explored as a means to address the challenge of chronic disease and multi-morbidity management, however research focusing on the perspective of doctors is still rare. In this study, we aimed to explore the impact of the patient's chronic disease(s) on their healthcare provider. METHODS: A qualitative approach was taken using semi-structured interviews with general practitioners working in outpatient clinics either in individual practices or in a hospital setting in Geneva, Switzerland...
September 11, 2018: BMC Family Practice
Krishnamachari Srinivasan, Amanda Mazur, Prem K Mony, Mary Whooley, Maria L Ekstrand
BACKGROUND: People who are diagnosed with both mental and chronic medical illness present unique challenges for the health care system. In resource-limited settings, such as rural India, people with depression and anxiety are often under-served, due to both stigma and lack of trained providers and resources. These challenges can lead to complications in the management of chronic disease as well as increased suffering for patients, families and communities. In this study, we evaluate the effects of integrating mental health and chronic disease treatment of patients in primary health care (PHC) settings using a collaborative care model to improve the screening, diagnosis and treatment of depression in rural India...
September 11, 2018: BMC Family Practice
Jeremy A Jones, Carole A Reeve
BACKGROUND: The Central Australian Remote Practitioners Association Standard Treatment Manual (CARPA) contains protocols for primary health care in remote Central Australia. This context stands in stark contrast to the mainstream settings in Australia and features an Aboriginal population with very poor health status, powerful social determinants of health, geographical isolation and high turnover of health practitioners. The manual consolidates the core elements of national guidelines, particularly as they pertain to Aboriginal health care, into a single document...
September 11, 2018: BMC Family Practice
Gavin Daker-White, Rebecca Hays, Thomas Blakeman, Sarah Croke, Benjamin Brown, Aneez Esmail, Peter Bower
BACKGROUND: In primary health care, patient safety failures can arise in service access, doctor-patient relationships, communication between care providers, relational and management continuity, or technical procedures. Through the lens of multimorbidty, and using qualitative ethnographic methods, our study aimed to illuminate safety issues in primary care. METHODS: Data were triangulated from electronic health records (EHRs); observation of primary care consultations; annual interviews with patients, (informal) care providers and GPs...
September 8, 2018: BMC Family Practice
Robin Lewis, Shona Kelly
BACKGROUND: The UK Government document 5 year forward view describes the need to move chronic disease management from secondary to primary care, which will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no specific recruitment strategy to address this increased need. In recent times, a number of solutions have been suggested to address this impending GPN recruitment crisis. For example, Health Education England (HEE) commission General Practitioners (GPs), who are members of the Advanced Training Practice Scheme (ATPS), to provide placements for student nurses within general practice...
September 8, 2018: BMC Family Practice
Maria Noonan, Owen Doody, Julie Jomeen, Andrew O'Regan, Rose Galvin
BACKGROUND: Responding to and caring for women who experience mental health problems during the perinatal period, from pregnancy up to one year after birth, is complex and requires a multidisciplinary response. Family physicians are ideally placed to provide an effective response as it is recognised that they are responsible for organising care and supports for women and their families. This paper reports an integrative review undertaken to examine family physicians' perceived role in perinatal mental health care and concludes with recommendations for health policy, research and practice...
September 8, 2018: BMC Family Practice
Mariko Higuchi, Keiichiro Narumoto, Takahiro Goto, Machiko Inoue
BACKGROUND: Vaccination is an important element of health maintenance in family medicine. The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is highly recommended for the elderly, but its uptake is low in Japan. Primary care system remains under development and preventive services tend to be neglected in the Japanese medical practice. The study aims to investigate the association between family physician's recommendations for PPSV23 during outpatient care and PPSV23 vaccination intention and behavior in the elderly...
September 5, 2018: BMC Family Practice
Pasqualina Santaguida, Lisa Dolovich, Doug Oliver, Larkin Lamarche, Anne Gilsing, Lauren E Griffith, Julie Richardson, Dee Mangin, Monika Kastner, Parminder Raina
BACKGROUND: Promoting the collection and use of health related outcome measures (HROM) in daily practice has long been a goal for improving and assessing the effectiveness of care provided to patients. However, there has been a lack of consensus on what criteria to use to select outcomes or instruments, particularly in the context of primary health care settings where patients present with multiple concurrent health conditions and interventions are whole-health and person-focused. The purpose of this proposed study is to undertake a formal consensus exercise to establish criteria for selecting HROM (including patient-reported (PRO or PROM), observer-reported (ObsR)), clinician-reported (ClinRO) and performance related outcomes (PerfO) for use in shared decision-making, or in assessing, screening or monitoring health status in primary health care settings...
September 4, 2018: BMC Family Practice
Judith Gellatly, Gosia Pelikan, Paul Wilson, Kate Woodward-Nutt, Michael Spence, Anthony Jones, Karina Lovell
BACKGROUND: Chronic widespread pain (CWP) is a major public health problem. Many people experiencing CWP experience mental health problems such as anxiety or depression. Complete relief of skeletal and body pain symptoms is unlikely but with appropriate treatment the impact upon quality of life, functioning and mental health symptoms can be reduced. Cognitive behavioural therapy (CBT) is widely used for a range of health conditions and can have short and long-term improvements in patients with CWP...
September 1, 2018: BMC Family Practice
Bruce A Griffin, John A A Nichols
BACKGROUND: When advising patients on diet and health, the general practitioner (GP) makes judgements based on the evidence available. Since current evidence on diet and cardiovascular disease is conflicted and confusing, we surveyed the current consensus amongst GPs. The aim of this study was to determine the views of GPs on dietary saturated fat, carbohydrates and long chain omega-3 fatty acids in the management of cardiovascular disease. METHOD: An online questionnaire inviting participants to comment on seven contentious statements on diet and cardiovascular disease...
August 31, 2018: BMC Family Practice
Jennifer Klein, Paula Brauer, Dawna Royall, Maya Israeloff-Smith, Doug Klein, Angelo Tremblay, Rupinder Dhaliwal, Caroline Rheaume, David M Mutch, Khursheed Jeejeebhoy
BACKGROUND: Patient perspectives on new programs to manage metabolic syndrome (MetS) are critical to evaluate for possible implementation in the primary healthcare system. Participants' perspectives were sought for the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) study, which enrolled 293 participants, and demonstrated 19% reversal of MetS after 1 year. The main purpose of this study was to examine participants' perceptions of their experiences with the CHANGE program, enablers and barriers to change...
August 31, 2018: BMC Family Practice
Lisa S Meredith, Benjamin Batorsky, Matthew Cefalu, Jill E Darling, Susan E Stockdale, Elizabeth M Yano, Lisa V Rubenstein
BACKGROUND: Poor morale among primary care providers (PCPs) and staff can undermine the success of patient-centered care models such as the patient-centered medical home that rely on highly coordinated inter-professional care teams. Medical home literature hypothesizes that participation in quality improvement can ease medical home transformation. No studies, however, have assessed the impact of quality improvement participation on morale (e.g., burnout or dissatisfaction) during transformation...
August 31, 2018: BMC Family Practice
Aisha K Lofters, Amy Mark, Monica Taljaard, Michael E Green, Richard H Glazier, Simone Dahrouge
BACKGROUND: Primary care has been reformed in recent years in Ontario, Canada, with a move away from traditional fee-for-service to enhanced fee-for-service and capitation-based models. It is unclear how new models have affected disparities in cancer screening. We evaluated whether Ontario's enhanced fee-for-service model was associated with a change in the gaps in cancer screening for people living with low income and people who are foreign-born. METHODS: We conducted a population-based longitudinal analysis from 2002 to 2013 of Ontario family physicians who transitioned from traditional fee-for-service to enhanced fee-for-service...
August 29, 2018: BMC Family Practice
Christine M Swoboda, Joseph M Van Hulle, Ann Scheck McAlearney, Timothy R Huerta
BACKGROUND: People use a variety of means to find health information, including searching the Internet, seeking print sources, and talking to healthcare providers, family members, and friends. Doctors are considered the most trusted source of health information, but people may be underutilizing them in favor of searching the Internet. METHODS: A multinomial logistic regression of cross-sectional data from Cycle 4 of the Health Information National Trends Survey (HINTS) was conducted...
August 29, 2018: BMC Family Practice
Katarzyna Budzynska, Daniel Passerman, Denise White-Perkins, Della A Rees, Jinping Xu, Lois Lamerato, Susan Schooley
BACKGROUND: Colorectal cancer (CRC) develops from colorectal adenomatous polyps. This study is to determine if diabetes mellitus (DM), its treatment, and hemoglobin A1c (HbA1c) level are associated with increased risk of colorectal adenomatous polyps. METHODS: This was a retrospective cohort study that included patients who had at least one colonoscopy and were continuously enrolled in a single managed care organization during a 10-year period (2002-2012). Of these patients (N = 11,933), 1800 were randomly selected for chart review to examine the details of colonoscopy and pathology findings and to confirm the diagnosis of DM...
August 29, 2018: BMC Family Practice
Stephanie Montesanti, Ardene Robinson-Vollman, Lee A Green
BACKGROUND: Despite significant investments to improve primary health care (PHC) delivery in Canada, provincial health care systems remain fragmented and uncoordinated. Canada's commitment to strengthening PHC should be driven by robust research and evaluation that reflects our health policy priorities and responds to the needs of the population. One challenge facing health services researchers is developing and sustaining meaningful research priorities and agendas in an overburdened, complex health care system with limited capacity for PHC research and support for clinician researchers...
August 29, 2018: BMC Family Practice
Jane Murray Cramm, Anna Petra Nieboer
BACKGROUND: Validated instruments are needed to assess the delivery of patient-centred care (PCC) to patients with multimorbidity in the primary care setting. Eight dimensions of PCC have been identified: respect for patients' preferences, access to care, emotional support, information and education, involvement of family and friends, continuity and secure transition between health care settings, physical comfort, and coordination of care. The main objective of this study was to validate an instrument for the assessment of PCC among patients with multimorbidity in the primary care setting: the 36-item patient-centred primary care (PCPC) instrument...
August 28, 2018: BMC Family Practice
Anne K Santalahti, Tero J Vahlberg, Sinikka H Luutonen, Päivi T Rautava
BACKGROUND: Frequent attenders (FAs) use a disproportionately large share of the resources of general practitioners (GPs) working in primary healthcare centres. The aim of this study was to estimate the proportion of FAs among all patients in the primary health care centres of a medium-sized city in Finland, and to examine whether providing GPs with administrative information about their frequent attenders (names and numbers of visits per year) can reduce the number of FAs and the frequency of their visits...
August 28, 2018: BMC Family Practice
Karin M A Swart, Myrthe van Vilsteren, Wesley van Hout, Esther Draak, Babette C van der Zwaard, Henriette E van der Horst, Jacqueline G Hugtenburg, Petra J M Elders
BACKGROUND: Adherence to osteoporosis treatment is crucial for good treatment effects. However, adherence has been shown to be poor and a substantial part of the patients don't even initiate treatment. This study aimed to gain insight into the considerations of both osteoporosis patients and general practitioners (GP) concerning intentional non-initiation of bisphosphonate treatment. METHODS: Osteoporosis patients and GPs were recruited from the SALT Osteoporosis Study and a transmural fracture liaison service, both carried out in the Netherlands...
August 23, 2018: BMC Family Practice
Angela Xiao Han, Sandy Rosalie Whitehouse, Steve Tsai, Sandy Hwang, Sally Thorne
BACKGROUND: Adolescents with chronic health conditions and/or disabilities (CHC/D's) often face challenges when transitioning to adult care, which leads to a higher risk of morbidity and mortality. Although it is recommended that establishing the medical home and family physician (FP) attachment prior to transfer will improve health outcomes, there is little evidence or policy surrounding the role of the FP during this transition. This study explores the described use of health services by adolescents with CHC/D's, as well as the adolescent's and caregiver's perceptions of their FP...
August 23, 2018: BMC Family Practice
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