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BMC Family Practice

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https://www.readbyqxmd.com/read/28231847/process-evaluation-of-a-stepped-care-program-to-prevent-depression-in-primary-care-patients-and-practice-nurses-experiences
#1
Alide D Pols, Karen Schipper, Debbie Overkamp, Susan E van Dijk, Judith E Bosmans, Harm W J van Marwijk, Marcel C Adriaanse, Maurits W van Tulder
BACKGROUND: Depression is common in patients with diabetes type 2 (DM2) and/or coronary heart disease (CHD), with high personal and societal burden and may even be preventable. Recently, a cluster randomized trial of stepped care to prevent depression among patients with DM2 and/or CHD and subthreshold depression in Dutch primary care (Step-Dep) versus usual care showed no effectiveness. This paper presents its process evaluation, exploring in-depth experiences from a patient and practice nurse perspective to further understand the results...
February 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28231821/patient-centeredness-to-anticipate-and-organize-an-end-of-life-project-for-patients-receiving-at-home-palliative-care-a-phenomenological-study
#2
Agnès Oude Engberink, Mélanie Badin, Philippe Serayet, Sylvain Pavageau, François Lucas, Gérard Bourrel, Joanna Norton, Grégory Ninot, Pierre Senesse
BACKGROUND: The development of end-of-life primary care is a socio-medical and ethical challenge. However, general practitioners (GPs) face many difficulties when initiating appropriate discussion on proactive shared palliative care. Anticipating palliative care is increasingly important given the ageing population and is an aim shared by many countries. We aimed to examine how French GPs approached and provided at-home palliative care. We inquired about their strategy for delivering care, and the skills and resources they used to devise new care strategies...
February 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28219325/the-validity-and-reliability-of-the-english-version-of-the-diabetes-distress-scale-for-type-2-diabetes-patients-in-malaysia
#3
Ying Woei Chin, Pauline Siew Mei Lai, Yook Chin Chia
BACKGROUND: Several disease specific instruments have been developed to identify and assess diabetes distress. In Malaysia, the Problem Areas in Diabetes Scale has been validated in Malay, but it does not have specific domains to assess the different areas of diabetes-related distress. Hence, we decided to use the Diabetes Distress Scale instead. To date, only the Malay version of the Diabetes Distress Scale has been validated in Malaysia. However, English is widely spoken by Malaysians, and is an important second language in Malaysia...
February 20, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28212621/feasibility-of-an-implementation-strategy-for-the-integration-of-health-promotion-in-routine-primary-care-a-quantitative-process-evaluation
#4
Alvaro Sanchez, Gonzalo Grandes, Josep M Cortada, Haizea Pombo, Catalina Martinez, Mary Helen Corrales, Enrique de la Peña, Justo Mugica, Esther Gorostiza
BACKGROUND: Process evaluation is recommended to improve the understanding of underlying mechanisms related to clinicians, patients, context and intervention delivery that may impact on trial or program results, feasibility and transferability to practice. The aim of this study was to assess the feasibility of the Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable") implementation strategy for enhancing the adoption and implementation of an evidence-based health promotion intervention in primary health care...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28212616/general-practitioners-views-on-long-term-prescription-and-use-of-problematic-and-potentially-inappropriate-medication-for-oldest-old-patients-a-qualitative-interview-study-with-gps-cim-triad-study
#5
Nadine Janis Pohontsch, Kathrin Heser, Antje Löffler, Britta Haenisch, Debora Parker, Tobias Luck, Steffi G Riedel-Heller, Wolfgang Maier, Frank Jessen, Martin Scherer
BACKGROUND: Potentially inappropriate medication (PIM) is defined as medication with uncertain therapeutic effects and/or potential adverse drug reactions outweighing the clinical benefits. The prescription rate of PIM for oldest-old patients is high despite the existence of lists of PIM (e.g. the PRISCUS list) and efforts to raise awareness. This study aims at identifying general practitioners' views on PIM and aspects affecting the (long-term) use of PIM. METHODS: As part of the CIM-TRIAD study, we conducted semi-structured, qualitative interviews with 47 general practitioners, discussing 25 patients with and 22 without PIM (according to the PRISCUS list)...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28212606/the-implementation-of-health-promotion-in-primary-and-community-care-a-qualitative-analysis-of-the-prescribe-vida-saludable-strategy
#6
Catalina Martinez, Gonzalo Bacigalupe, Josep M Cortada, Gonzalo Grandes, Alvaro Sanchez, Haizea Pombo, Paola Bully
BACKGROUND: The impact of lifestyle on health is undeniable and effective healthy lifestyle promotion interventions do exist. However, this is not a fundamental part of routine primary care clinical practice. We describe factors that determine changes in performance of primary health care centers involved in piloting the health promotion innovation 'Prescribe Vida Saludable' (PVS) phase II. METHODS: We engaged four primary health care centers of the Basque Healthcare Service in an action research project aimed at changing preventive health practices...
February 17, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28193184/survey-of-spanish-general-practitioners-attitudes-toward-management-of-sore-throat-an-internet-based-questionnaire-study
#7
Carl Llor, Isabel Vilaseca, Eduardo Lehrer-Coriat, Xavier Boleda, José L Cañada, Ana Moragas, Josep M Cots
BACKGROUND: The management of sore throat varies widely in Europe. The objective of this study was to gain insight into clinicians' perceptions on the current management of sore throat in Spain. METHODS: Cross-sectional, internet-based questionnaire study answered from July to September 2013. General practitioners (GPs) affiliated with the two largest scientific societies of primary care were invited to participate in the study. Questions were asked about physician knowledge, the use of current national guidelines for sore throat management, and management in two clinical scenarios, depicting a young adult with sore throat and: 1...
February 14, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28193174/using-theory-to-explore-facilitators-and-barriers-to-delayed-prescribing-in-australia-a-qualitative-study-using-the-theoretical-domains-framework-and-the-behaviour-change-wheel
#8
Lucy Sargent, Amanda McCullough, Chris Del Mar, John Lowe
BACKGROUND: Delayed antibiotic prescribing reduces antibiotic use for acute respiratory infections in trials in general practice, but the uptake in clinical practice is low. The aim of the study was to identify facilitators and barriers to general practitioners' (GPs') use of delayed prescribing and to gain pharmacists' and the public's views about delayed prescribing in Australia. METHODS: This study used the Theoretical Domains Framework and the Behaviour Change Wheel to explore facilitators and barriers to delayed prescribing in Australia...
February 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28178930/the-5as-team-patient-study-patient-perspectives-on-the-role-of-primary-care-in-obesity-management
#9
Jacqueline Torti, Thea Luig, Michelle Borowitz, Jeffrey A Johnson, Arya M Sharma, Denise L Campbell-Scherer
BACKGROUND: Over 60% of people have overweight or obesity, but only a third report receiving counselling from primary care providers. We explored patients' perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies. METHODS: Qualitative study employing semi-structured interviews and thematic analysis, with a sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices in Alberta...
February 8, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28173767/musculoskeletal-pain-and-co-morbid-insomnia-in-adults-a-population-study-of-the-prevalence-and-impact-on-restricted-social-participation
#10
Shula Baker, John McBeth, Carolyn A Chew-Graham, Ross Wilkie
BACKGROUND: Comorbidity is common in patients consulting in primary care. Musculoskeletal pain and insomnia each increase the risk of the other. Co-occurrence may pose an increased burden on well-being. However, the prevalence and impact of co-existing pain and insomnia in adults living in the community who may present to primary care is unclear. The aim of this study was to report the prevalence of pain and insomnia in adults registered with primary care, and to examine the impact of co-occurrence on social activities...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28173766/factors-influencing-decision-of-general-practitioners-and-managers-to-train-and-employ-a-nurse-practitioner-or-physician-assistant-in-primary-care-a-qualitative-study
#11
Mieke van der Biezen, Emmy Derckx, Michel Wensing, Miranda Laurant
BACKGROUND: Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28173764/-medically-unexplained-symptoms-and-symptom-disorders-in-primary-care-prognosis-based-recognition-and-classification
#12
EDITORIAL
Marianne Rosendal, Tim C Olde Hartman, Aase Aamland, Henriette van der Horst, Peter Lucassen, Anna Budtz-Lilly, Christopher Burton
BACKGROUND: Many patients consult their GP because they experience bodily symptoms. In a substantial proportion of cases, the clinical picture does not meet the existing diagnostic criteria for diseases or disorders. This may be because symptoms are recent and evolving or because symptoms are persistent but, either by their character or the negative results of clinical investigation cannot be attributed to disease: so-called "medically unexplained symptoms" (MUS). MUS are inconsistently recognised, diagnosed and managed in primary care...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28166725/does-a-complex-intervention-increase-patient-knowledge-about-oral-anticoagulation-a-cluster-randomised-controlled-trial
#13
Verena Maikranz, Andrea Siebenhofer, Lisa-R Ulrich, Karola Mergenthal, Sylvia Schulz-Rothe, Birgit Kemperdick, Sandra Rauck, Gudrun Pregartner, Andrea Berghold, Ferdinand M Gerlach, Juliana J Petersen
BACKGROUND: Oral anticoagulation therapy (OAT) is a challenge in general practice, especially for high-risk groups such as the elderly. Insufficient patient knowledge about safety-relevant aspects of OAT is considered to be one of the main reasons for complications. The research question addressed in this manuscript is whether a complex intervention that includes practice-based case management, self-management of OAT and additional patient and practice team education improves patient knowledge about anticoagulation therapy compared to a control group of patients receiving usual care (as a secondary objective of the Primary Care Management for Optimised Antithrombotic Treatment (PICANT) trial)...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28158992/patients-anticipated-actions-following-transient-ischaemic-attack-symptoms-a-qualitative-vignette-based-study
#14
Parker Magin, Terry Joyce, Christopher Levi, Daniel Lasserson
BACKGROUND: Transient Ischaemic Attack (TIA) requires urgent investigation and management. Urgent management reduces the risk of subsequent stroke markedly, but non-presentation or delays in patient presentation to health services have been found to compromise timely management. We aimed to explore general practice patients' anticipated responses to TIA symptoms. METHODS: This was a qualitative study employing semi-structured telephone interviews. Participants were recruited from respondents in an earlier quantitative study based in Australian general practices...
February 3, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28148245/from-practice-employee-to-co-owner-young-gps-predict-their-future-careers-a-cross-sectional-survey
#15
Luzia Birgit Gisler, Marius Bachofner, Cora Nina Moser-Bucher, Nathalie Scherz, Sven Streit
BACKGROUND: In Switzerland, the mean age of GPs in 1993 was 46. In 2015, it had increased to 55, and GPs over 65 made up 15% of the workforce of the about 6000 GPs. As older, self-employed GPs retire, young doctors will be needed to fill their positions and eventually take over their practices. We set out to determine what kind of employment young GPs wanted, if they thought their preference would change over time, and the working conditions and factors most important in their choice of practice...
February 2, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28148227/effective-team-based-primary-care-observations-from-innovative-practices
#16
Edward H Wagner, Margaret Flinter, Clarissa Hsu, DeAnn Cromp, Brian T Austin, Rebecca Etz, Benjamin F Crabtree, MaryJoan D Ladden
BACKGROUND: Team-based care is now recognized as an essential feature of high quality primary care, but there is limited empiric evidence to guide practice transformation. The purpose of this paper is to describe advances in the configuration and deployment of practice teams based on in-depth study of 30 primary care practices viewed as innovators in team-based care. METHODS: As part of LEAP, a national program of the Robert Wood Johnson Foundation, primary care experts nominated 227 innovative primary care practices...
February 2, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28143436/erratum-to-typologies-in-gps-referral-practice
#17
Olav Thorsen, Miriam Hartveit, Jan Olav Johannessen, Lars Fosse, Geir Egil Eide, Jörn Schulz, Anders Bærheim
No abstract text is available yet for this article.
January 31, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28143421/potential-for-substitution-of-mental-health-care-towards-family-practices-an-observational-study
#18
Tessa Magnée, Derek P de Beurs, Richard Boxem, Dinny H de Bakker, Peter F Verhaak
BACKGROUND: Substitution is the shift of care from specialized health care to less expensive and more accessible primary health care. It seems promising for restraining rising mental health care costs. The goal of this study was to investigate a potential for substitution of patients with psychological or social problems, but without severe psychiatric disorders, from Dutch specialized mental health care to primary care, especially family practices. METHODS: We extracted anonymized data from two national databases representing primary and specialized care in 2012...
January 31, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28125965/microbiological-point-of-care-testing-before-antibiotic-prescribing-in-primary-care-considerable-variations-between-practices
#19
Steffen Haldrup, Reimar W Thomsen, Flemming Bro, Robert Skov, Lars Bjerrum, Mette Søgaard
BACKGROUND: Point-of-care testing (POCT) in primary care may improve rational antibiotic prescribing. We examined use of POCT in Denmark, including patient- and general practitioner (GP)-related predictors. METHODS: We linked nationwide health care databases to assess POCT use (C-reactive protein (CRP), group A streptococcal (GAS) antigen swabs, bacteriological cultures, and urine test strips) per 1,000 overall GP consultations, 2004-2013. We computed odds ratios (OR) of POCT in patients prescribed antibiotics according to patient and GP age and sex, GP practice type, location, and workload...
January 26, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28122492/self-treatment-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-requires-more-than-symptom-recognition-a-qualitative-study-of-copd-patients-perspectives-on-self-treatment
#20
Johanna Laue, Hasse Melbye, Mette Bech Risør
BACKGROUND: Self-treatment of acute exacerbations of COPD with antibiotics and/or oral corticosteroids has emerged as a promising strategy to reduce hospitalization rates, mortality and health costs. However, for reasons little understood, the effect of self-treatment, particularly when not part of comprehensive self-management programs, remains unclear. Therefore, this study aims to get insight into the patients' perspective on self-treatment of acute exacerbations of COPD, focusing specifically on how patients decide for the right moment to start treatment with antibiotics and/or oral corticosteroids, what they consider important when making this decision and aspects which might interfere with successful implementation...
January 25, 2017: BMC Family Practice
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