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BMC Family Practice

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https://www.readbyqxmd.com/read/30390637/talking-about-depression-during-interactions-with-gps-a-qualitative-study-exploring-older-people-s-accounts-of-their-depression-narratives
#1
Isabel Gordon, Jonathan Ling, Louise Robinson, Catherine Hayes, Ann Crosland
BACKGROUND: Older people can struggle with revealing their depression to GPs and verbalising preferences regarding its management. This contributes to problems for GPs in both detecting and managing depression in primary care. The aim of this study was to explore older people's accounts of how they talk about depression and possible symptoms to improve communication about depression when seeing GPs. METHODS: Adopting a qualitative Interpretivist methodological approach, semi-structured interviews were conducted by IG based on the principles of grounded theory and situational analysis...
November 3, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30376826/implementing-multiple-health-behaviour-change-interventions-for-cardiovascular-risk-reduction-in-primary-care-a-qualitative-study
#2
Samah Alageel, Martin C Gulliford, Lisa McDermott, Alison J Wright
BACKGROUND: The implementation of multiple health behaviour change interventions for cardiovascular risk reduction in primary care is suboptimal. This study aimed to identify barriers and facilitators to implementing multiple health behaviour change interventions for cardiovascular disease (CVD) risk reduction in primary care. METHODS: Qualitative study using semi-structured interviews informed by the Theoretical Domains Framework. Interviews were conducted with a purposive sample of healthcare professionals working in the implementation of the NHS Health Check programme in London...
October 30, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30376811/symptoms-that-may-be-stress-related-and-lead-to-exhaustion-disorder-a-retrospective-medical-chart-review-in-swedish-primary-care
#3
Annika Adamsson, Susanne Bernhardsson
BACKGROUND: Mental illness, and particularly stress-related disorders such as exhaustion disorder, is continuously increasing in today's society. It is important to identify patients who consult for potentially stress-related symptoms early, before the stress condition develops into an exhaustion disorder. The purpose of the study was to investigate the frequency of different presenting complaints for which patients had consulted in the two years preceding receipt of their exhaustion disorder diagnosis, and to explore potential associations between stress-related presenting complaints and demographic factors, as well as comorbidity and other potentially stress-inducing factors...
October 30, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30340530/understanding-functional-and-social-risk-characteristics-of-frail-older-adults-a-cross-sectional-survey-study
#4
David R Lee, Eilann C Santo, Joan C Lo, Miranda L Ritterman Weintraub, Mary Patton, Nancy P Gordon
BACKGROUND: Frailty is a condition of increasing importance, given the aging adult population. With an anticipated shortage of geriatricians, primary care physicians will increasingly need to manage care for frail adults with complex functional risks and social-economic circumstances. METHODS: We used cross-sectional data from 4551 adults ages 65-90 who responded to the 2014/2015 cycle of the Kaiser Permanente Northern California Member Health Survey (MHS), a self-administered survey that covers multiple health and social characteristics, to create a deficits accumulation model frailty index, classify respondents as frail or non-frail, and then compare prevalence of functional health issues including Activities of Daily Living (ADL)/Instrumental Activities of Daily Living (IADL) and social determinants of health (SDOHs) by frailty status...
October 19, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30314468/how-general-practitioners-would-deprescribe-in-frail-oldest-old-with-polypharmacy-the-less-study
#5
Sophie Mantelli, Katharina Tabea Jungo, Zsofia Rozsnyai, Emily Reeve, Clare H Luymes, Rosalinde K E Poortvliet, Arnaud Chiolero, Nicolas Rodondi, Jacobijn Gussekloo, Sven Streit
BACKGROUND: Many oldest-old (> 80-years) with multimorbidity and polypharmacy are at high risk of inappropriate use of medication, but we know little about whether and how GPs would deprescribe, especially in the frail oldest-old. We aimed to determine whether, how, and why Swiss GPs deprescribe for this population. METHODS: GPs took an online survey that presented case-vignettes of a frail oldest-old patient with and without history of cardiovascular disease (CVD) and asked if they would deprescribe any of seven medications...
October 12, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30309316/general-practitioners-continuation-and-acceptance-of-medication-changes-at-sectorial-transitions-of-geriatric-patients-a-qualitative-interview-study
#6
Anja G Strehlau, Michael Due Larsen, Jens Søndergaard, Anna B Almarsdóttir, Jens-Ulrik Rosholm
BACKGROUND: Follow-up in general practice on medication initiated during hospitalisation is often perceived to be inadequate, which leads to unintended drug interaction and over- or underdosage of medication. Little is known about General Practitioners (GPs') views on medication changes during the transition from hospital to primary care. We conducted a qualitative interview study to understand GPs' views on the medication changes made for their patients by hospital physicians in a geriatric ward and the GPs' actions after discharge...
October 12, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30305077/characteristics-of-patients-with-acute-myocardial-infarction-contacting-primary-healthcare-before-hospitalisation-a-cross-sectional-study
#7
Per O Andersson, Sofia Sederholm Lawesson, Jan-Erik Karlsson, Staffan Nilsson, Ingela Thylén
BACKGROUND: The characteristics of patients with on-going myocardial infarction (MI) contacting the primary healthcare (PHC) centre before hospitalisation are not well known. Prompt diagnosis is crucial in patients with MI, but many patients delay seeking medical care. The aims of this study was to 1) describe background characteristics, symptoms, actions and delay times in patients contacting the PHC before hospitalisation when falling ill with an acute MI, 2) compare those patients with acute MI patients not contacting the PHC, and 3) explore factors associated with a PHC contact in acute MI patients...
October 10, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30301471/the-knowledge-and-attitudes-of-general-practitioners-to-the-assessment-and-management-of-pain-in-people-with-dementia
#8
Aisling A Jennings, Maura Linehan, Tony Foley
BACKGROUND: Pain in people with dementia is underdiagnosed and undertreated. General practitioners (GPs) play a pivotal role in dementia care but their perspectives on pain in people with dementia remains under-researched. The aim of this study was to explore GPs' knowledge and attitudes towards pain assessment and management in people with dementia. METHODS: This was a descriptive cross-sectional study. A questionnaire was adapted from a previous study and piloted with 5 GPs...
October 10, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30292242/shared-decision-making-and-antibiotic-benefit-harm-conversations-an-observational-study-of-consultations-between-general-practitioners-and-patients-with-acute-respiratory-infections
#9
Mina Bakhit, Chris Del Mar, Elizabeth Gibson, Tammy Hoffmann
BACKGROUND: Little research has examined whether shared decision making (SDM) occurs in consultations for acute respiratory infections (ARIs), including what, and how, antibiotic benefits and harms are discussed. We aimed to analyse the extent and nature of SDM in consultations between GPs and patients with ARIs, and explore communication with and without the use of patient decision aids. METHODS: This was an observational study in Australian general practices, nested within a cluster randomised trial of decision aids (for acute otitis media [AOM], sore throat, acute bronchitis) designed for general practitioners (GPs) to use with patients, compared with usual care (no decision aids)...
October 6, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30285746/patient-capacity-for-self-care-in-the-medical-record-of-patients-with-chronic-conditions-a-mixed-methods-retrospective-study
#10
Kasey R Boehmer, Maria Kyriacou, Emma Behnken, Megan Branda, Victor M Montori
BACKGROUND: Patients with chronic conditions must mobilize capacity to access and use healthcare and enact self-care. In order for clinicians to create feasible treatment plans with patients, they must appreciate the limits and possibilities of patient capacity. This study seeks to characterize the amount, nature, and comprehensiveness of the information about patient capacity documented in the medical record. METHODS: In this mixed-methods study, we extracted notes about 6 capacity domains from the medical records of 100 patients receiving care from 15 primary care clinicians at a single practice...
October 2, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30268092/does-patient-self-management-education-of-primary-care-professionals-improve-patient-outcomes-a-systematic-review
#11
Andree Rochfort, Sinead Beirne, Gillian Doran, Patricia Patton, Jochen Gensichen, Ilkka Kunnamo, Susan Smith, Tina Eriksson, Claire Collins
BACKGROUND: Patient self-management support is recognised as a key component of chronic care. Education and training for health professionals has been shown in the literature to be associated with better uptake, implementation and effectiveness of self-management programs, however, there is no clear evidence regarding whether this training results in improved health outcomes for patients with chronic conditions. METHODS: A systematic review was undertaken using the PRISMA guidelines using the Cochrane Library, PubMEd, ERIC, EMBASE, CINAHL, PsycINFO, Web searches, Hand searches and Bibliographies...
September 29, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30261850/patient-understanding-of-two-commonly-used-patient-reported-outcome-measures-for-primary-care-a-cognitive-interview-study
#12
Mairead Murphy, Sandra Hollinghurst, Chris Salisbury
BACKGROUND: Standardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own words) and transitional PROMs (in which respondents directly rate change over a period). The objective of this study was to test qualitatively, through cognitive interviews, two PROMs, one using each respective format...
September 27, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30249203/rationale-and-design-of-a-pragmatic-clinical-trial-to-assess-the-impact-of-self-monitoring-blood-pressure-at-home-and-self-titration-of-antihypertensive-medication-in-poorly-controlled-hypertension-the-adampa-study-protocol
#13
José Sanfélix-Genovés, Clara L Rodríguez-Bernal, Irene Marco-Moreno, Patricia Martinez-Ibañez, Lucía Martinez-Ibañez, María Bóveda-García, Ignacio Barreira-Franch, Mercedes Calleja-Del Ser, Greta Borrás-Moreno, Eugenia Avelino-Hidalgo, Marina Escrig-Veses, Margherita Lauriano, Margarita Giménez-Loreiro, Laura Bellot-Pujalte, Aníbal García-Sempere, Salvador Peiró, Gabriel Sanfélix-Gimeno
BACKGROUND: Lack of control of hypertension is one of the most prevalent problems encountered by general practitioners (GPs). Self-measured blood pressure monitoring at home (SMBP) and self-titration of medication could be a good strategy to improve hypertension management, however, evidence is limited and not conclusive. We aimed to assess the effectiveness, in the primary care setting, of an intervention that includes educational components, SMBP and self-titration of antihypertensive medication to decrease systolic blood pressure compared to usual care, in a population with poorly controlled hypertension, during a 12-month period...
September 24, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30249193/iron-deficiency-among-low-income-canadian-toddlers-a-cross-sectional-feasibility-study-in-a-community-health-centre-and-non-community-health-centre-sites
#14
Imaan Bayoumi, Patricia C Parkin, Gerald Lebovic, Rupa Patel, Kendra Link, Catherine S Birken, Jonathon L Maguire, Cornelia M Borkhoff
BACKGROUND: Iron deficiency in early childhood has been associated with poor developmental outcomes. Little is known about the nutritional health of young children receiving care at Canadian Community Health Centres (CHCs). Our objectives were to describe iron deficiency among toddlers at an Ontario CHC, to compare young children attending CHCs and non-CHCs, and assess the feasibility of conducting research on children in CHC settings. METHODS: One CHC, Kingston Community Health Centres (CHC) with two clinical sites and one community programming site was added to the nine non-CHC pediatric and primary care clinics in the existing TARGet Kids! research network...
September 24, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/30205832/the-impact-of-chronic-disease-management-on-primary-care-doctors-in-switzerland-a-qualitative-study
#15
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
https://www.readbyqxmd.com/read/30205830/improving-mental-health-through-integration-with-primary-care-in-rural-karnataka-study-protocol-of-a-cluster-randomized-control-trial
#16
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
https://www.readbyqxmd.com/read/30205819/factors-influencing-the-use-of-clinical-guidelines-by-general-practitioners-working-in-a-setting-of-complex-multimorbidity-a-case-study-by-interviews
#17
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
https://www.readbyqxmd.com/read/30193576/safety-work-and-risk-management-as-burdens-of-treatment-in-primary-care-insights-from-a-focused-ethnographic-study-of-patients-with-multimorbidity
#18
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
https://www.readbyqxmd.com/read/30193573/gp-gpn-partner-perspectives-on-clinical-placements-for-student-nurses-in-general-practice-can-a-community-of-practice-help-to-change-the-prevailing-culture-within-general-practice
#19
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
https://www.readbyqxmd.com/read/30193572/family-physicians-perceived-role-in-perinatal-mental-health-an-integrative-review
#20
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
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