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BMC Family Practice

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https://www.readbyqxmd.com/read/29788920/a-focus-group-study-to-understand-biases-and-confounders-in-a-cluster-randomized-controlled-trial-on-low-back-pain-in-primary-care-in-norway
#1
Erik L Werner, Ida Løchting, Kjersti Storheim, Margreth Grotle
BACKGROUND: Cluster randomized controlled trials are often used in research in primary care but creates challenges regarding biases and confounders. We recently presented a study on low back pain from primary care in Norway with equal effects in the intervention and the control group. In order to understand the specific mechanisms that may produce biases in a cluster randomized trial we conducted a focus group study among the participating health care providers. The aim of this study was to understand how the participating providers themselves influenced on the study and thereby possibly on the results of the cluster randomized controlled trial...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788914/nutrition-care-practices-of-primary-care-providers-for-weight-management-in-multidisciplinary-primary-care-settings-in-ontario-canada-a-qualitative-study
#2
Stephanie Aboueid, Ivy Bourgeault, Isabelle Giroux
BACKGROUND: Despite the recommended guidelines on addressing diet for the management and prevention of obesity in primary care, the literature highlights that their implementation has been suboptimal. In this paper, we provide an in-depth understanding of current nutrition-related weight management practices of primary care providers (PCPs) working in relatively new multidisciplinary health care settings in Ontario. METHODS: Three types of multidisciplinary primary care settings were included (2 Family Health Teams, 3 Community Health Centres and 1 Nurse Practitioner-Led Clinic)...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788908/perceptions-of-insulin-use-in-type-2-diabetes-in-primary-care-a-thematic-synthesis
#3
Kathy Ellis, Henrietta Mulnier, Angus Forbes
BACKGROUND: Increasing numbers of patients with type 2 diabetes mellitus are progressing to insulin therapy, and despite its potency many such individuals still have suboptimal glycaemic control. Insulin initiation and intensification is now often conducted by Practice Nurses and General Practitioners in many parts of the UK. Therefore, gaining insight into perspectives of patients and primary care clinicians is important in determining self-management and engagement with insulin. A thematic synthesis of studies was conducted exploring the views and experiences of people with type 2 diabetes and of healthcare professionals on insulin use and management in the context of primary care...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29788906/influences-on-the-adoption-of-patient-safety-innovation-in-primary-care-a-qualitative-exploration-of-staff-perspectives
#4
Ian Litchfield, Paramjit Gill, Tony Avery, Stephen Campbell, Katherine Perryman, Kate Marsden, Sheila Greenfield
BACKGROUND: Primary care is changing rapidly to meet the needs of an ageing and chronically ill population. New ways of working are called for yet the introduction of innovative service interventions is complicated by organisational challenges arising from its scale and diversity and the growing complexity of patients and their care. One such intervention is the multi-strand, single platform, Patient Safety Toolkit developed to help practices provide safer care in this dynamic and pressured environment where the likelihood of adverse incidents is increasing...
May 22, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29778099/general-practitioners-can-increase-participation-in-cervical-cancer-screening-a-model-program-in-hungary
#5
Anikó Gyulai, Attila Nagy, Vera Pataki, Dóra Tonté, Róza Ádány, Zoltán Vokó
BACKGROUND: Cervical cancer is a preventable disease. Unfortunately, its mortality is high in Hungary: 9.2 deaths /100000 women/year in 2015. The Hungarian organized, nationwide cervical screening program was launched in 2003, but it could improve the coverage rate of cervical cancer screening only by a few percentage points. The vast majority of women still uses opportunistic screening and the organized screening program had little impact on participation by women who never or rarely consult their gynecologists...
May 19, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29778091/health-care-provider-experiences-in-primary-care-memory-clinics-a-phenomenological-study
#6
Linda Sheiban, Paul Stolee, Carrie McAiney, Veronique Boscart
BACKGROUND: There is a growing need for community-based services for persons with Alzheimer's disease and related dementias (ADRD). Memory clinic (MC) teams in primary care settings have been established to provide care to people with ADRD. To consider wider adoption of these MC teams, insight is needed into the experiences of practitioners working in these models. The purpose of the current study is to explore the experiences of health care providers (HCPs) who work in primary care Memory Clinic (MC) teams to provide care to persons with Alzheimer's disease and related dementias (ADRD)...
May 19, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29776442/multimorbidity-can-general-practitioners-identify-the-health-conditions-most-important-to-their-patients-results-from-a-national-cross-sectional-study-in-switzerland
#7
Anouk Déruaz-Luyet, Alexandra A N'Goran, Jérôme Pasquier, Bernard Burnand, Patrick Bodenmann, Stefan Zechmann, Stefan Neuner-Jehle, Nicolas Senn, Daniel Widmer, Sven Streit, Andreas Zeller, Dagmar M Haller, Lilli Herzig
BACKGROUND: Faced with patients suffering from more than one chronic condition, or multimorbidity, general practitioners (GPs) must establish diagnostic and treatment priorities. Patients also set their own priorities to handle the everyday burdens associated with their multimorbidity and these may be different from the priorities established by their GP. A shared patient-GP agenda, driven by knowledge of each other's priorities, would seem central to managing patients with multimorbidity...
May 17, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29769026/cost-effectiveness-of-a-multicomponent-primary-care-program-targeting-frail-elderly-people
#8
Franca G H Ruikes, Eddy M Adang, Willem J J Assendelft, Henk J Schers, Raymond T C M Koopmans, Sytse U Zuidema
BACKGROUND: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. METHODS: Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen...
May 16, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29769025/use-of-diagnostic-tests-and-the-appropriateness-of-the-treatment-decision-in-patients-with-suspected-urinary-tract-infection-in-primary-care-in-denmark-observational-study
#9
Gloria Córdoba, Anne Holm, Tina Møller Sørensen, Volkert Siersma, Håkon Sandholdt, Marjukka Makela, Niels Frimodt-Møller, Lars Bjerrum
BACKGROUND: Inappropriate prescription of antibiotics is the leading driver of antimicrobial resistance (AMR). The majority of antibiotics are prescribed in primary care. Understanding how general practitioners (GPs) use diagnostic tests and the effect on treatment decision under daily practice conditions is important to reduce inappropriate prescription of antibiotics. The aim of the study was to investigate the use of diagnostic tests in primary care patients with suspected urinary tract infection (UTI) and to assess the appropriateness of the treatment decision (TD) under daily practice conditions in Denmark...
May 16, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29769022/development-and-validation-of-a-malawian-version-of-the-primary-care-assessment-tool
#10
Luckson Dullie, Eivind Meland, Øystein Hetlevik, Thomas Mildestvedt, Sturla Gjesdal
BACKGROUND: Malawi does not have validated tools for assessing primary care performance from patients' experience. The aim of this study was to develop a Malawian version of Primary Care Assessment Tool (PCAT-Mw) and to evaluate its reliability and validity in the assessment of the core primary care dimensions from adult patients' perspective in Malawi. METHODS: A team of experts assessed the South African version of the primary care assessment tool (ZA-PCAT) for face and content validity...
May 16, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29769017/a-cross-sectional-investigation-of-the-health-needs-of-asylum-seekers-in-a-refugee-clinic-in-germany
#11
Laura F Goodman, Guy W Jensen, Joseph M Galante, Diana L Farmer, Stephanie Taché
BACKGROUND: Over one million asylum seekers were registered in Germany in 2016, most from Syria and Afghanistan. The Refugee Convention guarantees access to healthcare, however delivery mechanisms remain heterogeneous. There is an urgent need for more data describing the health conditions of asylum seekers to guide best practices for healthcare delivery. In this study, we describe the state of health of asylum seekers presenting to a multi-specialty primary care refugee clinic. METHODS: Demographic and medical diagnosis data were extracted from the electronic medical records of patients seen at the ambulatory refugee clinic in Dresden, Germany between 15 September 2015 and 31 December 2016...
May 16, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29759070/identifying-frailty-in-primary-care-a-qualitative-description-of-family-physicians-gestalt-impressions-of-their-older-adult-patients
#12
Clara Korenvain, Ida-Maisie Famiyeh, Sheila Dunn, Cynthia R Whitehead, Paula A Rochon, Lisa M McCarthy
BACKGROUND: Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. METHODS: Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over...
May 14, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29747579/burnout-syndrome-and-its-prevalence-in-primary-care-nursing-a-systematic-review-and-meta-analysis
#13
Carolina S Monsalve-Reyes, Concepción San Luis-Costas, Jose L Gómez-Urquiza, Luis Albendín-García, Raimundo Aguayo, Guillermo A Cañadas-De la Fuente
BACKGROUND: burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. The aim of the study was to estimate the prevalence of emotional exhaustion, depersonalization and low personal accomplishment in primary care nurses. METHODS: We performed a meta-analysis. We searched Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN and LILACS databases up to September 2017 to identify cross-sectional studies assessing primary care nurses' burnout with the Maslach Burnout Inventory were included...
May 10, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29747575/assessing-treatment-fidelity-and-contamination-in-a-cluster-randomised-controlled-trial-of-motivational-interviewing-and-cognitive-behavioural-therapy-skills-in-type-2-diabetes
#14
Nicholas Magill, Helen Graves, Nicole de Zoysa, Kirsty Winkley, Stephanie Amiel, Emma Shuttlewood, Sabine Landau, Khalida Ismail
BACKGROUND: Competencies in psychological techniques delivered by primary care nurses to support diabetes self-management were compared between the intervention and control arms of a cluster randomised controlled trial as part of a process evaluation. The trial was pragmatic and designed to assess effectiveness. This article addresses the question of whether the care that was delivered in the intervention and control trial arms represented high fidelity treatment and attention control, respectively...
May 10, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29743033/knowledge-practices-and-expectations-of-preventive-care-a-qualitative-study-of-patients-attending-government-general-outpatient-clinics-in-hong-kong
#15
Denise Y S Tam, Yvonne Y C Lo, Wendy Tsui
BACKGROUND: Evidence-based preventive care recommendations have been well established, but studies have persistently reported gaps between these recommendations and general practitioners' practices in providing preventive care. Many studies have explored factors that affect the delivery of preventive care from the perspectives of the practitioners, but relatively few have evaluated the patients' point of view. The purpose of this study was to explore patients' understanding of preventive care, the actions they were taking in terms of preventive health and their expectations from family doctors in providing preventive care...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29743030/keys-to-success-of-a-community-of-clinical-practice-in-primary-care-a-qualitative-evaluation-of-the-ecopih-project
#16
David Lacasta Tintorer, Josep Maria Manresa Domínguez, Enriqueta Pujol-Rivera, Souhel Flayeh Beneyto, Xavier Mundet Tuduri, Francesc Saigí-Rubió
BACKGROUND: The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was created. This tool enables PC and non-GP specialist care (SC) professionals to raise clinical cases for consultation and to share information. The objective of this article is to explore healthcare professionals' views on communities of clinical practice (CoCPs) and the changes that need to be made in an uncontrolled real-life setting after more than two years of use...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29743021/shifting-hospital-care-to-primary-care-an-evaluation-of-cardiology-care-in-a-primary-care-setting-in-the-netherlands
#17
Tessa C C Quanjel, Jeroen N Struijs, Marieke D Spreeuwenberg, Caroline A Baan, Dirk Ruwaard
BACKGROUND: In an attempt to deal with the pressures on the healthcare system and to guarantee sustainability, changes are needed. This study is focused on a cardiology Primary Care Plus intervention in which cardiologists provide consultations with patients in a primary care setting in order to prevent unnecessary referrals to the hospital. This study explores which patients with non-acute and low-complexity cardiology-related health complaints should be excluded from Primary Care Plus and referred directly to specialist care in the hospital...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29743018/exploring-current-and-potential-roles-of-australian-community-pharmacists-in-gout-management-a-qualitative-study
#18
Allyce B Counsell, Amy D Nguyen, Melissa T Baysari, Diluk R W Kannangara, Andrew J McLachlan, Richard O Day
BACKGROUND: Gout is an increasingly prevalent form of inflammatory arthritis. Although effective treatments for gout exist, current management is suboptimal due to low medication adherence rates and treatments that are non-concordant with guidelines. Medications are the mainstay and most effective form of gout management. Thus, there is potential for community pharmacists to play an important primary health care role in gout management, however their current role and their potential to improve management of gout treatment is currently unclear...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29743017/difficult-medical-encounters-and-job-satisfaction-results-of-a-cross-sectional-study-with-general-practitioners-in-germany
#19
Katja Goetz, Janis Mahnkopf, Anna Kornitzky, Jost Steinhäuser
BACKGROUND: In primary care 15% of patient encounters are perceived as challenging by general practitioners (GP). However it is unknown what impact these encounters have regarding job satisfaction. The aim of this study was to evaluate which encounters are perceived as challenging by German GPs and whether they were associated with job satisfaction. METHODS: A total of 1538 questionnaires were sent to GPs in the federal state of Schleswig-Holstein, Germany. GPs should rate 14 medical conditions and 8 traits of patients on the perceived challenge using a Likert scale (1: 'not challenging at all' to 10: 'extremely challenging')...
May 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29734944/barriers-and-facilitators-to-hpv-vaccination-in-primary-care-practices-a-mixed-methods-study-using-the-consolidated-framework-for-implementation-research
#20
Jane M Garbutt, Sherry Dodd, Emily Walling, Amanda A Lee, Katharine Kulka, Rebecca Lobb
BACKGROUND: In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2-3 dose HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting could inform effective implementation strategies...
May 7, 2018: BMC Family Practice
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