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https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#1
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334936/satisfaction-with-general-practice-care-in-german-patients-with-multimorbidity-a-cross-sectional-study
#2
Achim Mortsiefer, Attila Altiner, Annette Ernst, Hanna Kadusziewicz, Alice Krahe, Christine Mellert, Ingmar Schäfer, Carl-Otto Stolzenbach, Birgitt Wiese, Christin Löffler
Background.: Little is known about the quality of general practice care received by patients suffering from multimorbidity. Objectives.: To assess how patients with multimorbidity evaluate their General Practitioners (GPs') performance and to identify factors associated with high patient satisfaction levels. Methods.: Cross-sectional study in Germany using the EUROPEP questionnaire consisting of 23 items with a five-point Likert scale and covering two dimensions: clinical performance of the GP and organisation of care...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334728/does-emergency-presentation-of-cancer-represent-poor-performance-in-primary-care-insights-from-a-novel-analysis-of-linked-primary-and-secondary-care-data
#3
Peter Murchie, Sarah M Smith, Michael S Yule, Rosalind Adam, Melanie E Turner, Amanda J Lee, Shona Fielding
BACKGROUND: People diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand. METHODS: Analysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation...
March 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28334653/the-impact-of-transitions-in-insurance-coverage-on-gp-visiting-among-children-in-ireland
#4
Anne Nolan, Richard Layte
The use of direct out-of-pocket payments to finance general practitioner (GP) care by the majority of the population in Ireland is unusual in a European context. Currently, approximately 40 per cent of the population have means-tested access to free GP care, while the remainder must pay the full out-of-pocket cost. In this paper, we use nationally representative data from the Growing up in Ireland (GUI) study to examine the impact of transitions in insurance coverage on GP utilisation among children. GUI surveys two cohorts of nearly 20,000 children (aged 9 months and 9 years at baseline); we use data from the first two waves of each cohort (which covers the period 2007-2012)...
March 16, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28333982/understanding-health-policy-leaders-training-needs
#5
Carey Roth Bayer, L Lerissa Smith, Renée Volny Darko, Marissa McKool, Fengxia Yan, Harry Heiman
PURPOSE: We assessed the training needs of health policy leaders and practitioners across career stages; identified areas of core content for health policy training programs; and, identified training modalities for health policy leaders. METHODS: We convened a focus group of health policy leaders at varying career stages to inform the development of the Health Policy Leaders' Training Needs Assessment tool. We piloted and distributed the tool electronically. We used descriptive statistics and thematic coding for analysis...
2017: PloS One
https://www.readbyqxmd.com/read/28332007/rethinking-critical-reflection-on-care-late-modern-uncertainty-and-the-implications-for-care-ethics
#6
Frans Vosman, Alistair Niemeijer
Care ethics as initiated by Gilligan, Held, Tronto and others (in the nineteen eighties and nineties) has from its onset been critical towards ethical concepts established in modernity, like 'autonomy', alternatively proposing to think from within relationships and to pay attention to power. In this article the question is raised whether renewal in this same critical vein is necessary and possible as late modern circumstances require rethinking the care ethical inquiry. Two late modern realities that invite to rethink care ethics are complexity and precariousness...
March 22, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28331631/improving-medication-management-for-patients-with-multimorbidity-in-primary-care-a-qualitative-feasibility-study-of-the-my-comrade-implementation-intervention
#7
Carol Sinnott, Molly Byrne, Colin P Bradley
BACKGROUND: For the majority of patients with multimorbidity, the prescription of multiple long-term medications (polypharmacy) is indicated. However, polypharmacy poses a risk of adverse drug events, drug interactions and excessive treatment burdens. To help general practitioners (GPs) conduct more comprehensive medication reviews for patients with multimorbidity, we developed the theoretically-informed MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) implementation intervention...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28331569/an-unusual-diagnosis-for-persistent%C3%A2-diarrhoea-and-vomiting
#8
James Nott, Asad Khan, Ravi Madhotra, George MacFaul, Kamran Rostami
Identifying the etiology of chronic diarrhoea might be challenging in some patients, and before a diagnosis is made these patients may spend a substantial length of time with unresolved symptoms leading to uncertainty and anxiety that is severely impairing their life quality. A 45-year-old female was referred by her general practitioner with a 5-year history of increasingly frequent episodes of cyclical diarrhoea, vomiting, abdominal pain and intermittent palpitations. Contrast CT Abdomen/Pelvis revealed a 36x33x46 mm mass in the aorto caval region of her retro-peritoneum, just above the bifurcation...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28331268/executive-summary-the%C3%A2-association-of-colon-rectal-surgeons-of-india-acrsi-practice-guidelines-for-the-management-of-haemorrhoids-2016
#9
REVIEW
Niranjan Agarwal, Kumkum Singh, Parvez Sheikh, Kushal Mittal, Varughese Mathai, Ashok Kumar
This paper outlines the recommendations from the Association of Colon & Rectal Surgeons of India (ACRSI) practice guidelines for the management of haemorrhoids-2016. It includes diagnosis and management of haemorrhoids including dietary, non-surgical, and surgical techniques. These guidelines are intended for the use of general practitioners, general surgeons, colorectal surgeons, and gastrointestinal surgeons in India.
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28330830/rates-delays-and-completeness-of-general-practitioners-responses-to-a-postal-versus-web-based-survey-a-randomized-trial
#10
Paul Sebo, Hubert Maisonneuve, Bernard Cerutti, Jean Pascal Fournier, Nicolas Senn, Dagmar M Haller
BACKGROUND: Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs). OBJECTIVE: Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs' preventive practices. METHODS: This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015...
March 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28330570/-information-quality-in-general-public-french-speaking-websites-dedicated-to-oral-cancer-detection
#11
A Vivien, V Kowalski, A Chatellier, E Babin, H Bénateau, A Veyssière
INTRODUCTION: The goal set by the French highest national authorities in the 2014-2019 Cancer Plan is to "heal more sick persons by promoting early diagnosis through screening". Screening requires information. Nowadays, Internet allows for access to information "in one click". The aim of our study was to evaluate the quality of information found on the Internet. MATERIALS AND METHODS: Several sites dedicated to oral cavity cancer screening were selected on Google...
February 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28330535/-advantages-and-disadvantages-of-direct-to-consumer-genetic-tests
#12
Camilla Worm Christiansen, Anne-Marie Axø Gerdes
Direct-to-consumer genetic tests are sold over the internet to consumers all over the world - including Denmark. No regulation of these tests has been introduced neither in Denmark nor in Europe, even though they have been on the market since 2007. Such tests have several advantages, but indeed also a long list of potential disadvantages, which are most often ignored, and among these is insufficient training of general practitioners in performing the necessary counselling but also the risk of increased expenses to unnecessary follow-up consultations...
March 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28330490/explaining-culturally-and-linguistically-diverse-cald-parents-access-of-healthcare-services-for-developmental-surveillance-and-anticipatory-guidance-qualitative-findings-from-the-watch-me-grow-study
#13
Pankaj Garg, My Trinh Ha, John Eastwood, Susan Harvey, Sue Woolfenden, Elisabeth Murphy, Cheryl Dissanayake, Bin Jalaludin, Katrina Williams, Anne McKenzie, Stewart Einfeld, Natalie Silove, Kate Short, Valsamma Eapen
BACKGROUND: Regular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry. However, there are few published reports from Australian culturally and linguistically diverse (CALD) communities exploring parents' experiences for accessing child health surveillance programs. This paper aims to describe and explain parental experiences for accessing developmental surveillance and anticipatory guidance for children...
March 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28329898/-analysis-of-secondary-data-to-determine-the-prevalence%C3%A2-of%C3%A2-cardiovascular-high-risk-patients-with-hypercholesterolemia-and-refractory-course-of-treatment
#14
Franz-Werner Dippel, Klaus G Parhofer, Thomas Müller-Bohn, Steffen Gebhardt, Karel Kostev
Background Hypercholesterolemia plays a causal role in the development of cardiovascular diseases. Patients are affected differently. There is a lack of epidemiological data about the frequence and characteristics of patients in Germany, especially about those who do not respond sufficiently to high intensity statins with or without other lipid modifying therapies. Methods From more than 2.6 million patient records of office based general practitioners, patients with hypercholestrolemia and high cardiovascular risk, who do not reach their individual LDL-C goal despite a best supplied twelve month maximum lipid lowering therapy (MPR ≥ 80 %), were extracted from the database...
March 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28329647/histological-completeness-of-bss-excisions-by-dermatologists-plastic-surgeons-and-general-practitioners
#15
Kirtie Hr Ramdas, Lotte B Van Lee, Samuel Beck, Vincent Noordhoek Hegt, Tamar Nijsten, Renate Van den Bos
OBJECTIVESFirst to determine the proportion of incompletely excised basal cell carcinomas (BCCs) treated by conventional excision by dermatologists, plastic surgeons and general practitioners. Second to identify characteristics of incomplete excised BCCs.METHODSAnalysis of pathology reports of 3005 primary BCC excisions by general practitioners (31%), dermatologists (34%) and plastic surgeons (35%) from an urbanized area in the South West of the Netherlands from 2008-2014. Chi-square test and independent T-tests were used to analyze the primary outcome...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#16
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28328531/provider-variability-in-the-initial-diagnosis-and-treatment-of-congenital-hypothyroidism
#17
Luke Cielonko, Tyler Hamby, John S Dallas, Luke Hamilton, Don P Wilson
BACKGROUND: Early diagnosis and expeditious treatment of newborns with congenital hypothyroidism (CH) is necessary to avoid mental retardation. METHODS: A survey of 44 practitioners in the southern US was conducted to better understand common practices regarding neonatal CH and the findings were compared with current guidelines in the US and Europe. RESULTS: Responses indicated some consensus that 10-15 μg of thyroid hormone/kg/day was the appropriate dosage...
March 22, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28327382/health-assessment-instruments-for-people-with-intellectual-disabilities-a-systematic-review
#18
REVIEW
E J Bakker-van Gijssel, P L B J Lucassen, T C Olde Hartman, L van Son, W J J Assendelft, H M J van Schrojenstein Lantman-de Valk
BACKGROUND: People with intellectual disabilities (ID) experience health disparities and are less likely to undergo recommended age- and gender-specific screening and health promotion. New diagnoses are frequently missed. Assessments with the aid of health assessment instruments are a way to address these problems. AIM: The aim of this review is to find the available health assessment instruments for people with ID used in primary care and evaluate their quality...
March 16, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28327186/clinical-behavioural-and-pharmacogenomic-factors-influencing-the-response-to-levothyroxine-therapy-in-patients-with-primary-hypothyroidism-protocol-for-a-systematic-review
#19
Rosie Dew, Onyebuchi Okosieme, Colin Dayan, Vinay Eligar, Ishrat Khan, Salman Razvi, Simon Pearce, Scott Wilkes
BACKGROUND: Suboptimal thyroid hormone therapy including under-replacement and over-replacement is common amongst patients with hypothyroidism. This is a significant health concern as affected patients are at risk of adverse cardiovascular or metabolic consequences. Despite a growing body of evidence on the effects of various factors on thyroid hormone replacement, a systematic appraisal of the evidence is lacking. This review aims to appraise and quantify the extent to which clinical, behavioural and pharmacogenomic factors affect levothyroxine therapy in patients with primary hypothyroidism...
March 21, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28327139/association-of-admission-and-patient-characteristics-with-quality-of-discharge-letters-posthoc-analysis-of-a-retrospective-study
#20
Maaike Langelaan, Rebecca J Baines, Martine C de Bruijne, Cordula Wagner
BACKGROUND: A complete, correct and timely discharge letter can communicate important information from the hospital to the general practitioner. The adequacy of the letter may vary with the patient and admission characteristics of the patient. Insight in the association between these characteristics and the presence and quality of the discharge letter will give rise to improvement activities for a better continuity of care after discharge. The objective was to determine the presence, correctness and timeliness of admission information in discharge letters and to determine the association between patient and admission characteristics, including unplanned readmissions and the quality of the discharge letter...
March 21, 2017: BMC Health Services Research
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