Studies of the symptom dyspnoea: A systematic review
Background: To deal with patients suffering from dyspnoea, it is crucial for general practitioners to know the prevalences of different diseases causing dyspnoea in the respective area and season, the likelihood of avoidable life-threatening conditions and of worsening or recovery from disease.AimAim of our project was to conduct a systematic review of symptom-evaluating studies on the prevalence, aetiology, and prognosis of dyspnoea as presented to GPs in a primary care setting. Methods: We did a systematic review of symptom-evaluating studies on dyspnoea in primary care. For this we included all studies investigating the...
Source: BMC Family Practice - October 24, 2015 Category: Primary Care Authors: Annika ViniolDominik BeidatschThomas FreseMilena BergmannPaula GrevenrathLaura SchmidtSonja SchwarmJörg HaasenritterStefan BösnerAnnette Becker Source Type: research

Feasibility of automated pre-screening for lifestyle and behavioral health risk factors in primary care
Conclusions: The percent endorsement for each behavioral health concern was generally consistent with studies of screening using other methods, and contrasts starkly with the reported low rates of screening and intervention for such concerns in typical PC practice. Results support the feasibility of IVR-based, large-scale pre-appointment behavioral health/ lifestyle risk factor screening of primary care patients. Pre-screening in this population facilitated participation in a controlled trial of brief treatment for unhealthy drinking, and also could be valuable clinically because it allows for case identification and manag...
Source: BMC Family Practice - October 23, 2015 Category: Primary Care Authors: Gail RoseTonya FerraroJoan SkellyGary BadgerCharles MacLeanTera FazzinoJohn Helzer Source Type: research

Impact of health literacy, accessibility and coordination of care on patient’s satisfaction with primary care in Germany
Background: Although health policy makers call for the transformation of health care organizations to health literacy responsive ones, there is limited evidence on the care experiences of patients with limited health literacy skills (HL) in respect to health care quality. We explored if HL and patient-reported experiences regarding access to care and support in care-coordination in primary care organizations (PCO) have an impact on patients satisfaction with the care received by their personal general practitioner (GP). Methods: A nationwide representative survey was administered in a random sample of 1125 German adults. B...
Source: BMC Family Practice - October 22, 2015 Category: Primary Care Authors: Sibel AltinStephanie Stock Source Type: research

Generalized anxiety disorder in primary care: mental health services use and treatment adequacy
Conclusions: This study suggests that further efforts towards GAD detection could lead to an increase in the delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow up of patients with a GAD medication and access to psychotherapy from the primary care setting. (Source: BMC Family Practice)
Source: BMC Family Practice - October 22, 2015 Category: Primary Care Authors: Pasquale RobergeFrançois Normand-LauzièreIsabelle RaymondMireille LucMarie-Michèle Tanguay-BernardArnaud DuhouxChristian BoctiLouise Fournier Source Type: research

Interventions to improve adherence to cardiovascular disease guidelines: a systematic review
Conclusions: Many interventions show promise to improve practitioner adherence to CVD guidelines. The quality of evidence and number of trials limited our ability to draw conclusions. (Source: BMC Family Practice)
Source: BMC Family Practice - October 22, 2015 Category: Primary Care Authors: Rebecca A. JefferyMatthew ToGabrielle Hayduk-CostaAdam CameronCameron TaylorColin Van ZoostJill A. Hayden Source Type: research

The ‘vicious cycle’ of personalised asthma action plan implementation in primary care: a qualitative study of patients and health professionals’ views
Conclusions: Primary care PAAP implementation is in a vicious cycle. Professionals infrequently review/update PAAPs with patients; patients with out-dated PAAPs do not value or use these; professionals observing patients’ lack of interest in PAAPs do not discuss these. Patients observing this do not refer to their plans and perceive them to be of little value in asthma self-management. Twenty-five years after PAAPs were first recommended, primary care practices are still not ready to support their implementation. Breaking this vicious cycle to create a healthcare context more conducive to PAAP implementation requires...
Source: BMC Family Practice - October 21, 2015 Category: Primary Care Authors: Nicola RingHazel BoothCaroline WilsonGaylor HoskinsHilary PinnockAziz SheikhRuth Jepson Source Type: research

Lessons learned from England’s Health Checks Programme: using qualitative research to identify and share best practice
Conclusions: The everyday experiences of practitioners who participated in this study suggest that overall, Health Check is perceived as a worthwhile exercise. But, organisational and structural barriers need to be addressed. We also recommend that clear referral pathways be in place so staff can refer patients to appropriate services (healthy eating sessions, smoking cessation, and exercise referrals). Local authorities need to support initiatives that enable data sharing and linkage so that GP Practices are informed when patients take up services such as smoking cessation or alcohol harm reduction programmes run by socia...
Source: BMC Family Practice - October 20, 2015 Category: Primary Care Authors: Hanif IsmailShona Kelly Source Type: research

Cancer survivors’ perspectives on delivery of survivorship care by primary care physicians: an internet-based survey
This study aims to evaluate cancer survivors’ perspectives on PCP-delivered survivorship care. Methods: We conducted an Internet-based cross-sectional survey of cancer survivors via www.OncoLink.org. Regression analyses were used to identify factors associated with perception of PCP-delivered survivorship care. Results: The 352 respondents rated overall PCP-delivered survivorship care as 60 out of 100 (SD = 23). The areas of care most strongly endorsed were general care (62 %), psychosocial support (65 %), and holistic care (68 %). Survivors were less likely to perceive their PCPs as know...
Source: BMC Family Practice - October 20, 2015 Category: Primary Care Authors: Ernestina NyarkoJames MetzGiang NguyenMargaret HampshireLinda JacobsJun Mao Source Type: research

Revealing hidden depression in older people: a qualitative study within a randomised controlled trial
Conclusions: Depression in older people is commonly hidden, and may coexist with physical conditions that are prioritised by both patients and GPs. Being invited to participate in a trial about depression may allow older people to disclose their feelings, name the problem, and seek help. Offering older people an opportunity to talk outside the primary care consultation is valued by patients and GPs. A psychosocial intervention delivered by a case manager in the primary care setting may fill the gap in the care of older people with depression.Trial registrationCurrent Controlled Trials ISRCTN45842879. (Source: BMC Family Practice)
Source: BMC Family Practice - October 19, 2015 Category: Primary Care Authors: Karen OverendKatharine BosanquetDella BaileyDeborah FosterSamantha GascoyneHelen LewisSarah NutbrownRebecca WoodhouseSimon GilbodyCarolyn Chew-Graham Source Type: research

Retaining the general practitioner workforce in England: what matters to GPs? A cross-sectional study
Conclusions: New models of professionalism and organisational arrangements may be needed to address the issues described here. Without urgent action, the GP workforce crisis in England seems set to worsen. (Source: BMC Family Practice)
Source: BMC Family Practice - October 16, 2015 Category: Primary Care Authors: Jeremy DaleRachel PotterKatherine OwenNicholas ParsonsAlba RealpeJonathan Leach Source Type: research

Exposure to and experiences with a computerized decision support intervention in primary care: results from a process evaluation
Conclusions: Several types of barriers may have negatively affected the impact of the intervention. Although users are generally positive about CDSSs, a large share of them is insufficiently aware of the functions of NHGDoc and, finds the decision support not always useful or relevant and difficult to integrate into daily practice. In designing CDSS interventions we suggest to more intensely involve the end-users and increase the system’s flexibility and learning capacity. To improve implementation a proper introduction of a CDSS among its target group including adequate training is advocated.Trial registrationClinic...
Source: BMC Family Practice - October 16, 2015 Category: Primary Care Authors: Marjolein LugtenbergDennis PasveerTrudy van der WeijdenGert WestertRudolf Kool Source Type: research

Challenges of managing people with multimorbidity in today’s healthcare systems
Multimorbidity is a growing issue and poses a major challenge to health care systems around the world. Multimorbidity is related to ageing but many studies have now shown that it is also socially patterned, being more common and occurring at an earlier age in areas of high socioeconomic deprivation. There is lack of research on patients with multimorbidity, and thus guidelines are based on single-conditions. Polypharmacy is common in multimorbidity, increasing drug-disease and drug-drug interactions. Multimorbid patients need holistic care, but secondary care services are highly specialised and thus are often duplicative a...
Source: BMC Family Practice - October 14, 2015 Category: Primary Care Authors: Keith MoffatStewart Mercer Source Type: research

Barriers and facilitators to primary care for people with mental health and/or substance use issues: a qualitative study
Conclusions: This study helps elucidate the mechanisms behind poor primary health care access among people with substance use and/or mental health issues. The results suggest that interdisciplinary, collaborative models of primary healthcare may improve accessibility and quality of care for this population, and that more education about mental health and substance use issues may be needed to support service providers in providing adequate care for their clients. (Source: BMC Family Practice)
Source: BMC Family Practice - October 13, 2015 Category: Primary Care Authors: Lori RossSimone VigodJessica WishartMyera WaeseJason SpenceJason OliverJennifer ChambersScott AndersonRoslyn Shields Source Type: research

Assessment of patient safety culture in primary care setting, Al-Mukala, Yemen
Conclusions: Although patient safety culture in Al-Mukala primary care setting is generally positive, patient safety and quality rating were fairly low. Implementation of a safety and quality management system in Al-Mukala primary care setting are paramount. Further research is needed to confirm the applicability of the Medical Office Survey on Patient Safety Culture (MOSPSC) for Al-Mukala primary care. (Source: BMC Family Practice)
Source: BMC Family Practice - October 13, 2015 Category: Primary Care Authors: Hana WebairSalwa Al-assaniReema Al-haddadWafa Al-ShaeebManal Bin SelmAbdulla Alyamani Source Type: research

Does patient’s sex influence treatment in primary care? Experiences and expressed knowledge among physicians – a qualitative study
Conclusions: The GPs stated they had little knowledge of sex and gender differences in drug treatment, but gave multiple examples of how the patient’s sex affects the choice of treatment. Sex and gender aspects were considered in diagnosing and in the treatment decision. However, once the decision to treat was made the choice of drug followed recommendations by local Drug and Therapeutics Committee, which were perceived to be evidence-based. In the analysis we found a gap between perceived and expressed knowledge of sex and gender differences in drug treatment indicating a need of education about this to be included ...
Source: BMC Family Practice - October 13, 2015 Category: Primary Care Authors: Desirée LoikasLinnéa KarlssonMia von EulerKarin HallgrenKarin Schenck-GustafssonPia Bastholm Rahmner Source Type: research

Recommendations to facilitate the ideal fit note: are they achievable in practice?
Conclusions: This study demonstrated that although many recommendations for the ideal fit note are considered achievable, there are considerable financial, legal, organisational and professional obstacles to be overcome in order for the recommendations to be implemented successfully. (Source: BMC Family Practice)
Source: BMC Family Practice - October 13, 2015 Category: Primary Care Authors: Carol CooleFiona NouriIskra PotgieterPaul WatsonLouise ThomsonRob HamptonAvril Drummond Source Type: research

Primary healthcare needs and barriers to care among Calgary’s homeless populations
Conclusions: Our findings highlight the diverse primary health care needs of Calgary’s homeless populations. Despite the fact that Canada has a universal publicly funded health care system, individuals experiencing homelessness face significant barriers in accessing primary care. (Source: BMC Family Practice)
Source: BMC Family Practice - October 13, 2015 Category: Primary Care Authors: David CampbellBraden O¿NeillKatherine GibsonWilfreda Thurston Source Type: research

Eligibility for interventions, co-occurrence and risk factors for unhealthy behaviours in patients consulting for routine primary care: results from the Pre-Empt study
Conclusion: Very few patients consulting for routine primary care screen ineligible for interventions about common unhealthy behaviours, and most engage in more than one of the major common unhealthy behaviours. Clinicians should be particularly alert to opportunities to engaging younger, non professional men and those with multi-morbidity about risky health behaviour.Trial registrationISRCTN22495456 (Source: BMC Family Practice)
Source: BMC Family Practice - October 9, 2015 Category: Primary Care Authors: Elizabeth RandellTimothy PicklesSharon SimpsonClio SpanouJim McCambridgeKerenza HoodChristopher Butler Source Type: research

Rationale, design and baseline results of the Treatment Optimisation in Primary care of Heart failure in the Utrecht region (TOPHU) study: a cluster randomised controlled trial
In this study we assess the effect of a single training of GPs in the pharmacological management of patients with HF.Methods/designA cluster randomised controlled trial. Thirty primary care practices are randomly assigned to care as usual or intervention defined as a single training in the up-titration and management of HF drug therapy according to the heart failure guidelines of the European Society of Cardiology (ESC). Patients with a GP’s diagnosis of HF will be re-evaluated by an expert panel of two cardiologists and a GP with expertise in HF to come to a definite diagnosis of HF according to the ESC heart failur...
Source: BMC Family Practice - October 7, 2015 Category: Primary Care Authors: Mark ValkArno HoesArend MosterdMarcel LandmanBerna BroekhuizenFrans Rutten Source Type: research

Ethnic differences in the association between depression and chronic pain: cross sectional results from UK Biobank
Conclusions: Chronic pain and depression reporting varies across ethnic groups. Differences in health seeking behaviour between ethnic groups may impact on the results reported. Clinicians, particularly in primary care, need to be aware of the cultural barriers within certain ethic groups to expressing concern over mood and to consider their approach accordingly. (Source: BMC Family Practice)
Source: BMC Family Practice - October 6, 2015 Category: Primary Care Authors: Barbara NichollDaniel SmithBreda CullenDaniel MackayJonathan EvansJana AndersonDonald LyallChloe Fawns-RitchieAndrew McIntoshIan DearyJill PellFrances Mair Source Type: research

Erratum to: Symptom attributions in patients with colorectal cancer
No description available (Source: BMC Family Practice)
Source: BMC Family Practice - October 5, 2015 Category: Primary Care Authors: Line JensenLine HvidbergAnette PedersenPeter Vedsted Source Type: research

Training general practitioners in early identification and anticipatory palliative care planning: a randomized controlled trial
Background: Most patients with advanced cancer, debilitating COPD or chronic heart failure (CHF) live at home. General practitioners (GPs) asked for guidance in how to recognize patients in need of palliative care in a timely way and to structure anticipatory care. For that reason, we developed a training for GPs in identifying patients in need of palliative care and in structuring anticipatory palliative care planning and studied its effect on out-of-hours contacts, contacts with their own GP, hospitalizations and place of death. Methods: We performed a cluster randomised controlled trial. GPs in the intervention group we...
Source: BMC Family Practice - September 22, 2015 Category: Primary Care Authors: Bregje ThoonsenKris VissersS. VerhagenJ. PrinsH. BorC. van WeelM. GrootY. Engels Source Type: research

What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?
Conclusion: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes. (Source: BMC Family Practice)
Source: BMC Family Practice - September 17, 2015 Category: Primary Care Authors: JY Le ResteP. NabbeH. LingnerD. Kasuba LazicR. AssenovaM. MunozA. SowinskaC. LygidakisC. DoerrS. CzachowskiS. ArgyriadouJ. ValderasB. Le FlochJ. DeriennicT. JanE. MelotP. BarraineM. OdoricoC. LietardP. Van RoyenH. Van Marwijk Source Type: research

Chronically ill patients’ self-management abilities to maintain overall well-being: what is needed to take the next step in the primary care setting?
Conclusions: These findings suggest that patient–professional interaction is not yet sufficiently productive to successfully protect against the deterioration of self-management abilities in some groups of chronically ill patients, although such interaction and high-quality care are important factors in such protection. Improvement of the quality of chronic care delivery should thus always be accompanied by investment in high-quality communication and patient–professional relationships. (Source: BMC Family Practice)
Source: BMC Family Practice - September 15, 2015 Category: Primary Care Authors: Jane CrammAnna Nieboer Source Type: research

Impact of medication adherence on renal function in comorbid patients with type 2 diabetes and depression: protocol for a cohort study
DiscussionTo our knowledge, this will be the first study to examine how adherence to hypoglycemic medication relates to the decline of renal function in comorbid patients with type 2 diabetes and depression. The results of the study will have implications for practitioners of diabetes care, policy makers, and researchers for the prevention and treatment of diabetic nephropathy.Trial registrationUMIN000017513 (Registered on May 22, 2015)  (Source: BMC Family Practice)
Source: BMC Family Practice - September 15, 2015 Category: Primary Care Authors: Hiroto ItoTosiya SatoNoriko Satoh-AsaharaMitsuhiko Noda Source Type: research

Understanding long-term opioid prescribing for non-cancer pain in primary care: a qualitative study
Conclusions: Problematic prescribing occurs when patients experience repeated consultations that do not meet their needs and GPs feel unable to negotiate alternative approaches to treatment. Therapeutic short-termism is perpetuated by inconsistent clinical encounters and the absence of mutually-agreed formulations of underlying problems and plans of action. Apart from commissioning improved access to appropriate specialist services, general practices should also consider how they manage problematic opioid prescribing and be prepared to set boundaries with patients. (Source: BMC Family Practice)
Source: BMC Family Practice - September 11, 2015 Category: Primary Care Authors: Carolyn McCrorieS. ClossAllan HouseDuncan PettyLucy ZieglerLiz GlidewellRobert WestRobbie Foy Source Type: research

Development and validation of a brief screener to measure the Health Literacy Responsiveness of Primary Care Practices (HLPC)
Conclusions: The HLPC is a valid screener to provide insights in the extent of the utilization of health literacy strategies in primary care practices. (Source: BMC Family Practice)
Source: BMC Family Practice - September 11, 2015 Category: Primary Care Authors: Sibel AltinKristina LorrekStephanie Stock Source Type: research

Rhinosinusitis in morbidity registrations in Dutch General Practice: a retro-spective case-control study
Conclusions: Rhinosinusitis is a common diagnosis in primary practice. In the used registries no difference could be made between acute and chronic rhinosinusitis, but they give insight in comorbidity and interventions taken by the GP in case of rhinosinusitis. (Source: BMC Family Practice)
Source: BMC Family Practice - September 11, 2015 Category: Primary Care Authors: Ruth HoffmansTjard SchermerKarin van der LindeHans BorKees van BovenChris van WeelWytske Fokkens Source Type: research

Patients' views and experiences of technology based self-management tools for the treatment of hypertension in the community: A qualitative study
Conclusions: Newer technologies such as mobile devices and the internet have been embraced across the globe despite technological challenges and concerns regarding privacy and security. In the design and development of technology based self-management tools for the treatment of hypertension, flexibility and security are vital to allow and encourage patients to customise, personalise and engage with their devices. (Source: BMC Family Practice)
Source: BMC Family Practice - September 9, 2015 Category: Primary Care Authors: Liam GlynnMonica CaseyJane WalshPatrick HayesRichard HarteDavid Heaney Source Type: research

Healthcare system intervention for safer use of medicines in elderly patients in primary care—a qualitative study of the participants’ perceptions of self-assessment, peer review, feedback and agreement for change
Conclusions: This study shows that our studied intervention method is feasible to use in primary care and that the multi-professional approach was perceived as being very positive by the participants. Multi-professional co-operation was time consuming, but was also deemed as an investment and an opportunity to share knowledge. Some points of improvement of the method were identified such as simplification of the self-assessment form and clearer instructions for reviewers. In addition, to have an impact on work the focus must lie in areas within the primary care units’ scope. (Source: BMC Family Practice)
Source: BMC Family Practice - September 4, 2015 Category: Primary Care Authors: Cecilia LenanderÅsa BondessonPatrik MidlövNina Viberg Source Type: research

Symptom attributions in patients with colorectal cancer
Conclusions: Symptom attribution in patients was associated with aspects of socio-demography and with the symptom type perceived by the patient as the most important. No significant associations were found between symptom attributions and patient interval. These results have implications for general practice as symptom attributions may prompt patients to present symptoms in a certain way and thereby influence the general practitioner’s assessment of presented symptoms. (Source: BMC Family Practice)
Source: BMC Family Practice - September 3, 2015 Category: Primary Care Authors: Line JensenLine HvidbergAnette PedersenPeter Vedsted Source Type: research

The Heart Health Study - increasing cardiovascular risk assessment in family practice for first degree relatives of patients with premature ischaemic heart disease: a randomised controlled trial
This study aimed to increase cardiovascular disease (CVD) risk assessment in adult first degree relatives of patients with premature ischaemic heart disease (PIHD) using written and verbal advice. Methods: Design: A prospective, randomised controlled trial. Setting: Cardiovascular wards at three South Australian hospitals. Cardiovascular risk assessments were performed in general practice. Participants: Patients experiencing PIHD (heart disease in men aged (Source: BMC Family Practice)
Source: BMC Family Practice - September 3, 2015 Category: Primary Care Authors: Nigel StocksJessica BroadbentMichelle LorimerPhilip TidemanDerek ChewGary WittertPhilip Ryan Source Type: research

Access to healthcare for long-term conditions in women involved in street-based prostitution: a qualitative study
Conclusion: This study highlights the unmet health needs of women who work in SBP, not just related to their occupation, but due to their co-morbid long-term conditions. Access to primary care was reported to be problematic and interactions with general practitioners not fulfilling their expectations, which impacted on future consultation behaviour. Understanding the health-seeking behaviours and self-management strategies of women involved in SBP with chronic health problems is essential in the design and commissioning of services and may reduce unscheduled care in this under-served group. (Source: BMC Family Practice)
Source: BMC Family Practice - September 3, 2015 Category: Primary Care Authors: Emma MastrocolaAnna TaylorCarolyn Chew-Graham Source Type: research

Modelling self-management pathways for people with diabetes in primary care
Conclusions: The model provides a clear visual picture of the complexities implicated in achieving optimal self-management support. Self-management is quickly hidden from view in a system orientated to treatment delivery rather than to enhancing patient self-management. The model created highlights the limited self-management support currently provided and illuminates points where service change might impact on providing support for self-management. Ensuring professionals are aware of locally available support and people’s existing network support has potential to provide appropriate and timely direction to community...
Source: BMC Family Practice - September 2, 2015 Category: Primary Care Authors: Marion PennAnne KennedyIvaylo VassilevCarolyn Chew-GrahamJoanne ProtheroeAnne RogersTom Monks Source Type: research

Evaluation of reliability and validity of the General Practice Physical Activity Questionnaire (GPPAQ) in 60–74 year old primary care patients
Conclusions: GPPAQ has reasonable reliability but results from this study measuring validity in older adults indicates poor agreement with objective accelerometry for accurately identifying physical activity levels. Including brisk walking in GPPAQ increased sensitivity, but reduced specificity and did not improve overall screening performance. GPPAQ’s use in National Health Service health checks in primary care in this age group cannot therefore be supported by this validity study comparing to accelerometry. (Source: BMC Family Practice)
Source: BMC Family Practice - September 2, 2015 Category: Primary Care Authors: Shaleen AhmadTess HarrisElizabeth LimbSally KerryChristina VictorUlf EkelundSteve IliffePeter WhincupCarole BeightonMichael UssherDerek Cook Source Type: research

When the phone rings - factors influencing its impact on the experience of patients and healthcare workers during primary care consultation: a qualitative study
Conclusion: Phone interruptions affected patient and HCW interaction during consultations and factors leading to their adverse reactions need to be recognized and addressed. (Source: BMC Family Practice)
Source: BMC Family Practice - September 2, 2015 Category: Primary Care Authors: A. KoongD. KootS. EngA. PuraniA. YusoffC. GohS. TeoN. Tan Source Type: research

“It is meaningful; I feel that I can make a difference” -A qualitative study about GPs’ experiences of work at nursing homes in Sweden
Conclusion: Working with NH patients was considered important and meaningful, with the GPs striving for the patient’s well-being with special consideration to the continuum of ageing. A continuous and well-functioning relationship between the GP and the nurse was crucial for the patients´ well-being. (Source: BMC Family Practice)
Source: BMC Family Practice - August 28, 2015 Category: Primary Care Authors: Beata BolmsjöEva StrandbergPatrik MidlövAnnika Brorsson Source Type: research

Sequential Simulation (SqS): an innovative approach to educating GP receptionists about integrated care via a patient journey – a mixed methods approach
Conclusion: SqS is an innovative and practical way of presenting current care pathways and health care scenarios in order to create a shared focus, engage the emotions of the participants and bring the principles of integrated care to life. Facilitated table discussions are an opportunity to see events from multiple perspectives, share reactions and ideas, and practise co-producing service reforms with patients. We believe this approach is a useful way of preparing front-line staff to participate in integrated care. (Source: BMC Family Practice)
Source: BMC Family Practice - August 27, 2015 Category: Primary Care Authors: Sharon-Marie WeldonShvaita RalhanElisabeth PaiceRoger KneeboneFernando Bello Source Type: research

Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis
Conclusions: Multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs, for adults with intellectual disabilities compared with the general population. There is no association with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities. (Source: BMC Family Practice)
Source: BMC Family Practice - August 27, 2015 Category: Primary Care Authors: Sally-Ann CooperGary McLeanBruce GuthrieAlex McConnachieStewart MercerFrank SullivanJill Morrison Source Type: research

Patient and practitioners’ views on the most important outcomes arising from primary care consultations: a qualitative study
Conclusions: No existing PROM captures all these outcomes. For example, many health empowerment PROMs do not consider patient preference on empowerment. Many health status tools are not responsive to changes resulting from primary care. Health perceptions PROMs have generally been designed for measuring personality traits rather than outcomes.This study provides a platform for designing a new PROM containing outcomes that matter to patients and can be influenced by primary care. Such a PROM would greatly enhance the value of primary care research. (Source: BMC Family Practice)
Source: BMC Family Practice - August 22, 2015 Category: Primary Care Authors: Mairead MurphySandra HollinghurstKatrina TurnerChris Salisbury Source Type: research

Implementation of integrated care for diabetes mellitus type 2 by two Dutch care groups: a case study
Conclusions: Dutch integrated diabetes care is still a work in progress, in the academic and the practice setting. This makes it difficult to establish whether overall quality of care has improved. Future efforts should focus on areas that this study found to be problematic or to not have received enough attention yet. Increased efforts are needed to improve the interoperability of the patient databases and to keep the negative consequences of the bundled payment system in check. Moreover, patient and community involvement should be incorporated. (Source: BMC Family Practice)
Source: BMC Family Practice - August 21, 2015 Category: Primary Care Authors: Loraine BusettoKatrien LuijkxAnna HuizingBert Vrijhoef Source Type: research

Point of care susceptibility testing in primary care - does it lead to a more appropriate prescription of antibiotics in patients with uncomplicated urinary tract infections? Protocol for a randomized controlled trial
This study aims to investigate whether POCT urine culture and susceptibility testing decreases the inappropriate use of antibiotics and leads to faster patient recovery.Methods/designRandomized controlled open label trial of two diagnostic approaches. 750 patients with symptoms of uncomplicated UTI, consecutively contacting their general practitioner (GP), randomized to either POCT urine culture and susceptibility testing and targeted treatment or POCT urine culture without susceptibility testing and empirical treatment. Treatment is started when the POCT is read. The two groups are compared with regard to appropriate choi...
Source: BMC Family Practice - August 21, 2015 Category: Primary Care Authors: Anne HolmGloria CordobaTina SørensenLisbeth JessenVolkert SiersmaLars Bjerrum Source Type: research

Primary care in Switzerland: evolution of physicians’ profile and activities in twenty years (1993–2012)
Background: According to the Organization for Economic Cooperation and Development, the Swiss healthcare system is one of the most effective in the world. Yet, as other occidental countries, it has to face the increase of chronic diseases frequency and its resulting cost, particularly for primary care (PC). However very few consistent data are available to describe PC features and its evolution over time. The aim of this study is to describe the evolution of the Swiss PC physicians’ (PCPs) profile and activities between 1993 and 2012. Methods: The date come from two independent European surveys carried out in Switzer...
Source: BMC Family Practice - August 21, 2015 Category: Primary Care Authors: Christine CohidonJacques CornuzNicolas Senn Source Type: research

Systematic review of clinical practice guidelines recommendations about primary cardiovascular disease prevention for older adults
Conclusion: Although most CVD prevention CPGs mention the older population to some extent, the information provided is vague and very limited. Older adults represent a growing proportion of the population. Guideline developers must ensure they consider older patients’ needs and provide appropriate advice to clinicians in order to support high quality care for this group. CPGs should at a minimum address the available evidence about CVD prevention for older people, and acknowledge the importance of patient involvement. (Source: BMC Family Practice)
Source: BMC Family Practice - August 20, 2015 Category: Primary Care Authors: Jesse JansenShannon McKinnCarissa BonnerLes IrwigJenny DoustPaul GlasziouBrooke NickelBarbara van MunsterKirsten McCaffery Source Type: research

Qualitative evaluation of primary care providers experiences of a training programme to offer brief behaviour change counselling on risk factors for non-communicable diseases in South Africa
Conclusions: This study showed that although training changed PCPs perception of their ability to offer BBCC, and increased their confidence to overcome certain barriers to implementation, significant barriers remained. It is clear that to incorporate BBCC into everyday care, not only training, but also a whole systems approach is needed, that involves the patient, provider, and service organisation at different levels. (Source: BMC Family Practice)
Source: BMC Family Practice - August 19, 2015 Category: Primary Care Authors: Zelra MalanRobert MashKatherine Everett-Murphy Source Type: research

Factors influencing the implementation of chronic care models: A systematic literature review
Conclusion: This systematic review demonstrated the importance of considering human factors including the influence that different stakeholders have on the success or otherwise of the implementing a CCM. (Source: BMC Family Practice)
Source: BMC Family Practice - August 19, 2015 Category: Primary Care Authors: Carol DavyJonathan BleaselHueiming LiuMaria TchanSharon PonniahAlex Brown Source Type: research

Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis
Conclusions: The limited available evidence precludes a sufficiently reliable assessment of the comparative effectiveness of psychological treatments in depressed primary care patients. Findings suggest that psychological interventions with a cognitive behavioral approach are promising, and primarily indirect evidence indicates that it applies also when they are delivered with a reduced number of therapist contacts or remotely.Systematic review registration: 01KG1012 at http://www.gesundheitsforschung-bmbf.de/de/2852.php (Source: BMC Family Practice)
Source: BMC Family Practice - August 19, 2015 Category: Primary Care Authors: Klaus LindeGerta RückerKirsten SigtermanSusanne JamilKarin MeissnerAntonius SchneiderLevente Kriston Source Type: research

General practitioners and sickness certification for injury in Australia
Conclusion: By exploring GP certification practice from the perspectives of four key stakeholders, this study suggests that certification is an administrative and clinical task underpinned by a host of social and systemic factors. The findings highlight opportunities such as practice guideline development and improvements to the sickness certificate itself that may be targeted to improve GP sickness certification behaviour and return to work outcomes in an Australian context. (Source: BMC Family Practice)
Source: BMC Family Practice - August 15, 2015 Category: Primary Care Authors: Danielle MazzaBianca BrijnathNabita SinghAgnieszka KosnyRasa RuseckaiteAlex Collie Source Type: research

Developing a computerised search to help UK General Practices identify more patients for palliative care planning: a feasibility study
Conclusions: It is possible to significantly improve the identification of patients for palliative care needs assessment using a computerised search however barriers remain to GPs’ finding it acceptable. Time-efficient systems were important as was a generic tool for anticipatory care planning not linked to ‘palliative’ care. (Source: BMC Family Practice)
Source: BMC Family Practice - August 8, 2015 Category: Primary Care Authors: Bruce MasonKirsty BoydScott MurrayJohn SteynPaul CormieMarilyn KendallDan MundayDavid WellerShirley FifePeter MurchieChristine Campbell Source Type: research

Hypertension: a cross-sectional study of the role of multimorbidity in blood pressure control
Background: Hypertension is the most prevalent cardiovascular long-term condition in the UK and is associated with a high rate of multimorbidity (MM). Multimorbidity increases with age, ethnicity and social deprivation. Previous studies have yielded conflicting findings about the relationship between MM and blood pressure (BP) control. Our aim was to investigate the relationship between multimorbidity and systolic blood pressure (SBP) in patients with hypertension. Methods: A cross-sectional analysis of anonymised primary care data was performed for a total of 299,180 adult patients of whom 31,676 (10.6 %) had a diagn...
Source: BMC Family Practice - August 7, 2015 Category: Primary Care Authors: Chandra SarkarHiten DodhiaJames CromptonPeter SchofieldPatrick WhiteChristopher MillettMark Ashworth Source Type: research