Alcohol dependence and treatment utilization in Europe – a representative cross-sectional study in primary care
Conclusion: A minority of people identified as having AD received treatment, showing heavier drinking patterns and a higher level of co-morbidity. Different types of treatment, depending on severity of AD, should be considered. (Source: BMC Family Practice)
Source: BMC Family Practice - July 29, 2015 Category: Primary Care Authors: Jürgen RehmAllaman AllamaniZsuzsanna ElekesAndrzej JakubczykJakob MantheyCharlotte ProbstPierluigi StruzzoRoberto Della VedovaAntoni GualMarcin Wojnar Source Type: research

Self-care behavior when suffering from the common cold and health-related quality of life in individuals attending an annual checkup in Japan: a cross-sectional study
Background: The World Health Organization and several governments encourage medical self-care (including self-medication) for minor illnesses. Accordingly, the factors that influence self-care have received research attention, with socioeconomic status identified as one such predictor. Although studies have examined the relationship between socioeconomic status and quality of life (QOL) in patients suffering from respiratory allergies or chronic illnesses, the relationship between QOL and self-care behavior for the common cold, the most common illness seen in primary care, has not been examined. Therefore, we investigated ...
Source: BMC Family Practice - July 29, 2015 Category: Primary Care Authors: Fumio ShakuMadoka TsutsumiAsako MiyazawaHiroshi TakagiTetsuhiro Maeno Source Type: research

Primary care nurses’ performance in motivational interviewing: a quantitative descriptive study
Conclusion: Primary care nurses did not achieve beginning proficiency/competency in all aspects of motivational interviewing in their recorded sessions with patients, where lifestyle change was discussed. This indicates a need for improvement and thus additional training, feedback and supervision in clinical practice with motivational interviewing. (Source: BMC Family Practice)
Source: BMC Family Practice - July 25, 2015 Category: Primary Care Authors: Ann-Sofi ÖstlundMarja-Leena KristofferzonElisabeth HäggströmBarbro Wadensten Source Type: research

Chest pain syndromes are associated with high rates of recidivism and costs in young United States Veterans
Background: Recurrent chest pain is common in patients with and without coronary artery disease. The prevalence and burden of these symptoms on healthcare is unknown.ObjectivesTo compare chest pain return visits (recidivism) in patients with unexplained chest pain (UCP) against reference group of patients with coronary artery disease (CAD) and estimate the annual cost of recurrent chest pain. Methods: In a retrospective cohort study, a Veteran Affairs (VA) administrative and clinical database of Veterans who were deployed to or served in support of the wars in Iraq or Afghanistan was queried for first disease specific ICD-...
Source: BMC Family Practice - July 23, 2015 Category: Primary Care Authors: Basmah SafdarJames DziuraHarini BathulapalliDouglas LeslieMelissa SkandersonCynthia BrandtSally Haskell Source Type: research

Effect evaluation of an interprofessional medication therapy management approach for multimorbid patients in primary care: a cluster-randomized controlled trial in community care (WestGem study protocol)
This study aims to provide data on the effects of an interprofessional MTM regarding quality of therapy, quality of life, costs and cost-effectiveness.Method/DesignThe study is designed as a cluster-randomized controlled trial in primary care, involving 12 outpatient clinics (clusters) and 165 patients. Primary care units are allocated to interventions using a Stepped Wedge Design. All units are initially assigned to the control group. After a 6 month observation period, general practitioners (GP) are randomly allocated to one of three groups and the interprofessional medication therapy management approach is implemen...
Source: BMC Family Practice - July 22, 2015 Category: Primary Care Authors: Olaf RoseCorinna SchaffertKathrin CzarneckiHugo MennemannIsabel WalteringStefanie HamacherMoritz FelschLena HerichJuliane Köberlein Source Type: research

‘I think positivity breeds positivity’: a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work
Conclusions: This research presents novel insights about the specific contribution made by significant others in helping their relatives with chronic musculoskeletal pain to stay at work. These findings add to the under-represented ‘social’ dimension of the biopsychosocial model currently applied to our understanding and treatment of pain, and point to harnessing support from significant others as a potentially effective management strategy. (Source: BMC Family Practice)
Source: BMC Family Practice - July 22, 2015 Category: Primary Care Authors: Serena McCluskeyHaitze de VriesMichiel RenemanJoanna BrooksSandra Brouwer Source Type: research

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community
Conclusions: For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive community -primary health care services. At present, however, pre-release planning is not always available, especially for Aboriginal inmates who are more likely to be on remand or in custody for less than six months. (Source: BMC Family Practice)
Source: BMC Family Practice - July 22, 2015 Category: Primary Care Authors: Jane LloydDea Delaney-ThielePenny AbbottEileen BaldryElizabeth McEntyreJennifer ReathDevon IndigJuanita SherwoodMark Harris Source Type: research

Assessment of the coordination of integrated health service delivery networks by the primary health care: COPAS questionnaire validation in the Brazilian context
Conclusion: The results showed that the COPAS instrument has satisfactory initial psychometric properties and may be used by healthcare managers and workers to assess the PHC coordination performance within the Integrated Health Service Delivery Network. (Source: BMC Family Practice)
Source: BMC Family Practice - July 22, 2015 Category: Primary Care Authors: Ludmila RodriguesClaudia dos SantosSueli GoyatáMarcela PopolinMellina YamamuraKeila DeonLuis LapãoMarcelino Santos NetoSeverina UchoaRicardo Arcêncio Source Type: research

Implementation of simple telehealth to manage hypertension in general practice: a service evaluation
Conclusions: Although simple telehealth may be an acceptable tool for diagnosing and monitoring hypertension among responding patient users, and can have a useful role in diagnosis of hypertension (particularly if ambulatory blood pressure monitoring (ABPM) is not possible or is declined), problems were identified. Reduced patient engagement over longer periods and acceptance of suboptimal BP control among patients on monitoring protocols need to be urgently addressed. Empirical work is required to identify barriers to achieving BP control among hypertensive patients using simple telehealth and, consequently, services be d...
Source: BMC Family Practice - July 17, 2015 Category: Primary Care Authors: Elizabeth CottrellTracey CoxPhil O¿ConnellRuth Chambers Source Type: research

Parents’ beliefs and knowledge about the management of acute otitis media: a qualitative study
Conclusion: There is discrepancy between parents’ beliefs and expectations of management of acute otitis media and the evidence-based recommendations. This study provides insights into parents’ expectations of management of acute otitis media, which may help inform clinicians about perceptions and misperceptions that may be valuable to elicit and discuss. (Source: BMC Family Practice)
Source: BMC Family Practice - July 7, 2015 Category: Primary Care Authors: Malene HansenJanine HowlettChris Del MarTammy Hoffmann Source Type: research

Near-patient tests and the clinical gaze in decision-making of Swedish GPs not following current guidelines for sore throat – a qualitative interview study
Conclusions: Inappropriate use of near-patient test can partly be understood as remnants of outdated knowledge. When new guidelines are introduced the differences between them and the former need to be discussed more explicitly. (Source: BMC Family Practice)
Source: BMC Family Practice - July 4, 2015 Category: Primary Care Authors: Hedvig GröndalKatarina HedinEva StrandbergMalin AndréAnnika Brorsson Source Type: research

Determinants of impact of a practice accreditation program in primary care: a qualitative study
Conclusions: Practice accreditation may have positive outcomes on quality of care, but not all planned elements may contribute to its outcomes. Both factors in the accreditation process and in the context were perceived as determinants of quality improvement. The challenge is to build on facilitating factors, while reducing the elements of accreditation that do not contribute to its impact. (Source: BMC Family Practice)
Source: BMC Family Practice - July 3, 2015 Category: Primary Care Authors: Elvira NouwensJan van LieshoutMichel Wensing Source Type: research

Decisions on statin therapy by patients’ opinions about survival gains: cross sectional survey of general practitioners
Conclusion: GPs were insensitive to patient preferences regarding survival gain when recommending statin therapy. The GPs' recommendations were strongly associated with their own estimates of survival gain. (Source: BMC Family Practice)
Source: BMC Family Practice - July 3, 2015 Category: Primary Care Authors: Peder HalvorsenOlaf AaslandIvar Kristiansen Source Type: research

Improving treatment adherence for blood pressure lowering via mobile phone SMS-messages in South Africa: a qualitative evaluation of the SMS-text Adherence SuppoRt (StAR) trial
Conclusion: Adherence support for treatment of raised blood pressure, delivered via SMS-text message on the patient’s own phone, was found to be acceptable, relevant and helpful, even for those who already had their own reminder systems in place. Our findings begin to identify for whom and what core elements of the SMS-text message intervention appear to work best in a low-resource operational setting, issues that future research should explore in greater depth. (Source: BMC Family Practice)
Source: BMC Family Practice - July 3, 2015 Category: Primary Care Authors: Natalie LeonRebecca SurenderKirsty BobrowJocelyn MullerAndrew Farmer Source Type: research

Design of the POINT study: Pharmacotherapy Optimisation through Integration of a Non-dispensing pharmacist in a primary care Team (POINT)
DiscussionAs the POINT study is a large-scale intervention study, it should provide evidence as to whether integration of a non-dispensing clinical pharmacist in primary care will result in safer pharmacotherapy. The qualitative study also generates knowledge on the optimal implementation of this model in primary care. Results are expected in 2016.Trial registration numberNTR4389, The Netherlands National Trial Register, 07-01-2014. (Source: BMC Family Practice)
Source: BMC Family Practice - July 2, 2015 Category: Primary Care Authors: Ankie HazenVivianne SloeserwijDorien ZwartAntoinette de BontMarcel BouvyJohan de GierNiek de WitAnne Leendertse Source Type: research

Improving antimicrobial prescribing in Irish primary care through electronic data collection and surveillance: a feasibility study
Conclusions: This research demonstrates the feasibility and potential use of direct data extraction of anonymised practice data directly through the patient management software system. The data extraction methods described can facilitate the provision of routinely collected data for sustained and inclusive surveillance of antimicrobial prescribing. These comparisons may initiate further improvements in antimicrobial prescribing practices by identifying potential areas for improvement. (Source: BMC Family Practice)
Source: BMC Family Practice - July 2, 2015 Category: Primary Care Authors: Sandra GalvinAoife CallanMartin CormicanSinead DuaneKathleen BennettAndrew MurphyAkke Vellinga Source Type: research

Erratum: Family medicine model in Turkey: a qualitative assessment from the perspectives of primary care workers
No description available (Source: BMC Family Practice)
Source: BMC Family Practice - June 26, 2015 Category: Primary Care Authors: Zeliha ÖcekMeltem Çiçeklio¿luUmmahan YücelRaziye Özdemir Source Type: research

Previous experiences and emotional baggage as barriers to lifestyle change - a qualitative study of Norwegian Healthy Life Centre participants
Conclusions: Behavioural change can be hard to perform as psychological distress from life baggage can influence the ability to change. The study participants’ experience of being stuck in old habits and having substantial emotional baggage raises questions as to whether or not Healthy Life Centres are able to help participants who need to make a lifestyle change. (Source: BMC Family Practice)
Source: BMC Family Practice - June 23, 2015 Category: Primary Care Authors: Ingrid FøllingMarit SolbjørAnne-S Helvik Source Type: research

Knowledge gaps and acceptability of abbreviated alcohol screening in general practice: a cross-sectional survey of hazardous and non-hazardous drinkers
Conclusions: While awareness of alcohol related health risks is generally good, future efforts may benefit from focusing on the association with cancer and calories. Our findings question the utility of the ‘unit’ system, as well as dissemination of suggested ‘health benefits’ of moderate consumption. General practice initiatives in screening and brief advice for alcohol deserve further study. (Source: BMC Family Practice)
Source: BMC Family Practice - June 20, 2015 Category: Primary Care Authors: Alexander IstedFrancesco FioriniTaavi Tillmann Source Type: research

Evaluation of the quality of care of a multi-disciplinary Risk Factor Assessment and Management Programme for Hypertension (RAMP-HT)
The objectives are to develop an evidence-based, structured and comprehensive evaluation framework on quality of care, to enhance the QOC of the RAMP-HT through an audit spiral of two evaluation cycles and to determine the effectiveness of the programme in reducing cardiovascular disease (CVD) risk.Method/DesignA longitudinal study is conducted using the Action Learning and Audit Spiral methodologies to measure whether pre-set target standards of care intended by the RAMP-HT are achieved. A structured evaluation framework on the quality of structure, process and outcomes of care has been developed based on the programme ob...
Source: BMC Family Practice - June 19, 2015 Category: Primary Care Authors: Esther YuEric WanKarina ChanCarlos WongRuby KwokDaniel FongCindy Lam Source Type: research

Comparison of STI-related consultations among ethnic groups in the Netherlands: an epidemiologic study using electronic records from general practices
Conclusions: Most EM consult their GP more often for STI care than native Dutch. However, it remains unclear whether this covers the need of EM groups at higher STI risk. As a first point of contact for care, GPs can play an important role in reaching EM for (proactive) STI/HIV testing. (Source: BMC Family Practice)
Source: BMC Family Practice - June 18, 2015 Category: Primary Care Authors: Petra WoestenbergAloysia van OeffelenIrina Stirbu-WagnerBirgit van BenthemJan van BergenIngrid van den Broek Source Type: research

Reasons for disagreement regarding illnesses between older patients with multimorbidity and their GPs – a qualitative study
Conclusions: For older patients with multimorbidity, our study demonstrated that there is a need to enhance the cooperation between GPs, specialists and outpatient care, a demand to improve doctor-patient communication and a need for interventions to increase patients’ knowledge of diseases. (Source: BMC Family Practice)
Source: BMC Family Practice - June 2, 2015 Category: Primary Care Authors: Heike HansenNadine PohontschHendrik van den BusscheMartin SchererIngmar Schäfer Source Type: research

Effectiveness of a PLISSIT model intervention in patients with type 2 diabetes mellitus in primary care: design of a cluster-randomised controlled trial
This study describes the design of a cluster-randomised controlled trial evaluating the effectiveness of a PLISSIT-model intervention in men and women with type 2 diabetes mellitus in primary care.Methods/DesignPatients with type 2 diabetes mellitus, aged 40–75 years, who indicate to be dissatisfied about their sexual functioning and that they would like to talk about their sexual problem(s) with their general practitioner are recruited. All participants receive an information leaflet from the practice nurse. In the intervention group, each participant will also receive sexual counselling based on the PLISSIT model f...
Source: BMC Family Practice - June 2, 2015 Category: Primary Care Authors: Anne RuttePatricia van OppenGiel NijpelsFrank SnoekPaul EnzlinPeter LeusinkPetra Elders Source Type: research

“Keeping Moving”: factors associated with sedentary behaviour among older people recruited to an exercise promotion trial in general practice
Conclusion: Some sedentary older adults will respond positively to an invitation to join an exercise study. Those who did so in this study had poor self-rated health, abnormal BMI, a history of smoking, and multiple medication use, and are therefore likely to benefit from an exercise intervention.Trial registrationISRCTN reference: ISRCTN43453770 (Source: BMC Family Practice)
Source: BMC Family Practice - May 28, 2015 Category: Primary Care Authors: Ruth HeseltineDawn SkeltonDenise KendrickRichard MorrisMark GriffinDeborah HaworthTahir MasudSteve Iliffe Source Type: research

Pneumococcal lower respiratory tract infections in adults: an observational case-control study in primary care in Belgium
Conclusions: SP was responsible for approximately 5 % of SLRTIs observed in primary care in Belgium. Pneumococcal infection was associated with a significant increase in morbidity. Sixty-eight percent of serotypes causing SLRTI were potentially preventable by PCV13. (Source: BMC Family Practice)
Source: BMC Family Practice - May 27, 2015 Category: Primary Care Authors: Johan FlamaingWilfried De BackerYves Van LaethemStéphane HeijmansAnnick Mignon Source Type: research

Erratum: What is the impact of primary care model type on specialist referral rates? A cross-sectional study
No description available (Source: BMC Family Practice)
Source: BMC Family Practice - May 24, 2015 Category: Primary Care Authors: Clare LiddyJatinderpreet SinghRyan KellySimone DahrougeMonica TaljaardJamie Younger Source Type: research

Towards an international taxonomy of integrated primary care: a Delphi consensus approach
Conclusions: The taxonomy provides a crucial differentiation that clarifies and supports implementation, policy formulation and research regarding the organisation of integrated primary care. Further research is needed to develop instruments based on the taxonomy that can reveal the realm of integrated primary care in practice. (Source: BMC Family Practice)
Source: BMC Family Practice - May 22, 2015 Category: Primary Care Authors: Pim ValentijnHubertus VrijhoefDirk RuwaardInge BoesveldRosa ArendsMarc Bruijnzeels Source Type: research

Evidence-based rules from family practice to inform family practice; the learning healthcare system case study on urinary tract infections
Conclusions: We describe clinically and statistically significant diagnostic associations observed between UTIs and pyelonephritis presenting as a new problem in family practice, and all associated RfEs, and demonstrate that the significant diagnostic cues obtained are consistent with the literature. We conclude that it is possible to generate clinically meaningful diagnostic evidence from electronic sources of patient data. (Source: BMC Family Practice)
Source: BMC Family Practice - May 16, 2015 Category: Primary Care Authors: Jean SolerDerek CorriganPrzemyslaw KazienkoTomasz KajdanowiczRoxana DangerMarcin KulisiewiczBrendan Delaney Source Type: research

Informal carers’ health-related quality of life and patient experience in primary care: evidence from 195,364 carers in England responding to a national survey
Background: We aim to describe the health-related quality of life of informal carers and their experiences of primary care. Methods: Responses from the 2011-12 English General Practice Patient Survey, including 195,364 informal carers, were analysed using mixed effect logistic regressions controlling for age, gender, ethnicity and social deprivation to describe carer health-related quality of life (mobility, self-care, usual activities, pain, and anxiety/depression, measured using EQ-5D) and primary care experience (access, continuity and communication). Results: Informal carers reported poorer health-related quality of li...
Source: BMC Family Practice - May 15, 2015 Category: Primary Care Authors: Gwilym ThomasCatherine SaundersMartin RolandCharlotte Paddison Source Type: research

Psychological impact of lifestyle-related disease disclosure at general checkup: a prospective cohort study
This study clarified the psychological impact on anxiety state of patients when lifestyle-related diseases are disclosed at general checkups for local residents.In particular, this study evaluated the short-term impact on patients, and how the notification of abnormal values and the disclosure of disease at general checkups affect patients’ subsequent behavioral changes. Methods: The study design was a prospective cohort study. We compared the anxiety state of participants using a self-administered anxiety assessment scale, State–Trait Anxiety Inventory (STAI), before and after Physician’s explanation of ...
Source: BMC Family Practice - May 14, 2015 Category: Primary Care Authors: Tomokazu TominagaMasato MatsushimaTakuya NagataAkinari MoriyaTakamasa WatanabeYuko NakanoYoko HirayamaYasuki Fujinuma Source Type: research

Does a local financial incentive scheme reduce inequalities in the delivery of clinical care in a socially deprived community? A longitudinal data analysis
Conclusions: Any gaps in achievement between practices were modest but mostly sustained or widened over the duration of the scheme. Given that financial rewards may not reflect the amount of work undertaken by practices serving more deprived patients, future pay-for-performance schemes also need to address fairness of rewards in relation to workload. (Source: BMC Family Practice)
Source: BMC Family Practice - May 14, 2015 Category: Primary Care Authors: Liz GlidewellRobert WestJulia HackettPaul CarderTim DoranRobbie Foy Source Type: research

OPTIMAL, an occupational therapy led self-management support programme for people with multimorbidity in primary care: a randomized controlled trial
Conclusions: OPTIMAL significantly improved frequency of activity participation, self-efficacy and quality of life for patients with multimorbidity. Further work is required to test the sustainability of these effects over time but this study indicates that it is a promising intervention that can be delivered in primary care and community settings.Trial registrationTrial Number: ISRCTN67235963 (Source: BMC Family Practice)
Source: BMC Family Practice - May 12, 2015 Category: Primary Care Authors: Jess GarveyDeirdre ConnollyFiona BolandSusan Smith Source Type: research

Why underserved patients do not consult their general practitioner for depression: results of a qualitative and a quantitative survey at a free outpatient clinic in Paris, France
Conclusions: Close to 50% of the depressed individuals did not seek primary care during a depressive episode, and close to 80% of them would have liked their mental health to be discussed more often by a health professional. Better information on depression and its treatments, and more-systematic screening by primary care personnel would improve the treatment of depressed patients, especially those in the most precarious situations. (Source: BMC Family Practice)
Source: BMC Family Practice - May 8, 2015 Category: Primary Care Authors: Claire RondetIsabelle ParizotJean CadwalladerJacques LebasPierre Chauvin Source Type: research

From hypertension control to global cardiovascular risk management: an educational intervention in a cluster-randomised controlled trial
Background: Guidelines on hypertension management recommend adjusting therapeutic efforts in accordance with global cardiovascular risk (CVR) rather than by blood pressure levels alone. However, this paradigm change has not yet arrived in German General Practice. We have evaluated the effect of an educational outreach visit with general practitioners (GPs), encouraging them to consider CVR in treatment decisions for patients with hypertension. Methods: Prospective cluster-randomised trial comprising 3443 patients with known hypertension treated by 87 GPs. Practices were randomly assigned to complex (A) or simple (B) interv...
Source: BMC Family Practice - May 7, 2015 Category: Primary Care Authors: Achim MortsieferTobias MeysenMartin SchumacherHeinz-Harald AbholzKarl WegscheiderJürgen in der Schmitten Source Type: research

Fracture diagnostics, unnecessary travel and treatment: a comparative study before and after the introduction of teleradiology in a remote general practice
Conclusion: Since the introduction of teleradiology the number of missed fractures in patients visiting the general practice with trauma and the number of the unnecessary trips to a hospital are reduced. In addition more patients with fractures and dislocations can be treated in the general practice as opposed to the hospital. (Source: BMC Family Practice)
Source: BMC Family Practice - May 6, 2015 Category: Primary Care Authors: Jac JacobsJan JacobsEric van SonderenThys van der MolenRobbert Sanderman Source Type: research

To what extent does sociodemographic composition of the neighbourhood explain regional differences in demand of primary out-of-hours care: a multilevel study
Conclusions: Although part of the variation between GP cooperatives could not be attributed to neighbourhood characteristics, the sociodemographic composition of the neighbourhood is a fair predictor of the demand of primary OOH care. Accordingly, this study provides a useful starting point for an improved planning of the supply of primary OOH care. (Source: BMC Family Practice)
Source: BMC Family Practice - May 6, 2015 Category: Primary Care Authors: Tessa JansenMarieke ZwaanswijkKarin HekDinny de Bakker Source Type: research

Does the availability of a South Asian language in practices improve reports of doctor-patient communication from South Asian patients? Cross sectional analysis of a national patient survey in English general practices
Background: Ethnic minorities report poorer evaluations of primary health care compared to White British patients. Emerging evidence suggests that when a doctor and patient share ethnicity and/or language this is associated with more positive reports of patient experience. Whether this is true for adults in English general practices remains to be explored. Methods: We analysed data from the 2010/2011 English General Practice Patient Survey, which were linked to data from the NHS Choices website to identify languages which were available at the practice. Our analysis was restricted to single-handed practices and included 19...
Source: BMC Family Practice - May 6, 2015 Category: Primary Care Authors: Faraz AhmedGary AbelCathy LloydJenni BurtMartin Roland Source Type: research

Dealing with workplace violence in emergency primary health care: a focus group study
Conclusion: Our study shows a potential for development of better organizational strategies for protecting EPC personnel who are at risk from workplace violence. (Source: BMC Family Practice)
Source: BMC Family Practice - May 1, 2015 Category: Primary Care Authors: Tone MorkenIngrid JohansenKjersti Alsaker Source Type: research

Association between general practice characteristics and use of out-of-hours GP cooperatives
Conclusions: Besides patient population characteristics, organisational characteristics of general practices are associated with lower use of out-of-hours care. Improving accessibility and availability of day time primary day care might be a potential effective way to improve the efficient use of out-of-hours care services. (Source: BMC Family Practice)
Source: BMC Family Practice - May 1, 2015 Category: Primary Care Authors: Marleen SmitsYvonne PetersSanne BroersEllen KeizerMichel WensingPaul Giesen Source Type: research

The association between general practitioner participation in joint teleconsultations and rates of referral: a discrete choice experiment
Background: Joint consultations – such as teleconsultations – provide opportunities for continuing education of general practitioners (GPs). It has been reported this form of interactive case-based learning may lead to fewer GP referrals, yet these studies have relied on expert opinion and simple frequencies, without accounting for other factors known to influence referrals. We use a survey-based discrete choice experiment of GPs’ referral preferences to estimate how referral rates are associated with participation in joint teleconsultations, explicitly controlling for a number of potentially confounding ...
Source: BMC Family Practice - April 21, 2015 Category: Primary Care Authors: Tiago Cravo OliveiraJames BarlowSteffen Bayer Source Type: research

Prescribed therapy for asthma: therapeutic ratios and outcomes
Background: Inhaled corticosteroids (ICS) are the cornerstone of asthma therapy. The ICS-to-total-asthma-medication ratios, calculated from claims data, indicate potentially risky disease management in asthma. Our aim was to assess the utility of ICS-to-total-asthma-medication ratios from primary care electronic medical records (EMRs) in detecting patients at risk of asthma exacerbation, as approached by prescription of oral corticosteroids and/or antibiotics. Methods: Retrospective cohort studies were identified, using the Health Improvement Network general practice database (THIN, United Kingdom) and the Cegedim Longitud...
Source: BMC Family Practice - April 14, 2015 Category: Primary Care Authors: Laurent LaforestIdlir LicajGilles DevouassouxIrene ErikssonPascal CailletGérard ChatteManon BelhassenEric Van Ganse Source Type: research

Decision support for chronic pain care: how do primary care physicians decide when to prescribe opioids? a qualitative study
Conclusions: This study identified and described primary care physicians’ struggles to deliver high quality care as they seek and make decisions based on an array of incomplete, conflicting, and often untrusted patient information. Decision support systems, education, and other interventions that address these challenges may alleviate primary care physicians’ struggles and improve outcomes for patients with chronic pain and other challenging conditions. (Source: BMC Family Practice)
Source: BMC Family Practice - April 14, 2015 Category: Primary Care Authors: Christopher HarleSarah BauerHuong HoangRobert CookRobert HurleyRoger Fillingim Source Type: research

A longitudinal study of the working relationship and return to work: perceptions by clients and occupational therapists in primary health care
Background: The working relationship between client and therapist can be important to enhance outcomes from vocational rehabilitation for women with stress-related disorders in primary health care. The aim was to investigate the working relationship, as perceived by clients and therapists in the Redesigning Daily Occupations (ReDO™) program, and its relationships to return to work and satisfaction with the rehabilitation. Another aim was to compare the ReDO™ group and a “care-as-usual” (CAU) group regarding perceptions of the working relationship with the social insurance officer.MethodForty-two ReD...
Source: BMC Family Practice - April 10, 2015 Category: Primary Care Authors: Mona EklundLena-Karin ErlandssonBirgitta Wästberg Source Type: research

Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial
Conclusion: The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone triage are shaped by the way practices communicate with staff, prepare for and sustain the changes required to implement triage effectively, as well as by existing practice culture, and staff and patient behaviour arising in response to the changes made.Trial registrationCurrent Controlled Trials ISRCT...
Source: BMC Family Practice - April 10, 2015 Category: Primary Care Authors: Jamie MurdochAnna VarleyEmily FletcherNicky BrittenLinnie PriceRaff CalitriColin GreenValerie LattimerSuzanne RichardsDavid RichardsChris SalisburyRod TaylorJohn Campbell Source Type: research

Analysis of factors influencing general practitioners’ decision to refer obese patients in Australia: a qualitative study
Conclusion: There were differences between GPs reported referral behaviour for lifestyle and surgical interventions. GPs’ attitudes to referral were often formed by their limited case experience rather than by a review of more systematic evidence, especially for surgical interventions. These patterns may be improved by educating and better communicating with GPs about the outcomes for their patients when they are referred. (Source: BMC Family Practice)
Source: BMC Family Practice - April 8, 2015 Category: Primary Care Authors: Kyoung KimLin-Lee YeongIan CatersonMark Harris Source Type: research

Influenza vaccination of primary healthcare physicians may be associated with vaccination in their patients: a vaccination coverage study
Conclusions: Vaccination of physicians together with their opinions on the effectiveness of the vaccine may be a predictor of vaccination coverage in their patients. Further studies are required to confirm this. (Source: BMC Family Practice)
Source: BMC Family Practice - March 31, 2015 Category: Primary Care Authors: Pere GodoyJesús CastillaJosé MayoralVicente MartínJenaro AstrayNúria TornerDiana ToledoNúria SoldevilaFernando González-CandelasSusana GarcíaJosé Diaz-BorregoSonia TamamesAngela Domínguezand the Working Group for the Survey on Influenza Vaccinati Source Type: research

Establishing chronic condition concordance and discordance with diabetes: a Delphi study
Conclusions: This study significantly adds to the number of conditions for which we have information on concordance and discordance for diabetes care. The results can be used for future studies to assess the impact of concordant and discordant conditions on diabetes care, and may prove useful in developing multimorbidity guidelines and interventions. (Source: BMC Family Practice)
Source: BMC Family Practice - March 28, 2015 Category: Primary Care Authors: Elizabeth MagnanRebecca GittelsonChristie BartelsHeather JohnsonNancy PandhiElizabeth JacobsMaureen Smith Source Type: research

Practical surrogate marker of pulmonary dysanapsis by simple spirometry: an observational case–control study in primary care
Background: We see patients who present with spirometry airflow limitation despite their forced expiratory volume in one second (FEV1) as well as forced vital capacity (FVC) to be supernormal (FEV1/FVC  (Source: BMC Family Practice)
Source: BMC Family Practice - March 26, 2015 Category: Primary Care Authors: Satomi ShiotaMasako IchikawaKazuhiro SuzukiYoshinosuke FukuchiKazuhisa Takahashi Source Type: research

Predictors of treatment with antibiotics and systemic corticosteroids for acute exacerbations of asthma and chronic obstructive pulmonary disease in primary care
Background: Antibiotic and oral corticosteroid prescribing rate in patients suffering from acute exacerbations of chronic obstructive pulmonary disease (COPD) or asthma in general practice are only sparsely described. Our aim was to identify predictors for such prescribing when results from CRP testing, spirometry, and pulse oximetry are available. Methods: Patients aged 40 years or more diagnosed with asthma, COPD or both, the previous five years from seven general practice offices in Norway, were invited to a baseline examination and asked to visit their GPs during exacerbations the following 12 months. At all ...
Source: BMC Family Practice - March 24, 2015 Category: Primary Care Authors: Salwan Al-aniMark SpigtJohanna LaueHasse Melbye Source Type: research

Efficacy of a cognitive and behavioural psychotherapy applied by primary care psychologists in patients with mixed anxiety-depressive disorder: a research protocol
DiscussionThe aim of this study is to assess the efficacy of a primary care-based cognitive-behavioural psychological intervention in patients with mixed anxiety-depressive disorder. The international scientific evidence has demonstrated the need for psychologists in primary care. However, given the differences between health policies and health services, it is important to test the effect of these psychological interventions in our geographical setting.Trial registrationNCT01907035 (July 22, 2013). (Source: BMC Family Practice)
Source: BMC Family Practice - March 20, 2015 Category: Primary Care Authors: Amale JaureguiJoaquín PonteMonika SalgueiroSaloa UnanueCarmen DonaireMaria GómezNatalia Burgos-AlonsoGonzalo Grandesrepresenting the PSICCAPAD group Source Type: research