Prevalence of perceived stress and associations to symptoms of exhaustion, depression and anxiety in a working age population seeking primary care - an observational study
Conclusion: More than half of this working age population perceived more than a little stress, as defined, women to a greater extent than men. Symptoms of burnout and exhaustion were common. A high level of perceived stress was often accompanied by symptoms of depression and/or anxiety. (Source: BMC Family Practice)
Source: BMC Family Practice - March 19, 2015 Category: Primary Care Authors: Lilian WiegnerDominique HangeCecilia BjörkelundGunnar Ahlborg Source Type: research

The implementation and sustainability of a combined lifestyle intervention in primary care: mixed method process evaluation
Conclusions: Protocol adherence in a CLI was problematic in both HCPs and participants. Mainly the amount of dietary guidance was lower than planned, and decreased with increasing guidance by PT. Thus, feasibility of changing physical activity and dietary habits simultaneously by one intervention in one year was not as high as expected. Also the sustainability of CLI was poor. When a CLI program is started, re-invention should be allowed and maximum effort should be taken to guarantee long term continuation, by planning both implementation and sustainability carefully.Trial registrationCurrent Controlled Trials ISRCTN46574...
Source: BMC Family Practice - March 17, 2015 Category: Primary Care Authors: Brenda BerendsenStef KremersHans SavelbergNicolaas SchaperMarike Hendriks Source Type: research

‘We can do only what we have the means for’ general practitioners’ views of primary care for older people with complex health problems
Conclusions: Limited financial resources, lack of cooperational networks, and attitudes appear to be barriers to assuring better primary care for older people with complex health problems. To overcome these barriers, geriatric training is likely to have a positive impact but needs to be supplemented by regulations regarding reimbursement. Most of all, general practitioners’ care for older people with complex health problems needs a conceptual framework that provides guidance regarding their specific role and contribution and assisting networks. For example, it is essential that general practice guidelines become more...
Source: BMC Family Practice - March 14, 2015 Category: Primary Care Authors: Anna HerzogBeate GaertnerChrista Scheidt-NaveMartin Holzhausen Source Type: research

Practice nurse chlamydia testing in Australian general practice: a qualitative study of benefits, barriers and facilitators
Conclusion: This study suggests that PNs could take a role in increasing chlamydia testing in general practice and that their involvement may result in possible benefits for patients, doctors, PNs and the community. Strategies to overcome identified barriers and facilitate their involvement must be further explored. (Source: BMC Family Practice)
Source: BMC Family Practice - March 14, 2015 Category: Primary Care Authors: Rebecca LorchJane HockingRebecca GuyAlaina VaiseyAnna WoodDyani LewisMeredith Temple-Smithon behalf of the ACCEPt consortium Source Type: research

` We can do only what we have the means for ¿ general practitioners¿ views of primary care for older people with complex health problems
Conclusions: Limited financial resources, lack of cooperational networks, and attitudes appear to be barriers to assuring better primary care for older people with complex health problems. To overcome these barriers, geriatric training is likely to have a positive impact but needs to be supplemented by regulations regarding reimbursement. Most of all, general practitioners’ care for older people with complex health problems needs a conceptual framework that provides guidance regarding their specific role and contribution and assisting networks. For example, it is essential that general practice guidelines become more...
Source: BMC Family Practice - March 14, 2015 Category: Primary Care Authors: Anna HerzogBeate GaertnerChrista Scheidt-NaveMartin Holzhausen Source Type: research

Primary health care utilization for alcohol-attributed diseases in British Columbia Canada 2001¿2011
Background: The purpose of this study was to determine whether general practitioner visits for alcohol-attributed diseases increased in a decade when several regulatory changes were made to the distribution and price of alcohol in British Columbia Canada. Methods: General practitioner consultations for alcohol-attributed diseases were examined using data from British Columbia’s Medical Services Plan database. Negative binomial regression was used to measure the significance of yearly variations using incidence rate ratios by disease type per year. Results: From 2001 to 2011, 690,401 visits were made to general practi...
Source: BMC Family Practice - March 11, 2015 Category: Primary Care Authors: Amanda SlaunwhiteScott Macdonald Source Type: research

Patients¿ willingness to attend the NHS cardiovascular health checks in primary care: a qualitative interview study
Conclusion: While a minority of non-attendees simply had made an informed choice not to have an NHSHC, improving the clarity and brevity of invitational materials, better advertising, and simple administrative interventions such as sending reminder letters, have considerable potential to improve NHSHC uptake. (Source: BMC Family Practice)
Source: BMC Family Practice - March 8, 2015 Category: Primary Care Authors: Caroline JenkinsonAnthea AspreyChristopher ClarkSuzanne Richards Source Type: research

Managing depression in people with multimorbidity: a qualitative evaluation of an integrated collaborative care model
Conclusion: The COINCIDE care model, that sought to integrate depression care within the context of LTC management, achieved service level integration but not therapeutic integration. Patients preferred a protected space to discuss mental health issues, and professionals maintained barriers around physical and mental health expertise. Findings therefore suggest that in the context of mental-physical multimorbidity, collaborative care can facilitate access to depression care in ways that overcome stigma and enhance the confidence of multidisciplinary health teams to work together. However, such care models need to be flexib...
Source: BMC Family Practice - March 5, 2015 Category: Primary Care Authors: Sarah KnowlesCarolyn Chew-GrahamIsabel AdeyemiNia CoupePeter Coventry Source Type: research

Reliability and applicability of the Patient Enablement Instrument (PEI) in a Swedish general practice setting
Conclusions: The Swedish version of the PEI instrument has high internal consistency and moderate to good reliability. It can be used in research but is not recommended as a measure of quality of care. The instrument could benefit from further development and validity testing. (Source: BMC Family Practice)
Source: BMC Family Practice - March 4, 2015 Category: Primary Care Authors: Mattias RööstAndrzej ZielinskiChrister PeterssonEva Strandberg Source Type: research

Decreasing cholesterol levels in the community ¿ lifestyle change with statin?
Background: The Lapinlahti 2005–2010 study was carried out to explore cardiovascular disease risk factors and changes in lifestyle in Lapinlahti residents in eastern Finland. Our aim was to analyse factors influencing the level of cholesterol in the community. Methods: In 2005, 480 subjects aged 30–65 years underwent a complete health survey (baseline study) that consisted of a structured questionnaire and a health examination. The follow-up was carried out five years later in 2010. The present study population included 326 individuals who did not use lipid-lowering medication at the baseline. A trained researc...
Source: BMC Family Practice - February 28, 2015 Category: Primary Care Authors: Jorma SavolainenHannu KautiainenLeo NiskanenPekka Mäntyselkä Source Type: research

Unmasking quality: exploring meanings of health by doing art
DiscussionThe model for structured participatory arts workshops such as ours is ‘art as conversation’. In creating textile art works, women involved in the sewing workshops engaged at a personal level, developing confidence through sharing ideas, experiences and humour. Group discussions built on the self-assurance gained from doing craft work together and talking in a relaxed way with a common purpose, exploring the health themes which were the focus of the art. For example, working on a textile about vitamin D created a framework which stimulated the emergence of a common discourse about different cultural pr...
Source: BMC Family Practice - February 27, 2015 Category: Primary Care Authors: Moira KellyCarol RivasJens FoellJanet Llewellyn-DunnDiana EnglandAnna CocciadiferroSally Hull Source Type: research

Factors associated with grade 1 hypertension: implications for hypertension care based on the Dietary Approaches to Stop Hypertension (DASH) in primary care settings
Conclusions: Dietary-intake factors were significantly associated with grade 1 hypertension, echoing the recommendation in the Reference Framework on incorporating dietary-related intervention based on the DASH approach for hypertension care in primary care settings. The association between aggregate risk factors and grade 1 hypertension should also be taken into consideration in long-term preventive strategy. (Source: BMC Family Practice)
Source: BMC Family Practice - February 27, 2015 Category: Primary Care Authors: Harry WangMartin WongRosina MokMandy KwanWai ChanCarmen FanCatherine LeeSian Griffiths Source Type: research

Modelling successful primary care for multimorbidity: a realist synthesis of successes and failures in concurrent learning and healthcare delivery
Conclusions: This study is novel in considering empirical evidence from patients, GPs and trainees engaged in concurrent learning and healthcare delivery. The findings should inform future interventions designed to produce a medical workforce equipped to provide multimorbidity care.Trial registrationPROSPERO International prospective register of systematic reviews CRD42013003862 (Source: BMC Family Practice)
Source: BMC Family Practice - February 25, 2015 Category: Primary Care Authors: Sarah YardleyElizabeth CottrellEliot ReesJoanne Protheroe Source Type: research

The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis
Conclusions: The effect of zinc acetate lozenges on cold symptoms may be associated with the local availability of zinc from the lozenges, with the levels being highest in the pharyngeal region. However our findings indicate that the effects of zinc ions are not limited to the pharyngeal region. There is no indication that the effect of zinc lozenges on nasal symptoms is less than the effect on the symptoms of the pharyngeal region, which is more exposed to released zinc ions.Given that the adverse effects of zinc in the three trials were minor, zinc acetate lozenges releasing zinc ions at doses of about 80 mg/day may...
Source: BMC Family Practice - February 25, 2015 Category: Primary Care Authors: Harri HemiläElizabeth Chalker Source Type: research

¿You don¿t want to lose that trust that you¿ve built with this patient¿¿: (Dis)trust, medical tourism, and the Canadian family physician-patient relationship
Conclusions: Family physicians face diverse tensions about medical tourism as they must balance their roles in: (1) providing information about medical tourism within a context of information deficits; (2) supporting decision-making while distancing themselves from patients’ decisions to engage in medical tourism; and (3) acting both as agents of the patient and of the domestic health care system. These tensions highlight the ongoing need for reliable third-party informational resources about medical tourism and the development of responsive policy. (Source: BMC Family Practice)
Source: BMC Family Practice - February 25, 2015 Category: Primary Care Authors: Valorie CrooksNeville LiJeremy SnyderShafik DharamsiShelly BenjaminyKaren JacobJudy Illes Source Type: research

BMC Family Practice reviewer acknowledgement 2014
Contributing reviewersThe editors of BMC Family Practice would like to thank all of our reviewers who have contributed to the journal in Volume 15 (2014). (Source: BMC Family Practice)
Source: BMC Family Practice - February 22, 2015 Category: Primary Care Authors: Magdalena Morawska Source Type: research

General practitioners¿ perceptions of working with the certification of sickness absences following changes in the Swedish social security system: a qualitative focus-group study
Conclusions: Swedish GPs still perceived COSA to be a burdensome task. However, system changes in recent years have facilitated work related to COSA. Cooperation with other professionals on COSA was perceived positively. (Source: BMC Family Practice)
Source: BMC Family Practice - February 21, 2015 Category: Primary Care Authors: Lars CarlssonLinda LännerströmThorne WallmanInger Holmström Source Type: research

An international cross-sectional survey on the Quality and Costs of Primary Care (QUALICO-PC): recruitment and data collection of places delivering primary care across Canada
Conclusions: The difficulties obtaining acceptable response rates by family physicians for survey participation is a universal challenge. This response rate for the QUALICO-PC arm in Canada was similar to rates found in other countries such as Australia and New Zealand. Even though most family physicians operate as self-employed small businesses, they could be supported to routinely submit data through a collective effort and provincial mandate. The groundwork in setting up pan-Canadian collaboration in primary care has been established through this study. (Source: BMC Family Practice)
Source: BMC Family Practice - February 18, 2015 Category: Primary Care Authors: Sabrina WongLeena ChauWilliam HoggGary TeareBaukje MiedemaMylaine BretonKris Aubrey-BasslerAlan KatzFred BurgeAntoine BoivinTim CookeDanièle FrancoeurWalter Wodchis Source Type: research

Quality of asthma care under different primary care models in Canada: a population-based study
Conclusions: Quality of asthma care improved over time within each of the primary care models. However, the amount by which they improved differed between the models. The newer primary care models (i.e., blended fee-for-service, blended capitation) appear to provide better quality of asthma care compared to the traditional fee-for-service model. (Source: BMC Family Practice)
Source: BMC Family Practice - February 14, 2015 Category: Primary Care Authors: Teresa ToJun GuanJingqin ZhuM LougheedAlan KaplanItamar TamariMatthew StanbrookJacqueline SimatovicLaura FeldmanAndrea Gershon Source Type: research

Timeliness in chronic kidney disease and albuminuria identification: a retrospective cohort study
This study aimed to describe the pattern and associations of timely CKD registration and uACR testing. Methods: A retrospective cohort of individuals with incident CKD 3?5 (two estimated glomerular filtration rates (eGFR) (Source: BMC Family Practice)
Source: BMC Family Practice - February 13, 2015 Category: Primary Care Authors: Simon FraserJulie ParkesDavid CullifordMiriam SanterPaul Roderick Source Type: research

General practitioners¿ perceptions on home medicines reviews: a qualitative analysis
Conclusions: Despite recognition of the value of the HMR service participating GPs were of the opinion that there are aspects of the HMR service that could be improved. As one of the success factors of HMRs is relying on GPs to utilise this service, this study provides valuable insight into issues that need to be addressed to improve HMR uptake. (Source: BMC Family Practice)
Source: BMC Family Practice - February 7, 2015 Category: Primary Care Authors: Amrith DhillonHendrika HattinghAndrew StaffordKreshnik Hoti Source Type: research

Facilitators and barriers of implementing the chronic care model in primary care: a systematic review
Conclusions: These findings highlight the importance of assessing organizational capacity and needs prior to and during the implementation of the CCM, as well as gaining a better understanding of health care providers? and organizational perspective. (Source: BMC Family Practice)
Source: BMC Family Practice - February 6, 2015 Category: Primary Care Authors: Mudathira KaduPaul Stolee Source Type: research

Clinical inertia in general practice, a matter of debate: a qualitative study with 114 general practitioners in Belgium
Conclusions: Although situations of clinical inertia exist in practice and need to be prevented or corrected, the term clinical inertia could potentially increase the already existing gap between general practice and specialised care, whereas sustained efforts toward more collaborative work and integrated care are called for. (Source: BMC Family Practice)
Source: BMC Family Practice - February 6, 2015 Category: Primary Care Authors: Isabelle AujoulatPatricia JacqueminMichel HermansErnst RietzschelAndré ScheenPatrick TréfoisElisabeth DarrasJohan Wens Source Type: research

Prescription of antibiotics and anxiolytics/hypnotics to asthmatic patients in general practice: a cross-sectional study based on French and Italian prescribing data
Background: Asthma is often poorly controlled and guidelines are often inadequately followed in medical practice. In particular, the prescription of non-asthma-specific drugs can affect the quality of care. The goal of this study was to measure the frequency of the prescription of antibiotics and anxiolytics/hypnotics to asthmatic patients and to look for associations between sex or age and the prescription of these drugs. Methods: A cross-sectional study was conducted using computerised medical records from French and Italian general practitioners? networks. Patients were selected according to criteria adapted from the HE...
Source: BMC Family Practice - February 6, 2015 Category: Primary Care Authors: David DarmonLaurent LaforestEric Van GanseFerdinando PetrazzuoliChris van WeelLaurent Letrilliart Source Type: research

Clinical and haematological predictors of antibiotic prescribing for acute cough in adults in Swiss practices ¿ an observational study
Conclusions: The antibiotic prescription rate of 22% in adult patients with acute cough in the Swiss primary care setting is low compared to other countries. GPs appear to use point-of-care CRP testing in addition to the duration of clinical symptoms to help them decide whether or not to prescribe antibiotics. (Source: BMC Family Practice)
Source: BMC Family Practice - February 6, 2015 Category: Primary Care Authors: Sven StreitPeter FreySarah SingerUeli BollagDamian Meli Source Type: research

Results of a survey among GP practices on how they manage patient safety aspects related to point-of-care testing in every day practice
Conclusions: We observed a number of risks for errors with POC tests in GP practices that may be reduced by proper training of personnel, introduction of standard operating procedures and measures for quality control and improved hygiene. To encourage proper use of POCT in general practices, a national POCT guideline, dedicated to primary care and in line with ISO standards, should be introduced. (Source: BMC Family Practice)
Source: BMC Family Practice - February 5, 2015 Category: Primary Care Authors: Claudette de VriesCarine DoggenEllen HilbersRobert VerheijMaarten IJzermanRobert GeertsmaRon Kusters Source Type: research

From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database
Conclusions: Comparison to medical chart review shows that at MaPCReN the CPCSSN case finding algorithms are valid with a few limitations. This study provides the basis for the validated data to be utilized for research and informs users of its limitations. Analysis of underlying discrepancies provides the ability to improve algorithm performance and facilitate improved data quality. (Source: BMC Family Practice)
Source: BMC Family Practice - February 5, 2015 Category: Primary Care Authors: Nathan ColemanGayle HalasWilliam PeelerNatalie CasaclangTyler WilliamsonAlan Katz Source Type: research

Missed opportunities: general practitioner identification of their patients¿ smoking status
Conclusion: Despite the important role general practitioners play in providing smoking cessation advice and support, a substantial proportion of general practitioners do not know their patient?s smoking status. This represents a significant missed opportunity in the provision of preventive healthcare. Electronic waiting room assessments may assist general practitioners in improving the identification of smokers. (Source: BMC Family Practice)
Source: BMC Family Practice - February 4, 2015 Category: Primary Care Authors: Jamie BryantMariko CareyRob Sanson-FisherElise MansfieldTim ReganAlessandra Bisquera Source Type: research

Prescribing style and variation in antibiotic prescriptions for sore throat: cross-sectional study across six countries
Conclusion: Prescribing style is an important source of variation in prescription of antibiotics within and across countries, even after adjusting for patient and GP characteristics. Interventions aimed at influencing the prescribing style of GPs must encompass context-specific actions at the policy-making level alongside GP-targeted interventions to enable GPs to react more objectively to the external demands that are in place when making the decision of prescribing antibiotics or not. (Source: BMC Family Practice)
Source: BMC Family Practice - January 29, 2015 Category: Primary Care Authors: Gloria CordobaVolkert SiersmaBeatriz Lopez-ValcarcelLars BjerrumCarl LlorRune AabenhusMarjukka Makela Source Type: research

More negative self-esteem and inferior coping strategies among patients diagnosed with IBS compared with patients without IBS - a case¿control study in primary care
Background: Irritable Bowel Syndrome (IBS) is a chronic, relapsing gastrointestinal disorder, that affects approximately 10% of the general population and the majority are diagnosed in primary care. IBS has been reported to be associated with altered psychological and cognitive functioning such as mood disturbances, somatization, catastrophizing or altered visceral interoception by negative emotions and stress. The aim was to investigate the psychosocial constructs of self-esteem and sense of coherence among IBS patients compared to non-IBS patients in primary care. Methods: A case?control study in primary care setting amo...
Source: BMC Family Practice - January 28, 2015 Category: Primary Care Authors: Ewa GrodzinskySusanna WalterLisa ViktorssonAnn-Kristin CarlssonMichael JonesÅshild Faresjö Source Type: research

Be SMART: examining the experience of implementing the NHS Health Check in UK primary care
Conclusions: HCPs? training needs to include the use and evidence of the effectiveness of SMART goals in changing health behaviours. The significance of fidelity to protocol needs to be communicated to HCPs and commissioners to ensure consistency. Monitoring and measurement of follow-up, e.g., tracking of referrals, need to be resourced to provide evidence of the success of the NHS Health Check in terms of healthier lifestyles and reduced CVD risk. (Source: BMC Family Practice)
Source: BMC Family Practice - January 22, 2015 Category: Primary Care Authors: Rachel ShawHelen PattisonCarol HollandRichard Cooke Source Type: research

Trajectories of multimorbidity: exploring patterns of multimorbidity in patients with more than ten chronic health problems in life course
Conclusion: There are many challenges facing multimorbidity research, including the implementation of a longitudinal, life-time approach from a family practice perspective. The present study, although exploratory by nature, shows that both general and specific mechanisms characterize the development of multimorbidity trajectories. A very small proportion of patients has a very high number of chronic health problems (MM11+) and keeps adding health problems in their life. However, GP?s need to realise that more than one third of their patients accumulate four or more chronic health problems (MM4-5 and MM6-10) in their lifeti...
Source: BMC Family Practice - January 22, 2015 Category: Primary Care Authors: Rein VosMarjan van den AkkerJos BoestenCaroline RobertsonJob Metsemakers Source Type: research

What do general practitioners think about an online self-regulation programme for health promotion? Focus group interviews
Conclusions: Overall, GPs are positive about the adoption of self-regulation techniques for health promotion in their practice. However, they raised doubts about the adoption in general practice. This barrier may be addressed (1) by offering various ways to deliver the programme, and (2) by allowing flexibility to match different work flow systems. GPs also believed that the acceptability and usability of the programmes was low for patients who are old or with low education. The issues raised by GPs will need to be taken into account when developing and implementing an eHealth programme in general practice. (Source: BMC Family Practice)
Source: BMC Family Practice - January 22, 2015 Category: Primary Care Authors: Jolien PlaeteGeert CrombezAnn DeSmetMyriam DeveugeleMaïté VerloigneIlse De Bourdeaudhuij Source Type: research

¿It¿s MAGIC¿ - development of a manageable geriatric assessment for general practice use
Conclusions: MAGIC promises to be a helpful screening instrument in primary care consultations involving elderly multimorbid patients. Applicable within a minimum of time it still covers health problems highly relevant with regard to a potential loss of autonomy. Feasibility will be tested in the context of a large, still ongoing randomized controlled trial on ?reduction of potentially inadequate medication in elderly patients? (RIME study; DRKS-ID: DRKS00003610) in general practice. (Source: BMC Family Practice)
Source: BMC Family Practice - January 22, 2015 Category: Primary Care Authors: Tanja BarkhausenUlrike Junius-WalkerEva Hummers-PradierChristiane MuellerGudrun Theile Source Type: research

Modifiable risk factors associated with prediabetes in men and women: a cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes (PREDAPS-Study)
Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population. (Source: BMC Family Practice)
Source: BMC Family Practice - January 22, 2015 Category: Primary Care Authors: Alicia Díaz-RedondoCarolina Giráldez-GarcíaLourdes CarrilloRosario SerranoFrancisco García-SoidánSara ArtolaJosep FranchJavier DíezPatxi EzkurraJosé MillarueloMateu SeguíJavier SangrósJuan Martínez-CandelaPedro MuñozAlbert GodayEnrique Regidor Source Type: research

Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: Phase III study
The objectives of this study are to assess the potential efficacy and safety of autologous platelet rich plasma for the treatment of venous ulcers compared to the conventional treatment (moist wound care) in primary care patients with chronic venous insufficiency (C, clinical class, E, aetiology, A, anatomy and P, pathophysiology classification C6).DesignWe will conduct a phase III, open-label, parallel-group, multicentre, randomized study. The subjects will be 150 patients aged between 40 and 100 years of age with an at least 2-month history of a vascular venous ulcer assigned to ten primary care centres. For the treatmen...
Source: BMC Family Practice - December 30, 2014 Category: Primary Care Authors: Kepa San SebastianIgone LobatoIgone HernándezNatalia Burgos-AlonsoMaria Gomez-FernandezJose LópezBegoña RodríguezAnna MarchGonzalo GrandesIsabel Andia Source Type: research

Efficacy and safety of autologous platelet rich plasma for the treatment of vascular ulcers in primary care: Phase III study
The objectives of this study are to assess the potential efficacy and safety of autologous platelet rich plasma for the treatment of venous ulcers compared to the conventional treatment (moist wound care) in primary care patients with chronic venous insufficiency (C, clinical class, E, aetiology, A, anatomy and P, pathophysiology classification C6).DesignWe will conduct a phase III, open-label, parallel-group, multicentre, randomized study. The subjects will be 150 patients aged between 40 and 100 years of age with an at least 2-month history of a vascular venous ulcer assigned to ten primary care centres. For the treatmen...
Source: BMC Family Practice - December 30, 2014 Category: Primary Care Authors: Kepa San SebastianIgone LobatoIgone HernándezNatalia Burgos-AlonsoMaria Gomez-FernandezJose LópezBegoña RodríguezAnna MarchGonzalo GrandesIsabel Andia Source Type: research

Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)
DiscussionIf referral of primary care patients to exercise specialists increases physical activity, this process offers the prospect of systematically and sustainably reaching a large proportion of insufficiently active adults. If shown to be efficacious this trial provides evidence to expand public funding beyond those with a chronic disease and for delivery via telephone as well as face-to-face consultations.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12611000884909. (Source: BMC Family Practice)
Source: BMC Family Practice - December 29, 2014 Category: Primary Care Authors: Erica JamesBen EwaldNatalie JohnsonWendy BrownFiona StaceyPatrick McelduffAngela BoothFan YangCharlotte HespeRonald Plotnikoff Source Type: research

Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial
DiscussionThis trial will provide insight into the effectiveness of a complex intervention to educate patients with heart failure including a 2-day GP workshop and patients’ education programme in the setting of a GP consultation to improve the quality of life in patients with chronic heart failure. This complex intervention tool could be used during initial and further medical training.Trial registrationETIC is a cluster-randomised, controlled trial registered on ClinicalTrials.gov [NCT01065142, 2010, Feb 8] and the French drug agency [Agence Nationale de Sécurité du Médicament et des produits d...
Source: BMC Family Practice - December 24, 2014 Category: Primary Care Authors: Hélène Vaillant-RousselCatherine LaporteBruno PereiraGilles TanguyJean CassagnesMarc RuivardGilles ClémentJean-Yves Le ResteJean-Pierre LebeauJean-François ChenotDenis PouchainClaude DubrayPhilippe Vorilhon Source Type: research

Focus groups to explore healthcare professionals¿ experiences of care coordination: towards a theoretical framework for the study of care coordination
Conclusions: External factors and the (inter)organizational mechanism should enhance ?roles? and ?quality of relationship? between healthcare professionals and with the patient as well as ?exchange of information?, and setting and sharing of common ?goals? to improve care coordination and quality of care. (Source: BMC Family Practice)
Source: BMC Family Practice - December 24, 2014 Category: Primary Care Authors: Sabine Van HoudtWalter SermeusKris VanhaechtJan De Lepeleire Source Type: research

Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial
DiscussionThis trial will provide insight into the effectiveness of a complex intervention to educate patients with heart failure including a 2-day GP workshop and patients? education programme in the setting of a GP consultation to improve the quality of life in patients with chronic heart failure. This complex intervention tool could be used during initial and further medical training.Trial registrationETIC is a cluster-randomised, controlled trial registered on ClinicalTrials.gov [NCT01065142, 2010, Feb 8] and the French drug agency [Agence Nationale de S?curit? du M?dicament et des produits de sant?; registration numbe...
Source: BMC Family Practice - December 24, 2014 Category: Primary Care Authors: Hélène Vaillant-RousselCatherine LaporteBruno PereiraGilles TanguyJean CassagnesMarc RuivardGilles ClémentJean-Yves Le ResteJean-Pierre LebeauJean-François ChenotDenis PouchainClaude DubrayPhilippe Vorilhon Source Type: research

Patient factors associated with SSRI dose for depression treatment in general practice: a primary care cross sectional study
This study?s aim was to investigate patient factors associated with selective serotonin re-uptake inhibitor (SSRI) prescribed daily dose for depression treatment in general practice. Methods: A stratified sample of low to high prescribing practices were selected. Routine individual patient-level data were extracted one practice at a time: September 2009 to January 2011. Patients included were ?18?years, and prescribed an SSRI for depression. Logistic regression analysis was undertaken to assess individual predictor variables on SSRI daily dose by standard therapeutic dose versus higher dose, as SSRIs demonstrate flat dose ...
Source: BMC Family Practice - December 24, 2014 Category: Primary Care Authors: Chris JohnsonNadine DougallBrian WilliamsStephen MacGillivrayAlasdair BuchananRichard Hassett Source Type: research

Chest pain out-of-hours ¿ an interview study of primary care physicians¿ diagnostic approach, tolerance of risk and attitudes to hospital admission
Conclusions: Physicians working out-of-hours showed considerable differences in their diagnostic approach, and not all physicians diagnose patients with chest pain according to current guidelines and evidence. Continuous medical education must focus on the diagnostic approach in patients with chest pain in primary care and empowerment of physicians through training and emphasis on risk assessment and “tolerance of risk”. (Source: BMC Family Practice)
Source: BMC Family Practice - December 21, 2014 Category: Primary Care Authors: Robert BurmanErik ZakariassenSteinar Hunskaar Source Type: research

Chest pain out-of-hours ¿ an interview study of primary care physicians¿ diagnostic approach, tolerance of risk and attitudes to hospital admission
Conclusions: Physicians working out-of-hours showed considerable differences in their diagnostic approach, and not all physicians diagnose patients with chest pain according to current guidelines and evidence. Continuous medical education must focus on the diagnostic approach in patients with chest pain in primary care and empowerment of physicians through training and emphasis on risk assessment and ?tolerance of risk?. (Source: BMC Family Practice)
Source: BMC Family Practice - December 21, 2014 Category: Primary Care Authors: Robert BurmanErik ZakariassenSteinar Hunskaar Source Type: research

Patient Safety skills in primary care: a national survey of GP educators
Conclusions: GPES believe a broad range of skills and attributes contribute to being a safe GP. Important but subtle differences exist between what primary care and secondary care doctors perceive as core safety attributes. Educationalists, GPs and patient safety experts should collaborate to develop and implement training in these skills to ensure that current and future GPs possess the necessary competencies to engage and lead in safety improvement efforts. (Source: BMC Family Practice)
Source: BMC Family Practice - December 17, 2014 Category: Primary Care Authors: Maria AhmedSonal AroraJohn McKaySusannah LongCharles VincentMoya KellyNick SevdalisPaul Bowie Source Type: research

Does receipt of 5As services have implications for patients¿ satisfaction in India?
Conclusions: Incorporating 5As interventions in the delivery of primary care would likely increase patients? satisfaction with physicians? delivered counseling services. Patients? recommendation of counseling services will aid in demand generation for cessation services in primary care. (Source: BMC Family Practice)
Source: BMC Family Practice - December 17, 2014 Category: Primary Care Authors: Divya PersaiRajmohan PandaSudhir VenkatesanMonika AroraJasjit Ahluwalia Source Type: research

Swedish general practitioners¿ attitudes towards treatment guidelines ¿ a qualitative study
Conclusions: Patient safety, trust in development of evidence-based recommendations, the patient-doctor encounter and cost containment were found to be key factors in GPs’ prescribing. Future studies should explore the need for transparency in forming and implementing guidelines, which might potentially increase adherence to evidence-based treatment guidelines in primary care. (Source: BMC Family Practice)
Source: BMC Family Practice - December 16, 2014 Category: Primary Care Authors: Veronica MilosTommy WesterlundPatrik MidlövEva Strandberg Source Type: research

Swedish general practitioners¿ attitudes towards treatment guidelines ¿ a qualitative study
Conclusions: Patient safety, trust in development of evidence-based recommendations, the patient-doctor encounter and cost containment were found to be key factors in GPs? prescribing. Future studies should explore the need for transparency in forming and implementing guidelines, which might potentially increase adherence to evidence-based treatment guidelines in primary care. (Source: BMC Family Practice)
Source: BMC Family Practice - December 16, 2014 Category: Primary Care Authors: Veronica MilosTommy WesterlundPatrik MidlövEva Strandberg Source Type: research

Long-term impact of a real-world coordinated lifestyle promotion initiative in primary care: a quasi-experimental cross-sectional study
Conclusions: The Lifestyle teams may have offered opportunities for lifestyle promotion practice and contributed to enabling conditions at centre level but had limited impact on lifestyle promotion practices. (Source: BMC Family Practice)
Source: BMC Family Practice - December 16, 2014 Category: Primary Care Authors: Kristin ThomasBarbro KreversPreben Bendtsen Source Type: research