Investigating the sustainability of careers in academic primary care: a UK survey
This study seeks to quantify the current situation for academics within primary care. Methods: A survey of academic primary care staff was undertaken. Fifty-three academic primary care departments were selected. Members were invited to complete a survey which contained questions about an individual?s career, clarity of career pathways, organisational culture, and general experience of working within the area. Data were analysed descriptively with cross-tabulations between survey responses and career position (early, mid-level, senior), disciplinary background (medical, scientist), and gender. Pearson chi-square test was us...
Source: BMC Family Practice - December 14, 2014 Category: Primary Care Authors: Raff CalitriAnn AdamsHelen AthertonJoanne ReeveNathan Hill Source Type: research

Primary care clinicians¿ perceptions about antibiotic prescribing for acute bronchitis: a qualitative study
Conclusions: Clinicians continued to cite patient demand as the main reason for antibiotic prescribing for acute bronchitis, though some clinicians perceived a recent decrease. Clinicians felt that other clinicians were responsible for inappropriate antibiotic prescribing and that better pre-visit triage by nurses could prevent visits and change patients’ expectations. (Source: BMC Family Practice)
Source: BMC Family Practice - December 12, 2014 Category: Primary Care Authors: Patrick DempseyAlexandra BusingerLauren WhaleyJoshua GagneJeffrey Linder Source Type: research

The effect and acceptability of tympanometry and pneumatic otoscopy in general practitioner diagnosis and management of childhood ear disease
We examined how, after targeted short training, GP?s diagnosis and management of childhood ear disease was changed by the addition of these techniques to non-pneumatic otoscopy. We further explored factors influencing the uptake of these techniques. Methods: Between 2011 and 2012, we used a crossover experimental design to determine associations between tympanometry and pneumatic otoscopy and the GP diagnosis and management of ear disease in children aged 6?months to 6?years. GPs recorded a diagnosis and management plan after examining ears using non-pneumatic otoscopy, and another after using either tympanometry or pneuma...
Source: BMC Family Practice - December 12, 2014 Category: Primary Care Authors: Penelope AbbottSara RosenkranzWendy HuHasantha GunasekeraJennifer Reath Source Type: research

The value of signs, symptoms and plasma heart-type fatty acid-binding protein (H-FABP) in evaluating patients presenting with symptoms possibly matching acute coronary syndrome: background and methods of a diagnostic study in primary care
DiscussionA safe diagnostic elimination of ACS by application of the algorithm can be of significant clinical relevance. Improved triage and thus reduction of the number of patients with chest complaints without underlying ACS, that are referred to secondary care facilities, could lead to a substantial cost reduction.Trial registrationClinicalTrials.gov, NCT01826994, accepted April 8th 2013. (Source: BMC Family Practice)
Source: BMC Family Practice - December 12, 2014 Category: Primary Care Authors: Robert WillemsenFrank BuntinxBjorn WinkensJan GlatzGeert DinantThe `RAPIDA¿-study team Source Type: research

Primary care clinicians¿ perceptions about antibiotic prescribing for acute bronchitis: a qualitative study
Conclusions: Clinicians continued to cite patient demand as the main reason for antibiotic prescribing for acute bronchitis, though some clinicians perceived a recent decrease. Clinicians felt that other clinicians were responsible for inappropriate antibiotic prescribing and that better pre-visit triage by nurses could prevent visits and change patients? expectations. (Source: BMC Family Practice)
Source: BMC Family Practice - December 12, 2014 Category: Primary Care Authors: Patrick DempseyAlexandra BusingerLauren WhaleyJoshua GagneJeffrey Linder Source Type: research

Estimating the workload associated with symptoms-based ovarian cancer screening in primary care: an audit of electronic medical records
Conclusion: One in two women aged 45?74 present to primary care at least once a year with an OC symptom, 11.9% with a new NICE symptom. This would be comparable to 2 to 8 yearly screening (depending on what symptoms triggered testing). (Source: BMC Family Practice)
Source: BMC Family Practice - December 12, 2014 Category: Primary Care Authors: Anita LimDavid MesherPeter Sasieni Source Type: research

Development of a family physician impact assessment tool in the district health system of the Western Cape Province, South Africa
Background: Policy makers in Africa are ambivalent about the need for family physicians to strengthen district health services. Evidence on the impact of family physicians is therefore needed. The aim was to develop a tool to evaluate the impact of family physicians on district health services according to the six expected roles that have been defined nationally. Methods: Mixed methods were used to develop, validate, pilot and test the reliability of the tool in the Western Cape Province, South Africa. An expert panel validated the content and construction of the tool. The tool was piloted by 94 respondents who evaluated e...
Source: BMC Family Practice - December 12, 2014 Category: Primary Care Authors: Kevin PasioRobert MashTracey Naledi Source Type: research

To what extent do primary care practice nurses act as case managers lifestyle counselling regarding weight management? A systematic review
Conclusion: The PN can play the role of case manager lifestyle counselling regarding weight management in primary care in the UK, and wherever PNs are working under supervision of a GP and a primary health care team is already developed with agreement on roles. In countries in which a primary health care team is still in development and there is no agreement on respective roles, such as the USA, it is still the question whether the PN can play the case manager role. (Source: BMC Family Practice)
Source: BMC Family Practice - December 10, 2014 Category: Primary Care Authors: Sonja van DillenGerrit Hiddink Source Type: research

Acute admissions to a community hospital - health consequences: a randomized controlled trial in Hallingdal, Norway
Conclusions: No statistical significant differences at a 5% level were found related to health consequences between the two randomized groups. The study however, indicates a consistent trend of health benefits rather than risk from acute admissions to a community hospital, as compared to the general hospital. Emergency admission and treatment at a lower-level facility than the hospital thus appears to be a feasible solution for a selected group of patients.Trial registrationClinicalTrials.gov NCT01069107. Registered 2 April 2010. (Source: BMC Family Practice)
Source: BMC Family Practice - December 10, 2014 Category: Primary Care Authors: Øystein LappegardPer Hjortdahl Source Type: research

Development of the Health Literacy of Caregivers Scale - Cancer (HLCS-C): item generation and content validity testing
Conclusion: A resultant 88 item questionnaire was developed to assess cancer caregiver health literacy. Further work is required to assess the construct validity and reliability of the new measure, and to remove poorly performing and redundant items, which will result in a shorter, final measure. The new measure has the potential to inform the development and evaluation of interventions and the improvement of health service delivery to cancer caregivers. (Source: BMC Family Practice)
Source: BMC Family Practice - December 10, 2014 Category: Primary Care Authors: Eva YuenTess KnightSarity DodsonLina RicciardelliSusan BurneyPatricia Livingston Source Type: research

Measuring patient-perceived continuity of care for patients with long-term conditions in primary care
Conclusion: The context-specific items in the Chao PC scale are difficult for respondents to interpret in a United Kingdom Primary Care setting resulting in missing data and low response rates. The Chao-PC therefore cannot be recommended for wider application as a general measure of continuity of care without significant modification.Our findings reflect the acknowledged dimensions of continuity and support the concept of continuity of care as a multi-dimensional construct. We demonstrate the overlapping boundaries across the dimensions in the factor structure derived. Trust and interpersonal knowledge are clearly identifi...
Source: BMC Family Practice - December 5, 2014 Category: Primary Care Authors: Kate HillMaureen TwiddyJenny HewisonAllan House Source Type: research

Managing the consultation with patients with medically unexplained symptoms: a grounded theory study of supervisors and registrars in general practice
Conclusions: Negative feelings and a lack of diagnostic language and frameworks may prevent registrars from managing these patients effectively. Some of these negative feelings, such as frustration, shame and helplessness, are shared between doctors and patients. Registrars need assistance to identify and manage these difficult feelings so that consultations are more effective. The care of these patients also raises issues of professional identity, roles and responsibilities. Supervisors can assist their registrars by proactively sharing models of the consultation, strategies for managing their own feelings and frustration...
Source: BMC Family Practice - December 5, 2014 Category: Primary Care Authors: Louise Stone Source Type: research

Repeated primary care consultations for non-specific physical symptoms in children in UK: a cohort study
Conclusions: Repeated consultation for NSPS is common among children. It is important for primary care physicians and secondary care clinicians, managing children referred from primary care for NSPS, to be aware that consultation for NSPS in mothers is a risk factor for repeated consultations for NSPS among children. More research is needed to uncover exactly how parental health influences health and consulting behavior of children. (Source: BMC Family Practice)
Source: BMC Family Practice - December 5, 2014 Category: Primary Care Authors: Mujahed ShraimMilisa Blagojevic-BucknallChristian MallenKate Dunn Source Type: research

Use of exercise tests in primary care: importance for referral decisions and possible bias in the decision process; a prospective observational study
Conclusions: Exercise tests are important for selecting patients for referral to cardiologic care. Interactions related to gender and socioeconomic status affected referral rates. In patients with positive exercise tests, referral rates decreased with age. An increased awareness of possible bias regarding age, gender, and socioeconomic status, which may influence medical decisions, is therefore necessary. (Source: BMC Family Practice)
Source: BMC Family Practice - November 30, 2014 Category: Primary Care Authors: Gunnar NilssonThomas MooeLars SöderströmEva Samuelsson Source Type: research

General practitioners uses and perceptions of voluntary electronic feedback on treatment outcomes ¿ a qualitative study
Conclusions: The study points to the importance of clarifying limitations as well as possibilities with respect to different aspects of clinical quality when introducing indicator-based technologies to practitioners. The results also emphasize that an indicator-based approach to quality improvement should not stand alone in general practice since some of the most central and challenging aspects of clinical work are not covered by this approach. (Source: BMC Family Practice)
Source: BMC Family Practice - November 30, 2014 Category: Primary Care Authors: Maria LippertMarius KousgaardLars Bjerrum Source Type: research

Predictors of patient self-report of chronic kidney disease: baseline analysis of a randomised controlled trial
Background: Improving the quality of care for patients with vascular disease is a priority. Clinical guidance has emphasised the importance of early identification and active management of chronic kidney disease (CKD) in primary care in order to maintain vascular health. However, awareness of stage 3 CKD amongst patients remains limited. We aimed to identify predictors of patient self-report of CKD to inform tailoring of conversations around CKD in primary care for diverse patient populations. Methods: We conducted a cross-sectional analysis of baseline data from 436 patients with stage 3 CKD from 24 GP practices taking pa...
Source: BMC Family Practice - November 30, 2014 Category: Primary Care Authors: Hannah GaffneyThomas BlakemanChristian BlickemAnne KennedyDavid ReevesShoba DawsonRahena MossabirPeter BowerCaroline GardnerVictoria LeeAnne Rogers Source Type: research

Effective teamwork in primary healthcare through a structured patient-sorting system - a qualitative study on staff members¿ conceptions
Conclusions: This study demonstrates that the introduction of a structured patient-sorting system makes it possible for several important change processes to take place concurrently: improvement of healthcare processes, empowerment of professionals and team development. It therefore indicates the importance of an appropriate, contextualized framework to support multiple concomitant quality improvement processes. Knowledge from this study can be used to assist and improve future implementations in primary healthcare centres. (Source: BMC Family Practice)
Source: BMC Family Practice - November 28, 2014 Category: Primary Care Authors: Andy MaunMiriam EngströmAnna FrantzElisabeth BrämbergJörgen Thorn Source Type: research

Defining dimensions of research readiness: a conceptual model for primary care research networks
Conclusions: The model might enable the development of interventions to increase participation in primary care-based research and become a tool to measure the progress of practice networks towards the most advanced state of readiness. (Source: BMC Family Practice)
Source: BMC Family Practice - November 26, 2014 Category: Primary Care Authors: Helen CarrSimon de LusignanHarshana LiyanageSiaw-Teng LiawAmanda TerryImran Rafi Source Type: research

Drugs prescribed by general practitioners according to age, gender and socioeconomic status after adjustment for multimorbidity level
Conclusion: Age, gender and socioeconomic status are associated with large differences in the use of prescribed drugs in primary health care, even after adjustment for multimorbidity level. (Source: BMC Family Practice)
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Jessica SkoogPatrik MidlövAnders BeckmanJan SundquistAnders Halling Source Type: research

Cost-effectiveness of chronic fatigue self-management versus usual care: a pilot randomized controlled trial
Conclusion: This economic evaluation found initial evidence that a two-session brief CBT-based FSM may be cost-effective as compared to usual care over 12?months. The FSM intervention is potentially a promising intervention for chronic fatigue patients in primary care. Additional research is needed to examine the reproducibility and generalizability of these findings.Trial registrationClinicalTrials.gov (NCT00997451, March 28, 2009). (Source: BMC Family Practice)
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Hongdao MengFred FriedbergMelissa Castora-Binkley Source Type: research

Association of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional study
Conclusions: Self-rated health provides a simple, integrative patient-centred assessment for evaluation of illness in the context of multiple chronic disease diagnoses. Those registering in general practice in particular men with three or more diseases or those with cardiovascular comorbidities and with poorer self-rated health may warrant further assessment and intervention to improve their physical and subjective health. (Source: BMC Family Practice)
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Nahal MavaddatJose ValderasRianne van der LindeKay KhawAnn Kinmonth Source Type: research

Feasibility of implementing routine nutritional screening for older adults in Australian general practices: a mixed-methods study
This study aimed to demonstrate the feasibility of including a validated nutrition screening tool and accompanying nutrition resource kit for use with older patients attending general practice. Secondary aims were to assess nutrition-related knowledge of staff and to identify the extent of malnutrition in this patient group. Methods: Nine general practitioners, two general practice registrars and 11 practice nurses from three participating general practices in a rural, regional and metropolitan area within a local health district of New South Wales, Australia were recruited by convenience sampling.Individual in-depth inter...
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Aliza HamirudinKaren CharltonKaren WaltonAndrew BonneyJan PotterMarianna MilosavljevicAdam HodgkinsGeorge AlbertAbhijeet GhoshAndrew Dalley Source Type: research

Point of care testing for urinary tract Infection in primary care (POETIC): protocol for a randomised controlled trial of the clinical and cost effectiveness of FLEXICULT¿ informed management of uncomplicated UTI in primary care
DiscussionAlthough the Flexicult? POCT is used in some countries in routine primary care, it?s clinical and cost effectiveness has never been evaluated in a randomised clinical trial. If shown to be effective, the use of this POCT could benefit individual sufferers and provide evidence for health care authorities to develop evidence based policies to combat the spread and impact of the unprecedented rise of infections caused by antibiotic resistant bacteria in Europe.Trial registration numberISRCTN65200697 (Registered 10 September 2013). (Source: BMC Family Practice)
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Janine BatesEmma Thomas-JonesTimothy PicklesNigel KirbyMicaela GalEmily BongardKerenza HoodNicolas FrancisPaul LittleMichael MooreKate RumsbyCarlos LlorCurt BurgmanTheo VerheijDavid CohenMandy WoottonRobin HoweChristopher Butler Source Type: research

Concerns voiced by patients and GPs¿ responses during psychosocial visits in primary care: a historical cross-sectional study
Conclusions: Our study shows that patients have become somewhat more explicit in expressing their worries. However, GPs need to be aware that, still, most worries are expressed implicitly and that new concerns may appear towards the end of consultations. (Source: BMC Family Practice)
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Ligaya ButalidPeter VerhaakSandra van DulmenJozien Bensing Source Type: research

Why primary care practices should become digital health information hubs for their patients
DiscussionWe contribute to this debate by proposing that primary care practices become digital health information hubs for their patients. Such hubs would offer health data coordination in a medically professional setting with the benefits of expert, trustworthy advice coupled with active patient engagement. We acknowledge challenges including: costs, information quality and provenance, willingness-to-share information and records, willingness-to-use (by both providers and patients), primary care scope creep, and determinations of technical and process effectiveness. Even with such potential challenges, we strongly believe...
Source: BMC Family Practice - November 25, 2014 Category: Primary Care Authors: Aaron BairdSamantha Nowak Source Type: research

Relationships between actual and desired workplace characteristics and job satisfaction for community health workers in China: a cross-sectional study
Conclusions: These findings suggested that managers wishing to enhance job satisfaction should assess workplace characteristics comprehensively and design mechanisms that reduce the gap between actual and desired workplace characteristics. (Source: BMC Family Practice)
Source: BMC Family Practice - November 18, 2014 Category: Primary Care Authors: Li LiZhong ZhangZhinan SunHao ZhouXinyan LiuHeng LiLihua FanPeter Coyte Source Type: research

Does use of pooled cohort risk score overestimate the use of statin?: a retrospective cohort study in a primary care setting
Conclusions: An extra 40% of patients need to be treated with statin if the 2013 ACC/AHA blood cholesterol guideline is used. However the absolute number of patients who needed to be treated based on the ACC/AHA guideline is lower than the number of patients actually receiving it in a daily clinical practice. The pooled cohort risk score does not increase the absolute number of patients who are actually treated with statins. However these findings and the use of the pooled cohort risk score need to be validated further. (Source: BMC Family Practice)
Source: BMC Family Practice - November 12, 2014 Category: Primary Care Authors: Yook ChiaHooi LimSiew Ching Source Type: research

Effect of accreditation on the quality of chronic disease management: a comparative observational study
Conclusions: Improvements of the quality of primary care for patients with chronic diseases were found, but few could be attributed to the accreditation program. Further development of accreditation is needed to enhance its effectiveness on chronic disease management. (Source: BMC Family Practice)
Source: BMC Family Practice - November 4, 2014 Category: Primary Care Authors: Arna van Doorn ¿ KlombergJozé BraspenningRené WoltersMargriet BoumaMichel Wensing Source Type: research

Perceptions of primary care in Korea: a comparison of patient and physician focus group discussions
Conclusions: The focus group discussions revealed that such discrepancies in perception have resulted from Korea?s distorted healthcare delivery system, undifferentiated roles among healthcare organizations, patients? freedom of choice in selecting healthcare providers and other institutional factors. There are several steps that should be taken to promote primary care in Korea. First, we should undertake efforts to improve the quality of primary care provided by physicians. Second, we should inform the general public about using clinics instead of hospitals for the treatment of simple or minor diseases. Third, we should i...
Source: BMC Family Practice - October 31, 2014 Category: Primary Care Authors: Minsu OckJung-Eun KimMin-Woo JoHyeon-Jeong LeeHyun KimJin Lee Source Type: research

Do practice characteristics explain differences in morbidity estimates between electronic health record based general practice registration networks?
Conclusion: Practice characteristics do not explain the differences in morbidity estimates between GPRNs. (Source: BMC Family Practice)
Source: BMC Family Practice - October 30, 2014 Category: Primary Care Authors: C van den DungenN HoeymansM van den AkkerM BiermansK van BovenJ JoostenR VerheijM de WaalF SchellevisJ van Oers Source Type: research

Transient ischaemic attack: a qualitative study of the long term consequences for patients
Conclusion: Current definitions conceptualise TIA as a transient event however our study suggests that some patients experienced long term consequences as a result of their TIA. These included anxiety and uncertainty in the light of their increased stroke risk. TIA patients need access to detailed, evidence based stroke prevention information from a credible source, and support to help them understand and apply the information over time, if they are to effectively self-manage the long term consequences of TIA and reduce their risk of future stroke. (Source: BMC Family Practice)
Source: BMC Family Practice - October 29, 2014 Category: Primary Care Authors: Elizabeth CrootTony RyanJennifer ReadFiona CampbellAlicia O¿CathainGraham Venables Source Type: research

Tools for primary care patient safety: a narrative review
Background: Patient safety in primary care is a developing field with an embryonic but evolving evidence base. This narrative review aims to identify tools that can be used by family practitioners as part of a patient safety toolkit to improve the safety of the care and services provided by their practices. Methods: Searches were performed in 6 healthcare databases in 2011 using 3 search stems; location (primary care), patient safety synonyms and outcome measure synonyms. Two reviewers analysed the results using a numerical and thematic analyses. Extensive grey literature exploration was also conducted. Results: Overall, 1...
Source: BMC Family Practice - October 26, 2014 Category: Primary Care Authors: Rachel SpencerStephen Campbell Source Type: research

Primary care treatment guidelines for skin infections in Europe: congruence with antimicrobial resistance found in commensal Staphylococcus aureus in the community
Conclusions: Most of the first- and second-choice recommendations in the treatment guidelines for skin infections were congruent with commensal S. aureus antimicrobial resistance patterns in the community, except for two recommendations for penicillin. Given the variation in antimicrobial resistance levels between countries, age groups and health care settings, national data regarding antimicrobial resistance in the community should be taken into account when updating or developing primary care treatment guidelines. (Source: BMC Family Practice)
Source: BMC Family Practice - October 25, 2014 Category: Primary Care Authors: Evelien van BijnenW PagetCasper den HeijerEllen StobberinghCathrien BruggemanFrançois Schellevisin collaboration with the APRES Study Team Source Type: research

`Just another incentive scheme¿: a qualitative interview study of a local pay-for-performance scheme for primary care
Conclusions: The contentious nature of pay-for-performance was not necessarily reduced by local adaptation. Those developing future schemes should consider differential rewards and supportive resources for practices serving more deprived populations, and employing a wider range of levers to promote professional understanding and ownership of indicators. (Source: BMC Family Practice)
Source: BMC Family Practice - October 25, 2014 Category: Primary Care Authors: Julia HackettLiz GlidewellRobert WestPaul CarderTim DoranRobbie Foy Source Type: research

Anticoagulant treatment in German family practices ¿ screening results from a cluster randomized controlled trial
Conclusions: The screening results showed that a high proportion of patients were receiving appropriate anticoagulation therapy. The numbers of patients with a long-term indication for OAC therapy that were not receiving oral anticoagulants, and without a long-term indication that were receiving OAC, were considerably lower than expected. Most patients take coumarins, and the quality of OAC control is reasonably high.Trial registrationCurrent Controlled Trials ISRCTN41847489. (Source: BMC Family Practice)
Source: BMC Family Practice - October 25, 2014 Category: Primary Care Authors: Lisa-R UlrichKarola MergenthalJuliana PetersenIna RoehlSandra RauckBirgit KemperdickSylvia Schulz-RotheAndrea BergholdAndrea Siebenhofer Source Type: research

Disease diagnosis in primary care in Uganda
Conclusions: We observed a broad range of diagnoses, a high percentage of multiple diagnoses including true co-morbidities, and underutilization of laboratory support. This emphasizes the complexity of illnesses to be addressed by primary healthcare workers. An improved HMIS collecting timely, quality data is needed. This would adequately describe the burden of disease and processes of care at primary care level, enable appropriate national guidelines, programs and policies and improve accountability for the quality of care. (Source: BMC Family Practice)
Source: BMC Family Practice - October 8, 2014 Category: Primary Care Authors: Martin MbonyeSarah BurnettRobert ColebundersSarah NaikobaJean-Pierre Van GeertruydenMarcia WeaverAllan Ronald Source Type: research

Patient information leaflets: informing or frightening? A focus group study exploring patients¿ emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices
Conclusions: Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions. (Source: BMC Family Practice)
Source: BMC Family Practice - October 2, 2014 Category: Primary Care Authors: Oliver HerberVerena GiesDavid SchwappachPetra ThürmannStefan Wilm Source Type: research

Patient information leaflets: informing or frightening? A focus group study exploring patients' emotional reactions and subsequent behavior towards package leaflets of commonly prescribed medications in family practices
Conclusions: Future PILs need to convey potential risk information in a language that is less frightening while retaining the information content required to make informed decisions about the prescribed medication. Thus, during the production process greater emphasis needs to be placed on testing the degree of emotional arousal provoked in patients when reading risk information to allow them to undertake a benefit-risk-assessment of their medication that is based on rational rather than emotional (fearful) reactions. (Source: BMC Family Practice)
Source: BMC Family Practice - October 2, 2014 Category: Primary Care Authors: Oliver HerberVerena GiesDavid SchwappachPetra ThürmannStefan Wilm Source Type: research

How women manage recurrent urinary tract infections: an analysis of postings on a popular web forum
Conclusion: A web-based analysis can vividly capture the views of a diverse population. RUTIs can have a disabling effect on women's health, their intimate and social relationships, self-esteem, and capacity for work. Further research is required to clarify the wider relevance of the qualitative themes identified, to identify key elements of good practice, and to provide a more rigorous assessment of CAM interventions. (Source: BMC Family Practice)
Source: BMC Family Practice - September 26, 2014 Category: Primary Care Authors: Andrew FlowerFelicity BishopGeorge Lewith Source Type: research

Weight related health status of patients treated by dietitians in primary care practice: first results of a cohort study
Conclusion: The study was effective in recruiting dietitians to participate. The sample is representative for dietitians working in primary care. The majority of patients (94%) had a high to extremely high weight related health risk (WRHR). (Source: BMC Family Practice)
Source: BMC Family Practice - September 25, 2014 Category: Primary Care Authors: Elisabeth GoversJacob SeidellMarjolein VisserIngeborg Brouwer Source Type: research

Quality of primary care for resettled refugees in the Netherlands with chronic mental and physical health problems: a cross-sectional analysis of medical records and interview data
Conclusion: This study shows that awareness in resettled refugees of GP diagnosed DMII and HT is high, whereas GP recognition of CMD and overall guideline adherence are moderate. (Source: BMC Family Practice)
Source: BMC Family Practice - September 23, 2014 Category: Primary Care Authors: Marije van MelleMajda LamkaddemMartijn StuiverAnnette GerritsenWalter DevilléMarie-Louise Essink-Bot Source Type: research

Organisation of services for people with cardiovascular disorders in primary care: transfer to primary care or to specialist-generalist multidisciplinary teams?
DiscussionIn this paper we argue, having searched for evidence on approaches to shifting care for some people with cardiovascular problems from secondary to primary care, that a collaborative, multidisciplinary approach is required to achieve high quality outcomes from cardiovascular care in the primary care setting. Simply transferring patients from specialist care to management by primary care teams is likely to lead to worse outcomes than services that involve both specialists and primary care teams together, in planned and effectively managed systems of care.The care of patients with certain chronic conditions in the c...
Source: BMC Family Practice - September 22, 2014 Category: Primary Care Authors: Egle PriceRichard BakerJane KrauseChristine Keen Source Type: research

Daytime use of general practice and use of the Out-of-Hours Primary Care Service for patients with chronic disease: a cohort study
Conclusion: Recent and frequent use of daytime GP for patients with the selected chronic diseases was associated with contacts to the OOH services due to exacerbation. These findings indicate that the most severely chronically ill patients tend to make more use of general practice. The provision of an annual follow-up daytime GP consultation may indicate a lower risk of contacting OOH due to exacerbation. (Source: BMC Family Practice)
Source: BMC Family Practice - September 20, 2014 Category: Primary Care Authors: Lone FlarupGrete MothMorten ChristensenMogens VestergaardFrede OlesenPeter Vedsted Source Type: research

Functional and self-rated health mediate the association between physical indicators of diabetes and depressive symptoms
Conclusions: The way individuals perceive their health appears to have a stronger effect on their depressive symptoms than objective physical indicators of diabetes. Therefore practitioners should be trained to pay more attention to their patients' subjective health perceptions. (Source: BMC Family Practice)
Source: BMC Family Practice - September 20, 2014 Category: Primary Care Authors: Sylvia BoehmeChristian GeiserBabette Renneberg Source Type: research

A prospective clinical trial of specialist renal nursing in the primary care setting to prevent progression of chronic kidney: a quality improvement report
Conclusions: The results suggest that a collaborative model of care between specialist renal nurses and primary care clinicians may improve the management of risk factors for progression of CKD and CV death. Further larger, controlled studies are warranted to definitively determine the effectiveness and costs of this intervention.Trial registration: Australian and New Zealand Clinical Trials Registry number: ACTRN12613000791730 (Source: BMC Family Practice)
Source: BMC Family Practice - September 20, 2014 Category: Primary Care Authors: Rachael WalkerMark MarshallNick Polaschek Source Type: research

Are ¿part-time¿ general practitioners workforce idlers or committed professionals?
Conclusion: "Part-time" general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants' clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession. (Source: BMC Family Practice)
Source: BMC Family Practice - September 19, 2014 Category: Primary Care Authors: Kathryn DwanKirsty DouglasLaura Forrest Source Type: research

Are "part-time" general practitioners workforce idlers or committed professionals?
Conclusion: "Part-time" general practice is a misnomer that masks the contribution these GPs make as part of the health workforce. Sessional practice more accurately describes the nature of our participants' clinical work. Their choice of sessional work is a professional response to the increasing demands within the consultation. It enables GPs to maintain their commitment to quality patient care and their profession, while attenuating the challenges of demanding consultations. Sessional general practitioners demonstrate strong commitment to their patients and the profession. (Source: BMC Family Practice)
Source: BMC Family Practice - September 19, 2014 Category: Primary Care Authors: Kathryn DwanKirsty DouglasLaura Forrest Source Type: research

A qualitative study of a primary-care based intervention to improve the management of patients with heart failure: the dynamic relationship between facilitation and context
Conclusions: When facilitating the transfer of evidence, context is an important aspect to consider at a macro and micro level; a complex interplay can exist between these levels, which may constrain or enable efforts to amend practice. Those involved in facilitating change within primary care have to manage tensions arising from the interplay of these different contextual forces to minimise their impact on efforts to alter practice based on best evidence. (Source: BMC Family Practice)
Source: BMC Family Practice - September 18, 2014 Category: Primary Care Authors: Stephanie TierneyRoman KislovChristi Deaton Source Type: research

Rating general practitioner consultation performance in cancer care: does the specialty of assessors matter? A simulated patient study
Conclusion: The assessment of GP consultation performance is not consistent across assessors from different disciplines even when they deploy the same assessment tool. (Source: BMC Family Practice)
Source: BMC Family Practice - September 13, 2014 Category: Primary Care Authors: Moyez JiwaGeorgia HalkettXingqiong MengMelissa Berg Source Type: research

Study protocol of EMPOWER Participatory Action Research (EMPOWER-PAR): a pragmatic cluster randomised controlled trial of multifaceted chronic disease management strategies to improve diabetes and hypertension outcomes in primary care
Background: Chronic disease management presents enormous challenges to the primary care workforce because of the rising epidemic of cardiovascular risk factors. The chronic care model was proven effective in improving chronic disease outcomes in developed countries, but there is little evidence of its effectiveness in developing countries. The aim of this study was to evaluate the effectiveness of the EMPOWER-PAR intervention (multifaceted chronic disease management strategies based on the chronic care model) in improving outcomes for type 2 diabetes mellitus and hypertension using readily available resources in the Malays...
Source: BMC Family Practice - September 13, 2014 Category: Primary Care Authors: Anis RamliSharmila LakshmananJamaiyah HaniffSharmini SelvarajahSeng TongMohamad-Adam BujangSuraya Abdul-RazakAsrul ShafieVerna LeeThuhairah Abdul-RahmanMaryam DaudKien NgFarnaza AriffinHasidah Abdul-HamidMd-Yasin MazapuspavinaNafiza Mat-NasirMaizatullifah Source Type: research