Primary prevention in general practice ¿ views of German general practitioners: a mixed-methods study
Conclusions: The mixed-method study showed that primary prevention approaches such as lifestyle counseling is not well established in primary care. GPs used a selective approach to offer preventive advice based upon indication. GPs had a strong sense that a universal prevention approach carried the potential to destroy a good patient-physician relationship. Other approaches to public health may be warranted such as a multisectoral approach to population health. This type of restructuring of the health care sector may benefit patients who are unable to afford specific prevention programmes and who have competing demands tha...
Source: BMC Family Practice - May 25, 2014 Category: Primary Care Authors: Christine HolmbergGiselle SarganasNadine MittringVittoria BraunLorena DiniChristoph HeintzeNina RieckmannRebecca MuckelbauerJacqueline Müller-Nordhorn Source Type: research

Safety relevant knowledge of orally anticoagulated patients without self-monitoring: a baseline survey in primary care
Conclusions: Patients have relevant knowledge gaps, potentially affecting safe and effective OAT. There is a need to assess patients' knowledge and for structured education programs.Trial registration: Deutsches Register Klinischer Studien (German Clinical Trials Register): DRKS00000586.Universal Trial Number (UTN U1111-1118-3464). (Source: BMC Family Practice)
Source: BMC Family Practice - May 25, 2014 Category: Primary Care Authors: Jean-François ChenotThanh HuaManar Abu AbedHannelore Schneider-RudtTim FriedeSimon SchneiderStefan Vormfelde Source Type: research

Influenza vaccination during pregnancy: a qualitative study of the knowledge, attitudes, beliefs, and practices of general practitioners in Central and South-Western Sydney
Conclusions: General practitioners have varied knowledge, attitudes, and beliefs about influenza vaccination during pregnancy, which influence their practices. Addressing these could have a significant impact on improving vaccine uptake during pregnancy. (Source: BMC Family Practice)
Source: BMC Family Practice - May 23, 2014 Category: Primary Care Authors: Louise MaherAngela DawsonKerrie WileyKirsty HopeSiranda TorvaldsenGlenda LawrenceStephen Conaty Source Type: research

Exploration of population and practice characteristics explaining differences between practices in the proportion of hospital admissions that are emergencies
Conclusion: In monitoring use of secondary care services, the role of population characteristics in determining levels of use is important, but so too is the ability of practices to meet the demands for care that face them. The level of resources, and the way in which available resources are used, are likely to be key in determining whether a practice is able to meet the health care needs of its patients. (Source: BMC Family Practice)
Source: BMC Family Practice - May 21, 2014 Category: Primary Care Authors: Chantelle WisemanRichard Baker Source Type: research

Extending the authority for sickness certification beyond the medical profession: the importance of 'boundary work'
Conclusions: Extending the authority to certify sickness absence beyond the medical profession is not simply a matter of addressing practical and organisational obstacles. There is also a need to consider the impact on, and preferences of, the specific occupations and their respective boundary claims. This paper explores the implications of extending the sick certification role beyond general practice. We conclude that the main policy challenge of such a move is to a) persuade GPs to relinquish this role (or to share it with other professions), and b) to understand the 'boundary work' involved. (Source: BMC Family Practice)
Source: BMC Family Practice - May 17, 2014 Category: Primary Care Authors: Victoria WelshTom SandersJane RichardsonGwenllian Wynne-JonesClare JinksChristian Mallen Source Type: research

Type 2 diabetes patients¿ perspectives on lifestyle counselling and weight management in general practice: a qualitative study
Conclusions: Ambivalence towards patient self-management and tensions between the necessary changes to patients' lifestyles and their culture, makes the GP's role difficult and full of conflict. Instead of focusing exclusively on the guidelines of diabetes management and provision of information, GPs should explore the patients' capabilities of self-management through open communication and accept their patients' wishes to protect nutrition as part of their culture. (Source: BMC Family Practice)
Source: BMC Family Practice - May 15, 2014 Category: Primary Care Authors: Matthias WermelingUlrike Thiele-ManjaliJanka KoschackGabriele Lucius-HoeneWolfgang Himmel Source Type: research

Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in local communities
Conclusions: The development of a theory-based program logic model provided a framework for evaluation that allows the tracking of progress towards desired outcomes and exploration of the particular aspects of context and mechanisms that produce outcomes. This is important because there are no existing models which enable the evaluation of CPHC services in their entirety. (Source: BMC Family Practice)
Source: BMC Family Practice - May 15, 2014 Category: Primary Care Authors: Angela LawlessToby FreemanMichael BentleyFran BaumGwyn Jolley Source Type: research

Type 2 diabetes patients' perspectives on lifestyle counselling and weight management in general practice: a qualitative study
Conclusions: Ambivalence towards patient self-management and tensions between the necessary changes to patients' lifestyles and their culture, makes the GP's role difficult and full of conflict. Instead of focusing exclusively on the guidelines of diabetes management and provision of information, GPs should explore the patients' capabilities of self-management through open communication and accept their patients' wishes to protect nutrition as part of their culture. (Source: BMC Family Practice)
Source: BMC Family Practice - May 15, 2014 Category: Primary Care Authors: Matthias WermelingUlrike Thiele-ManjaliJanka KoschackGabriele Lucius-HoeneWolfgang Himmel Source Type: research

Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care - a 14-year follow-up questionnaire study
Conclusions: Despite major reforms in Finnish health care policy, patients seem to be less satisfied. Our findings challenge both Finnish authorities and GPs to improve the accessibility and continuity of care in primary health services. (Source: BMC Family Practice)
Source: BMC Family Practice - May 15, 2014 Category: Primary Care Authors: Risto RaivioJuhani JääskeläinenDoris Holmberg-MarttilaKari Mattila Source Type: research

The patient perspective on overactive bladder: a mixed-methods needs assessment
Conclusions: The significant time gap between symptom onset and diagnosis indicates ongoing need for screening and diagnosis of overactive bladder. Contrary to guideline recommendations, urinalysis and physical examination are not widely used in clinical practice. Many patients experience no improvement in symptoms over time. Patients indicate that clinician/patient relationships and communication regarding their condition are important. (Source: BMC Family Practice)
Source: BMC Family Practice - May 14, 2014 Category: Primary Care Authors: Frank FilipettoKimberly FuldaAmy HolthusenThomas McKeithenPam McFadden Source Type: research

Health care needs of cancer survivors in general practice: a systematic review
Conclusions: Cancer survivors have different types of general practice needs that are currently not or insufficiently met. This review provides a starting point for the development of new guidelines for general practitioners to support in cancer survivorship. (Source: BMC Family Practice)
Source: BMC Family Practice - May 13, 2014 Category: Primary Care Authors: Renske HoekstraMarianne HeinsJoke Korevaar Source Type: research

Patient presentation and physician management of upper respiratory tract infections: a retrospective review of over 5 million primary clinic consultations in Hong Kong
Conclusion: There was a decline in overall antibiotic prescription over the study period. However, the use of antibiotics was high in some conditions e.g. otitis media and acute laryngitis a. Multiple symptomatic medications were given for upper respiratory tract infections. Further research is needed to develop clinical and patients directed interventions to reduce the number of prescriptions of symptomatic medications and antibiotics that could reduce costs for health care services and iatrogenic risk to patients. (Source: BMC Family Practice)
Source: BMC Family Practice - May 13, 2014 Category: Primary Care Authors: Kenny KungCarmen WongSamuel WongAugustine LamChristy ChanSian GriffithsChris Butler Source Type: research

A monitoring and feedback tool embedded in a counselling protocol to increase physical activity of patients with COPD or type 2 diabetes in primary care: study protocol of a three-arm cluster randomised controlled trial
DiscussionResults of this study will give insight into the effects of the It's LiFe! monitoring and feedback tool combined with care from a practice nurse for people with COPD or DM2 on physical activity.Trial registration: ClinicalTrials.gov: NCT01867970 (Source: BMC Family Practice)
Source: BMC Family Practice - May 12, 2014 Category: Primary Care Authors: Renée VerweySanne van der WeegenMarieke SpreeuwenbergHuibert TangeTrudy van der WeijdenLuc de Witte Source Type: research

Design of the INTEGRATE study: effectiveness and cost-effectiveness of a cardiometabolic risk assessment and treatment program integrated in primary care
The objective of the INTEGRATE study is to investigate the effectiveness and cost-effectiveness of PPA CMR, as well as to establish determinants for participation and compliance. Methods: The INTEGRATE study is designed as a stepped-wedge randomized controlled trial with a waiting list control group. In approximately 40 general practices, all enlisted patients without CMD aged 45-70 years, are invited to participate in PPA CMR. After an online risk estimation, patients with a score above risk threshold are invited to the GP for additional measurements, detailed risk profiling and tailored treatment of risk factors through ...
Source: BMC Family Practice - May 9, 2014 Category: Primary Care Authors: Ilse BadenbroekDaphne StolMarcus NielenMonika HollanderRoderik KraaijenhagenG de WitFrançois SchellevisNiek de Wit Source Type: research

General practice and ethnicity: an experimental study of doctoring
Conclusions: We found no evidence that GPs discriminated against ethnic minority patients when it came to medical decisions. However, our study did identify a risk of drugs being used inappropriately in some ethnic-specific encounters. We also observed that, with ethnic minority patients, GPs engage less in the relational dimension of doctoring, particularly when working within a demanding environment. In general practice, the quality of the relationship between doctor and patient is an essential component of the effective management of chronic illness. Our research highlights the complexity of ethnic discrimination in gen...
Source: BMC Family Practice - May 9, 2014 Category: Primary Care Authors: Brice LepièceChristine ReynaertPhilippe van MeerbeeckVincent Lorant Source Type: research

Utility of a primary care based transient ischaemic attack electronic decision support tool: a prospective sequential comparison
Conclusion: The availability of TIA/Stroke electronic decision support in the primary care setting was associated with reductions in management delays without compromising patient safety. (Source: BMC Family Practice)
Source: BMC Family Practice - May 6, 2014 Category: Primary Care Authors: Annemarei RantaChwan-Fen YangMichael FunnellPietro CarigaCatherine Murphy-RahalNaomi Cogger Source Type: research

Gaining information about home visits in primary care: methodological issues from a feasibility study
Conclusions: The results of our feasibility study provide evidence for improvement of the study design and study instruments to effectively conduct a documentation-intensive study of GPs doing home visits. Improvement of instructions and questionnaire regarding time variables and assessment of the need for home visits will be carried out to increase the reliability of future data. One particularly important methodological issue yet to be resolved is how to increase the representativeness of home visit care by including the homebound patient population that is unable to provide informed consent. (Source: BMC Family Practice)
Source: BMC Family Practice - May 6, 2014 Category: Primary Care Authors: Karen VoigtStephanie TachéAndreas KlementThomas FankhaenelStefan BojanowskiAntje Bergmann Source Type: research

Patient reported outcome measures (PROMs) in primary care: an observational pilot study of seven generic instruments
Conclusions: The present study is among the first to explore the use of generic patient-reported outcome measures in primary care. It provides several leads for developing a generic PROM questionnaire in primary care as well as for potential limitations of such instruments. (Source: BMC Family Practice)
Source: BMC Family Practice - May 6, 2014 Category: Primary Care Authors: Jan-Willem WeeninkJozé BraspenningMichel Wensing Source Type: research

Implementing tobacco dependence treatment during clinical consultations: a qualitative study of clinicians' experiences, perceptions and behaviours in a South African primary health care setting
Conclusion: The reported selective screening and limited TDT interventions offered by HCPs are related to interactions between health systems constraints, personal limitations, and misperceptions and misconceptions about the effectiveness and feasibility of TDT during clinical consultation. Implementing the recommended systems changes has the potential to improve the implementation of TDT in South African primary health care (PHC). (Source: BMC Family Practice)
Source: BMC Family Practice - May 6, 2014 Category: Primary Care Authors: Olufemi OmoleOlalekan Ayo-YusufKabilabe Ngobale Source Type: research

Quality of life and health care consumption in primary care patients with elevated serum calcium concentrations in - a prospective, case control, study
Background: Patients with elevated calcium concentrations have an increased morbidity due to various underlying illnesses. However, there is a lack of studies of quality of life and health care consumption in patients with hypercalcaemia per se. The study aims to investigate quality of life and health care consumption, as measured by, sick leave, drug prescriptions and the number of visits and admissions to health care centres and hospitals, in primary care patients with elevated calcium concentrations. Methods: A prospective, case control, study in primary care centre, in Sweden. Patients with elevated, (n = 127, 28 men),...
Source: BMC Family Practice - May 5, 2014 Category: Primary Care Authors: Sofia DalemoRobert EggertsenPer HjerpeSvante JanssonKristina Boström Source Type: research

An exploratory trial of insulin initiation and titration among patients with type 2 diabetes in the primary care setting with retrospective continuous glucose monitoring as an adjunct: INITIATION study protocol
This study also explores the feasibility and efficacy of retrospective continuous glucose monitoring (r-CGM) in comparison with self-monitoring of blood glucose (SMBG) among people with T2D in primary care. Methods: The study employs a before and after design with a nested exploratory trial of SMBG and r-CGM. A total of 102 insulin naive T2D patients with a glycated haemoglobin (HbA1c) level of>7.5% in the previous 6 months while treated with maximal oral therapy will be recruited and screened from 22 primary care practices in Melbourne, Australia. All patients will be commenced on a basal insulin regimen following rand...
Source: BMC Family Practice - May 3, 2014 Category: Primary Care Authors: Irene BlackberryJohn FurlerLouise GinnivanHanan DerrazAlicia JenkinsNeale CohenJames BestDoris YoungDanny LiewGlenn WardJo-Anne Manski-NankervisDavid O¿Neal Source Type: research

Counseling on lifestyle habits in the United States and Sweden: a report comparing primary care health professionals' perspectives on lifestyle counseling in terms of scope, importance and competence
Background: The role of primary care providers in lifestyle counseling for smoking, alcohol consumption, physical activity, and diet is receiving attention at the national level in many countries. The U. S. and Sweden are two countries currently establishing priorities in these areas. A previously existing international research collaboration provides a unique opportunity to study this issue. Methods: Data from a national survey in Sweden and a study in rural Upstate New York were compared to contrast the perspectives, attitudes, and practice of primary care providers in the two countries. Answers to four key questions on ...
Source: BMC Family Practice - May 3, 2014 Category: Primary Care Authors: Lars WeinehallHelene JohanssonJulie SorensenLars JerdénJohn MayPaul Jenkins Source Type: research

Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group
Conclusion: The study showed that CRP testing in patients with acute cough/RTI may reduce antibiotic prescribing and referral for radiography, probably without compromising recovery.Trial registration: The trial was registered in the ClinicalTrials.gov Protocol Registration System (identification number: NCT01794819). (Source: BMC Family Practice)
Source: BMC Family Practice - May 2, 2014 Category: Primary Care Authors: Elena AndreevaHasse Melbye Source Type: research

Experiences of patients identifying with chronic Lyme disease in the healthcare system: a qualitative study
Conclusions: Participants reported a significant decline in health status associated with chronic Lyme disease and were often unsatisfied with care in conventional settings. Negative experiences were associated with reports of dismissive, patronizing, and condescending attitudes. Positive experiences were associated with providers who were reported to be attentive, optimistic, and supportive. Consultations with CAM practitioners and use of CAM therapies were common. Actively engaged and sympathetic clinical encounters may foster greater satisfaction in healthcare settings. (Source: BMC Family Practice)
Source: BMC Family Practice - May 1, 2014 Category: Primary Care Authors: Ather AliLawrence VitulanoRobert LeeTheresa WeissEve Colson Source Type: research

Factors influencing the work passion of Chinese community health service workers: an investigation in five provinces
Conclusions: Based on the results, the government should concern for CHS workers' working status and work-related demands, pay more attention and meet their demands for reasonable compensation packages and self-development, balance the income and workload, provide more learning and training opportunities and personal development opportunities for CHS workers, in order to promote CHS workers' work satisfaction, improve their work passion and enthusiasm. (Source: BMC Family Practice)
Source: BMC Family Practice - May 1, 2014 Category: Primary Care Authors: Zhenni LuoXue BaiRui MinChangmin TangPengqian Fang Source Type: research

Facilitating professional liaison in collaborative care for depression in UK primary care; a qualitative study utilising normalisation process theory
Conclusion: Primary care professionals in this study valued the potential for collaboration, but GPs' understanding of CC and organisational barriers hindered opportunities for communication. Further work is needed to address these organisational barriers in order to facilitate collaboration around individual patients with depression, including shared IT systems, facilitating opportunities for informal discussion and building in formal collaboration into the CC framework.Trial registration: ISRCTN32829227 30/9/2008. (Source: BMC Family Practice)
Source: BMC Family Practice - May 1, 2014 Category: Primary Care Authors: Nia CoupeEmma Anderson emmaLinda GaskPaul SykesDavid RichardsCarolyn Chew-Graham Source Type: research

Comparison of perceived quality amongst migrant and local patients using primary health care delivered by community health centres in Shenzhen, China
This study aimed to compare patients' perceptions of quality of primary health care between migrants and local patients, and their willingness to use and recommend primary health care to others. Methods: A cross-sectional survey was conducted. 787 patients in total were chosen from four randomly drawn Community Health Centers (CHCs) for interviews. Results: Local residents scored higher than migrants in terms of their satisfaction with types of drugs available (3.62 vs. 3.45, p = 0.035), attitude of health workers (4.41 vs. 4.14, p = 0.042) and waiting time (4.30 vs. 3.86, p
Source: BMC Family Practice - April 29, 2014 Category: Primary Care Authors: Haitao LiRoger ChungXiaolin WeiJin MouSamuel WongMartin WongDan ZhangYingji ZhangSian Griffiths Source Type: research

Primary care referrals of patients with potentially serious diseases to the emergency department or a quick diagnosis unit: a cross-sectional retrospective study
Background: In Spain, primary healthcare (PHC) referrals for diagnostic procedures are subject to long waiting-times, and physicians and patients often use the emergency department (ED) as a shortcut. We aimed to determine whether patients evaluated at a hospital outpatient quick diagnosis unit (QDU) who were referred to ED from 12 PHC centers could have been directly referred to QDU, thus avoiding ED visits. As a secondary objective, we determined the proportion of QDU patients who might have been evaluated in a less rapid, non-QDU setting. Methods: We carried out a cross-sectional retrospective cohort study of patients w...
Source: BMC Family Practice - April 28, 2014 Category: Primary Care Authors: Xavier BoschOna EscodaDavid NicolásEmmanuel ColomaSara FernándezAntonio CocaAlfonso López-Soto Source Type: research

Under the radar: a cross-sectional study of the challenge of identifying at-risk alcohol consumption in the general practice setting
Conclusions: GP awareness of which patients might benefit from advice regarding at-risk alcohol consumption appears low. Given the complexities associated with establishing whether alcohol consumption is 'at-risk', computer-based approaches to routine screening of patients are worthy of exploration as a method for prompting the provision of advice in primary care. (Source: BMC Family Practice)
Source: BMC Family Practice - April 28, 2014 Category: Primary Care Authors: Christine PaulSze YoongRob Sanson-FisherMariko CareyGrant RussellMeredith Makeham Source Type: research

¿Doctor, please tell me it¿s nothing serious¿: an exploration of patients¿ worrying and reassuring cognitions using stimulated recall interviews
Conclusions: Patients described a wide range of worrying cognitions, some of which were not expressed during the consultation. Gaining a thorough understanding of the specific cognitions and tailoring reassuring strategies to them should be an effective way of achieving reassurance. The identified reassuring cognitions can guide doctors in applying these strategies in their daily practice. (Source: BMC Family Practice)
Source: BMC Family Practice - April 23, 2014 Category: Primary Care Authors: Esther GiroldiWemke VeldhuijzenAlexandra MannaertsTrudy van der WeijdenFrits BaremanCees van der Vleuten Source Type: research

"Doctor, please tell me it's nothing serious": an exploration of patients' worrying and reassuring cognitions using stimulated recall interviews
Conclusions: Patients described a wide range of worrying cognitions, some of which were not expressed during the consultation. Gaining a thorough understanding of the specific cognitions and tailoring reassuring strategies to them should be an effective way of achieving reassurance. The identified reassuring cognitions can guide doctors in applying these strategies in their daily practice. (Source: BMC Family Practice)
Source: BMC Family Practice - April 23, 2014 Category: Primary Care Authors: Esther GiroldiWemke VeldhuijzenAlexandra MannaertsTrudy van der WeijdenFrits BaremanCees van der Vleuten Source Type: research

Diagnostic characteristics and prognoses of primary-care patients referred for clinical exercise testing: a prospective observational study
Conclusions: Clinical characteristics can be used to predict exercise test outcome. Primary care patients with a negative exercise test have a very low risk of cardiovascular events, within six months. A predictive model based on clinical characteristics can be used to refine the identification of low-risk patients. (Source: BMC Family Practice)
Source: BMC Family Practice - April 18, 2014 Category: Primary Care Authors: Gunnar NilssonThomas MooeHans StenlundEva Samuelsson Source Type: research

GPs¿ role security and therapeutic commitment in managing alcohol problems: a randomised controlled trial of a tailored improvement programme
Conclusions: A tailored, multi-faceted programme aimed at improving GP management of patients with hazardous and harmful alcohol consumption improved GPs’ therapeutic commitment towards patients with alcohol-related problems, but failed to improve GPs’ role security. How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs’ reported proportion of patients asked about alcohol consumption at baseline, both increased the impact of the programme on therapeutic commitment. It might be worthwhile to monitor proceeding of role security and therapeutic commitment thr...
Source: BMC Family Practice - April 17, 2014 Category: Primary Care Authors: Myrna KeurhorstIvonne van BeurdenPeter AndersonMaud HeinenReinier AkkermansMichel WensingMiranda Laurant Source Type: research

Current utility of the ankle-brachial index (ABI) in general practice: implications for its use in cardiovascular disease screening
This study aimed to determine the current utility of ABI measurement in general practices across Wales, with consideration of the implications for its use as a cardiovascular risk screening tool.MethodA self-reporting questionnaire was distributed to all 478 General Practices within Wales, sent via their responsible Health Boards. Results: The survey response rate was 20%. ABI measurement is primarily performed by nurses (93%) for the purpose of wound management (90%). It is infrequently (73%
Source: BMC Family Practice - April 17, 2014 Category: Primary Care Authors: Jane DaviesJoyce KenkreE Williams Source Type: research

GPs' role security and therapeutic commitment in managing alcohol problems: a randomised controlled trial of a tailored improvement programme
Conclusions: A tailored, multi-faceted programme aimed at improving GP management of patients with hazardous and harmful alcohol consumption improved GPs' therapeutic commitment towards patients with alcohol-related problems, but failed to improve GPs' role security. How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, both increased the impact of the programme on therapeutic commitment. It might be worthwhile to monitor proceeding of role security and therapeutic commitment throughout the year a...
Source: BMC Family Practice - April 17, 2014 Category: Primary Care Authors: Myrna KeurhorstIvonne van BeurdenPeter AndersonMaud HeinenReinier AkkermansMichel WensingMiranda Laurant Source Type: research

Unmet needs of patients with chronic obstructive pulmonary disease (COPD): a qualitative study on patients and doctors
Conclusions: In conclusion, our study showed that knowledge of COPD is generally poor. There was mislabelling of COPD as asthma by both patients and physicians. This could have resulted in the lack of understanding of treatment options, outcomes, and prognosis of COPD. The misconception that cough due to COPD was contagious, and breathlessness that resulted from COPD, had important physical and psychosocial impact, and could lead to social isolation. Most patients and physicians did not favour self-management approaches, suggesting innovations based on self-management may be of limited benefit. (Source: BMC Family Practice)
Source: BMC Family Practice - April 16, 2014 Category: Primary Care Authors: Stalia SLWongNurdiana AbdullahAdina AbdullahSu-May LiewSiew-Mooi ChingEe-Ming KhooMoyez JiwaYook-Chin Chia Source Type: research

Aiming to improve the quality of primary mental health care: developing an intervention for underserved communities
Conclusions: This study demonstrates how engaging with practices and delivering training in a changing health care system might best be attempted. The importance of engaging with community agencies is clear, as is the use of the AMP model as a template for further research. (Source: BMC Family Practice)
Source: BMC Family Practice - April 16, 2014 Category: Primary Care Authors: Carolyn Chew-GrahamHeather BurroughsDerek HibbertLinda GaskSusan BeattyKatja GravenhorstWaquas WaheedMarija Kovand¿i¿Mark GabbayChris Dowrick Source Type: research

The effectiveness of a semi-tailored facilitator-based intervention to optimise chronic care management in general practice: a stepped-wedge randomised controlled trial
Conclusion: The mixed results from this study indicate that a semi-tailored facilitator-based intervention of relatively low intensity is unlikely to add substantially to the implementation of disease management programmes for DM2 and COPD in a context marked by important concurrent initiatives (including financial incentives and mandatory registry participation) aimed at moving all practices towards changes in chronic care.Trial registration: ClinicalTrials.gov: NCT01297075 (Source: BMC Family Practice)
Source: BMC Family Practice - April 9, 2014 Category: Primary Care Authors: Tina DueThorkil ThorsenMarius KousgaardVolkert SiersmaFrans Waldorff Source Type: research

The safe implementation of a prison-based methadone maintenance programme: 7 year time-series analysis of primary care prescribing data
Conclusion: The phased introduction of opiate replacement therapies into a busy remand prison did not result in any deaths within the prison for which opiate replacement was identified as the cause. GPsi led opiate prescribing programmes can be introduced safely into secure environments. (Source: BMC Family Practice)
Source: BMC Family Practice - April 8, 2014 Category: Primary Care Authors: Nat WrightCharlotte FrenchVictoria Allgar Source Type: research

How communication affects prescription decisions in consultations for acute illness in children: a systematic review and meta-ethnography
Conclusions: Misunderstandings occurred due to parents and clinicians talking at cross purposes about the 'seriousness' of the illness and because parents' expressions of concern or requests for additional information were sometimes perceived as a challenge to the clinicians' diagnosis or treatment decision. This modifiable problem may be an important contribution to the unnecessary and unwanted prescribing of antibiotics. Primary care clinicians should be offered training to understand parent communication primarily as expressions of concern or attempts at understanding and always to check rather than infer parental expec...
Source: BMC Family Practice - April 8, 2014 Category: Primary Care Authors: Christie CabralJeremy HorwoodAlastair HayPatricia Lucas Source Type: research

The safe implementation of a prison-based methadone maintenance programme: 7 year time-series analysis of primary care prescribing data
Conclusion: The phased introduction of opiate replacement therapies into a busy remand prison did not result in any deaths within the prison for which opiate replacement was identified as the cause. GPsi led opiate prescribing programmes can be introduced safely into secure environments. (Source: BMC Family Practice)
Source: BMC Family Practice - April 8, 2014 Category: Primary Care Authors: Nat WrightCharlotte FrenchVictoria Allgar Source Type: research

Health coaching in primary care: a feasibility model for diabetes care
Conclusions: It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention. (Source: BMC Family Practice)
Source: BMC Family Practice - April 3, 2014 Category: Primary Care Authors: Clare LiddySharon JohnstonKate NashNatalie WardHannah Irving Source Type: research

Cardiovascular polypharmacy is not associated with unplanned hospitalisation: evidence from a retrospective cohort study
Conclusions: We found no evidence that increasing numbers of cardiovascular medicines were associated with an increased risk of unplanned non-cardiovascular hospitalisation, following adjustment for confounding. Assumptions that polypharmacy is hazardous and represents poor care should be moderated in the context of cardiovascular disease. (Source: BMC Family Practice)
Source: BMC Family Practice - March 31, 2014 Category: Primary Care Authors: Sarah AppletonGary AbelRupert Payne Source Type: research

Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis
We examined the extent to which practice members' perceptions of how well they organized to deliver care consistent with the CCM were associated with their patients' perceptions of the chronic illness care they have received. Methods: Analysis of baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM in small, community-based primary care practices. All practice "members" (i.e., physician providers, non-physician providers, and staff) completed the Assessment of Chronic Illness Care (ACIC) survey and adult patients with 1 or more chronic illn...
Source: BMC Family Practice - March 29, 2014 Category: Primary Care Authors: Polly NoëlMichael ParchmanRay PalmerRaquel RomeroLuci LeykumHolly LanhamJohn ZeberKrista Bowers Source Type: research

The value of prostate cancer support groups: a pilot study of primary physicians¿ perspectives
Conclusions: Findings suggest PPs highly valued the role and potential benefits of PCSGs. Information provision and an educational role were perceived as key benefits amid the need to improve local and provincial marketing of PCSGs. The potential for web-based PCSGs to help in the support of PCa patients was also recognized. (Source: BMC Family Practice)
Source: BMC Family Practice - March 28, 2014 Category: Primary Care Authors: Bernard GarrettJohn OliffeJoan BottorffMichael McKenzieChristina HanJohn Ogrodniczuk Source Type: research

The value of prostate cancer support groups: a pilot study of primary physicians' perspectives
Conclusions: Findings suggest PPs highly valued the role and potential benefits of PCSGs. Information provision and an educational role were perceived as key benefits amid the need to improve local and provincial marketing of PCSGs. The potential for web-based PCSGs to help in the support of PCa patients was also recognized. (Source: BMC Family Practice)
Source: BMC Family Practice - March 28, 2014 Category: Primary Care Authors: Bernard GarrettJohn OliffeJoan BottorffMichael McKenzieChristina HanJohn Ogrodniczuk Source Type: research

Impact of multimorbidity: acute morbidity, area of residency and use of health services across the life span in a region of south Europe
Background: Concurrent diseases, multiple pathologies and multimorbidity patterns are topics of increased interest as the world's population ages. To explore the impact of multimorbidity on affected patients and the consequences for health services, we designed a study to describe multimorbidity by sex and life-stage in a large population sample and to assess the association with acute morbidity, area of residency and use of health services. Methods: A cross-sectional study was conducted in Catalonia (Spain). Participants were 1,749,710 patients aged 19+ years (251 primary care teams). Primary outcome: Multimorbidity (>...
Source: BMC Family Practice - March 26, 2014 Category: Primary Care Authors: Quintí Foguet-BoreuConcepció ViolanAlbert Roso-LlorachTeresa Rodríguez-BlancoMariona Pons-ViguésMiguel Muñoz-PérezEnriqueta Pujol-RiberaJose Valderas Source Type: research

Intervention to improve social and family support for caregivers of dependent patients: ICIAS study protocol
DiscussionIf the intervention intended to improve social and family support is effective in reducing the burden on primary informal caregivers of dependent patients, this model can be readily applied throughout usual PHCT clinical practice.Trial registration: Clinical trials registrar: NCT02065427 (Source: BMC Family Practice)
Source: BMC Family Practice - March 25, 2014 Category: Primary Care Authors: Magdalena MurphyJosep Bonet-SimóEsther BaenaGemma PrietoEva BellerinoFrancesc SoléMontserrat RubioIlona KrierPascuala TorresSonia Mimoso Source Type: research

The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on
This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. Methods: In the nascence of the expansion of the role of nurses in Australian general practice (2003-2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009-2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Results: Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 comp...
Source: BMC Family Practice - March 25, 2014 Category: Primary Care Authors: Elizabeth HalcombYenna SalamonsonPatricia DavidsonRajneesh KaurSamantha Young Source Type: research

General practitioner teachers¿ job satisfaction and their medical students' wish to join the field ¿ a correlational study
Conclusions: Medical students’ perception of their GP teachers’ job satisfaction positively affect their wish to become GPs, and their satisfaction with their internships adds to this. Enhancing the positive aspects of GP work, such as recognition, and improving negative ones, such as administrative duties, are necessary to attract medical students into the GP field. (Source: BMC Family Practice)
Source: BMC Family Practice - March 24, 2014 Category: Primary Care Authors: Damian MeliAngie NgSarah SingerPeter FreyMireille Schaufelberger Source Type: research