Disorders of Pubertal Onset.
Abstract Evaluation of the child with abnormal pubertal development can be challenging for the primary care provider. Understanding the factors associated with timing of pubertal onset and the normal sequence of pubertal changes is useful in evaluation of children with puberty disorders. A thorough workup includes assessment of growth rate, Tanner staging, and rate of pubertal progression, in addition to an extensive history and physical examination to identify signs and symptoms of disorders associated with abnormal pubertal timing. Initial diagnostic studies will most often include a bone age, levels of gonadotr...
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Elchuri SV, Momen JJ Tags: Prim Care Source Type: research

Adolescent Vaccines: Current Recommendations and Techniques to Improve Vaccination Rates.
This article reviews the current guidelines, recommended vaccinations and schedules, and methods to improve compliance rates. PMID: 32423710 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Adelman M, Barrickman AL, Garofoli GK Tags: Prim Care Source Type: research

School-Based Health Care.
This article illustrates the various models of school-based health care, the particular benefit of school-based health care for adolescents, and opportunities and challenges in maintaining and sustaining a school-based health program. PMID: 32423711 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: North S, Dooley DG Tags: Prim Care Source Type: research

Evaluation and Treatment of Primary Headaches in Adolescents.
Abstract Headache is a common episodic and chronic pain syndrome in adolescents. Evaluation of headaches in primary care requires a comprehensive assessment including lifestyle behaviors and physical examination, as well as an understanding of when to pursue appropriate testing. Primary headache disorders seen in adolescents include migraine and tension-type headache. Pharmacologic management for primary headache includes both acute and prophylactic treatment strategies. PMID: 32423712 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Walter SM, Banvard-Fox C, Cundiff C Tags: Prim Care Source Type: research

Selected Musculoskeletal Issues in Adolescents.
Abstract Musculoskeletal care of the adolescent patient involves unique knowledge of their rapidly changing physical and psychological health. In this article, the importance of preventing early sports specialization is elucidated, and an encouragement of the safety and necessity of resistance training in adolescents is undertaken. It also explores two common conditions, one affecting the immature skeleton (apophysitis), and one affecting the improperly developed muscular system (patellofemoral syndrome), both of which are diagnosed clinically, and require little advanced imaging. Finally, a brief overview of rela...
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Bernstein K, Seales P, Mroszczyk-McDonald A Tags: Prim Care Source Type: research

Providing Care for Transgender and Gender Diverse Youth.
This article educates providers about TGDY, reviews the role of mental health care, and provides an overview of medical interventions for gender affirmation. PMID: 32423714 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Kidd KM, Thornburgh C, Casey CF, Murray PJ Tags: Prim Care Source Type: research

Health Care for Refugee and Immigrant Adolescents.
This article describes the current scope of immigration to the United States, defines the different categories of immigrants, and describes the Centers for Disease Control and Prevention-mandated overseas and postarrival medical assessment of adolescent refugees. Guidelines for primary care physicians who care for refugee youth are provided, including diagnosis and treatment of common medical and mental health conditions. Special considerations in caring for this vulnerable population include acknowledging prior traumas, acculturation and challenges to education such as bullying, and adjustment to a new health care system ...
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Brown CM, Swaminathan L, Saif NT, Hauck FR Tags: Prim Care Source Type: research

Human Trafficking in Adolescents: Adopting a Youth-centered Approach to Identification and Services.
This article describes core design features of a youth-centered approach to care that 2 organizations-Mount Sinai Adolescent Health Center and Covenant House New Jersey-use to serve clients in nontraditional primary care settings and subsequently illustrates the ways in which this approach succeeds at identifying and serving youth who have experienced human trafficking. Primary care providers are uniquely positioned to connect adolescent human trafficking survivors to existing protection and treatment resources. The primary care community can adapt these interventions for adolescent patients who have experienced human traf...
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Einbond J, Diaz A, Cossette A, Scriven R, Blaustein S, Arden MR Tags: Prim Care Source Type: research

Crisis and Adolescents: Assessments and Initial Management.
This article highlights the impact of crisis and trauma on adolescents. An overview of current assessments and evidence-based interventions to address adolescent patients' crisis needs is provided. In addition, recommendations for community referrals and partnerships that could improve the health outcomes of these youth are discussed. PMID: 32423717 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Leverett PM, D'Costa S, Cassella H, Shah M Tags: Prim Care Source Type: research

Sexual Assault in Adolescents.
Abstract Child sexual abuse is a severely underreported crime in the United States. The consequences of child sexual abuse extend beyond physical injury, including an increased likelihood to develop chronic physical and mental diseases/disorders, including substance abuse and suicide. Care involves trauma-informed screening, assessment, and documentation, education of, and access to sexually transmitted infection prophylaxis and emergency contraception, safety interventions, and access to community resources. Medical providers should know the response process their facility, community, and state practices for vict...
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Banvard-Fox C, Linger M, Paulson DJ, Cottrell L, Davidov DM Tags: Prim Care Source Type: research

Human Immunodeficiency Virus in Adolescents: Risk, Prevention, Screening, and Treatment.
Abstract Adolescents and young adults are at high risk for human immunodeficiency virus (HIV) infection. Several risk factors that strongly contribute to HIV infection risk are described, including physical, cognitive, social, and economic factors. Strategies for screening and prevention of HIV infection, including universal screening, behavioral counseling, and preexposure prophylaxis, are reviewed, and the initial treatment approach to a diagnosis of HIV in adolescents is outlined. PMID: 32423719 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Chang JJ, Ashcraft AM Tags: Prim Care Source Type: research

Adolescent Sexual Health: Identity, Risk, and Screening for Sexually Transmitted Infections.
This article discusses the appropriate language to use while conducting a sexual history, summarizes the epidemiologic data on sexually transmitted infections, and reviews the screening and reporting guidelines set forth by the United States Preventive Services Task Force and the Centers for Disease Control and Prevention. PMID: 32423720 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Kessler R, Hinkle BT, Moyers A, Silverberg B Tags: Prim Care Source Type: research

Adolescent Substance Abuse.
Abstract Adolescent substance abuse is America's #1 public health problem as per the National Center on Addiction and Substance Abuse. People are most likely to begin abusing drugs during adolescence, and the longer adolescents defer experimentation, the less likely they are to develop long-term drug abuse problems. The CRAFFT and DAST questionnaires are brief, reliable tools for adolescent substance abuse screening. Health care professionals can help continue low adolescent substance utilization rate by having open conversations with adolescents regarding all substances and medications, including illicit substanc...
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Garofoli M Tags: Prim Care Source Type: research

Culture Shock and Changing Times.
PMID: 32423722 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Heidelbaugh JJ Tags: Prim Care Source Type: research

Too Much Go, Not Enough Slow: Navigating the Challenges of Adolescence.
PMID: 32423723 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Silverberg B Tags: Prim Care Source Type: research

Primary Palliative Care for Emergency Medicine (PRIM-ER): Applying form and function to a theory-based complex intervention.
Conclusion: The application of theory and delineation of forms and functions, as well prospective adaptation monitoring of large complex interventions can support the balance of fidelity with adaptability to encourage successful interventions among a variety of clinical environments. PMID: 32426550 [PubMed] (Source: Primary Care)
Source: Primary Care - May 21, 2020 Category: Primary Care Authors: Hill J, Cuthel AM, Lin P, Grudzen CR Tags: Contemp Clin Trials Commun Source Type: research

Individual differences in processes of lifestyle changes among people with obesity: an acceptance and commitment therapy (ACT) intervention in a primary health care setting.
This study investigated a subset of data from a larger web-based lifestyle intervention. This subset consisted of online logbooks written by 17 obese participants (n = 17, body mass index mean 41.26 kg/m2) during the six-week online module. The logbooks were analyzed via data-driven content analysis. FINDINGS: Four groups were identified based on the participants being at different phases in their lifestyle changes: stuck with barriers, slowly forward, reflective and hardworking, and convincingly forward with the help of concrete goals. Differences between the groups were manifested in personal barriers, goal setting,...
Source: Primary Care - May 18, 2020 Category: Primary Care Authors: Kasila K, Vainio S, Punna M, Lappalainen P, Lappalainen R, Kaipainen K, Kettunen T Tags: Prim Health Care Res Dev Source Type: research

Quality of spirometry and related diagnosis in primary care with a focus on clinical use.
Abstract American and European societies' (ATS/ERS) criteria for spirometry are often not met in primary care. Yet, it is unknown if quality is sufficient for daily clinical use. We evaluated quality of spirometry in primary care based on clinical usefulness, meeting ATS/ERS criteria and agreement on diagnosis between general practitioners (GPs) and pulmonologists. GPs included ten consecutive spirometry tests and detailed history questionnaires of patients who underwent spirometry as part of usual care. GPs and two pulmonologists assessed the spirometry tests and questionnaires on clinical usefulness and formulat...
Source: Primary Care - May 15, 2020 Category: Primary Care Authors: van de Hei SJ, Flokstra-de Blok BMJ, Baretta HJ, Doornewaard NE, van der Molen T, Patberg KW, Ruberg ECM, Schermer TRJ, Steenbruggen I, van den Berg JWK, Kocks JWH Tags: NPJ Prim Care Respir Med Source Type: research

Diabetes in Appalachia: providers' perspectives.
CONCLUSIONS: Evidence-based interventions tailored to Appalachian culture and training designed to increase the cultural competency and cultural humility of primary care providers may be effective approaches to reduce barriers to diabetes care in Appalachian Ohio. PMID: 32404218 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 14, 2020 Category: Primary Care Authors: Beverly EA, Ritholz MD, Cook K, Johnson LK, Ruhil A, Singh RP, Berryman DE Tags: Prim Health Care Res Dev Source Type: research

Oral health training for general practitioners and general practice teams.
Abstract The role of oral health in promoting general health and wellbeing is recognised, but there is minimal oral health training for doctors, including GPs. The Directorate of Multi-Disciplinary Dental Education (DMDE) at Health Education England North East and North Cumbria has introduced oral health training for GPs, incorporating training recommended by NICE oral health guidance.DMDE oral health training for GPs and general practice teams covered the diagnosis, prevention and management of oral disease, relevant prescribing and accessing dental care. Training has been shown to be worthwhile, positively impac...
Source: Primary Care - May 13, 2020 Category: Primary Care Authors: Blaylock P, Lish R, Smith M Tags: Educ Prim Care Source Type: research

Why do doctors in Norway choose general practice and remain there? A qualitative study about motivational experiences.
Abstract Objective: To explore experiences motivating doctors to become and remain GPs.Design and contributors: Qualitative analysis of written responses from an open-ended question about motivational experiences posted on an internet discussion list for GPs in Norway. Texts from 25 contributors were analysed with Systematic Text Condensation, supported by theories about calling as motivation.Results: Analysis revealed numerous aspects of motivation to become and remain a general practitioner. Inspirations from early experiences and skilled role models had conveyed values and offered insight into a fascinating wor...
Source: Primary Care - May 12, 2020 Category: Primary Care Authors: Gronseth IM, Malterud K, Nilsen S Tags: Scand J Prim Health Care Source Type: research

GPs should not try to detect mild COPD.
PMID: 32393734 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 11, 2020 Category: Primary Care Authors: Enright P, Fragoso CV Tags: NPJ Prim Care Respir Med Source Type: research

Interventions to improve medication adherence in tuberculosis patients: a systematic review of randomized controlled studies.
We report a systematic review of randomized controlled trials that included either latent tuberculosis infection (LTBI) or active TB patients. Outcomes of interest included adherence rate, completed treatment, defaulted treatment and treatment outcomes. We identified four LTBI and ten active TB studies. In active TB patients, directly observed treatment (DOT) by trained community workers, short messaging service combined with education, counselling, monthly TB vouchers, drug box reminders and combinations of those were found effective. In LTBI patients, shorter regimens and DOT effectively improved treatment completion. In...
Source: Primary Care - May 11, 2020 Category: Primary Care Authors: Pradipta IS, Houtsma D, van Boven JFM, Alffenaar JC, Hak E Tags: NPJ Prim Care Respir Med Source Type: research

Potentially inappropriate medications in older individuals with diabetes: A population-based study in Quebec, Canada.
CONCLUSION: PIM use is highly prevalent among older individuals with diabetes. Interventions to promote optimal medication use should particularly target individuals with comorbidities and polypharmacy who are most vulnerable to adverse drug events. PMID: 32402848 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - May 10, 2020 Category: Primary Care Authors: Gagnon ME, Sirois C, Simard M, Roux B, Plante C Tags: Prim Care Diabetes Source Type: research

Rationale and design of a cohort study evaluating triage of acute chest pain in out-of-hours primary care in the Netherlands (TRACE).
Abstract The aims of this study are (1) to evaluate the performance of current triage for chest pain; (2) to describe the case mix of patients undergoing triage for chest pain; and (3) to identify opportunities to improve performance of current Dutch triage system for chest pain. Chest pain is a common symptom, and identifying patients with chest pain that require urgent care can be quite challenging. Making the correct assessment is even harder during telephone triage. Temporal trends show that the referral threshold has lowered over time, resulting in overcrowding of first responders and emergency services. Whil...
Source: Primary Care - May 8, 2020 Category: Primary Care Authors: Manten A, Cuijpers CJJ, Rietveld R, Groot E, van de Graaf F, Voerman S, Himmelreich JCL, Lucassen WAM, van Weert HCPM, Harskamp RE Tags: Prim Health Care Res Dev Source Type: research

Promising peak flow diary compliance with an electronic peak flow meter and linked smartphone app.
Abstract Peak expiratory flow (PEF) monitoring is recommended in the management of asthma. However, compliance is poor, and this is often attributed to the burden of measurement and recording. The Smart Peak Flow (SPF) device and app allow self-measuring and self-monitoring of PEF. Compliance with self-monitoring was promising in 399 UK users, calling for research to confirm these results and explore its potential as an intervention to improve self-monitoring. PMID: 32385281 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - May 8, 2020 Category: Primary Care Authors: Antalffy T, De Simoni A, Griffiths CJ Tags: NPJ Prim Care Respir Med Source Type: research

Increasing general practice appeal: the student voice.
PMID: 32379014 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - May 7, 2020 Category: Primary Care Authors: Shah R, Odedra K, Kauser Z Tags: Educ Prim Care Source Type: research

Symptom-based screening tool for asthma syndrome among young children in Uganda.
rd MS Abstract Under-diagnosis of asthma in 'under-fives' may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 'under-fives' with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensus diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as "asthma syndrome". Using this approach,...
Source: Primary Care - May 6, 2020 Category: Primary Care Authors: Nantanda R, Siersma V, Ndeezi G, Tumwine JK, Østergaard MS Tags: NPJ Prim Care Respir Med Source Type: research

The value of 'expert trainees' in primary care postgraduate education.
Abstract Peer-led teaching is well established within many undergraduate medical courses but relatively underutilised in postgraduate training, despite the fact it can be useful for both teachers and learners. A significant number of doctors training to be GPs bring expertise and experience from other specialities and in this paper we explore the potential of using 'expert trainees' to teach their peers on postgraduate GP training programmes. A GP trainee with expertise in Lifestyle Medicine taught alongside local and national experts and delivered workshops to her peers. Questionnaires were used to establish the ...
Source: Primary Care - May 6, 2020 Category: Primary Care Authors: Thurston E, Forde E, Wedderburn C Tags: Educ Prim Care Source Type: research

Editorial: Covid-19 special collection.
Abstract No abstract available. PMID: 32370525 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - May 4, 2020 Category: Primary Care Authors: Ray SC Tags: Afr J Prim Health Care Fam Med Source Type: research

Personalized text message and checklist support for initiation of antihypertensive medication: the cluster randomized, controlled check and support trial.
auml; P Abstract Objective: To assess whether the use of a checklist combined with text message support improves systolic blood pressure (SBP) control.Design and setting: A cluster randomized controlled trial in Finnish primary care.Interventions: Personalized text message support and a checklist for initiation of antihypertensive medication.Patients: 111 newly diagnosed hypertensive patients aged 30-75 years.Main outcome measures: The proportion of patients achieving 1) the office SBP target
Source: Primary Care - May 2, 2020 Category: Primary Care Authors: Tahkola A, Korhonen P, Kautiainen H, Niiranen T, Mäntyselkä P Tags: Scand J Prim Health Care Source Type: research

Group C beta hemolytic Streptococci as a potential pathogen in patients presenting with an uncomplicated acute sore throat - a systematic literature review and meta-analysis.
Abstract Objective: The pathogenicity of beta-hemolytic Streptococcus group C (GCS) in patients attending for an uncomplicated acute sore throat is unknown and it was the objective to clarify this.Design: Systematic literature review with meta-analysis. Setting Medline and Scopus were searched from inception to February 2019, with searches of reference lists, Subjects case-control studies stating prevalence of GCS in patients as well as healthy controls presented for children and adults separately. Studies including patients already treated with antibiotics and studies focused on patients with HIV, malignancy or i...
Source: Primary Care - May 2, 2020 Category: Primary Care Authors: Gunnarsson RK, Manchal N Tags: Scand J Prim Health Care Source Type: research

Insomnia in the elderly: reported reasons and their associations with  medication in general practice in Denmark.
Conclusion: Somatic and psychiatric diseases were the most commonly reported reasons for insomnia symptoms in the elderly, suggesting a high prevalence of comorbid insomnia. Regardless of reason, a majority of the consultations resulted in prescription of sleep medication with potential serious adverse effects. This indicates that there is still room for improving the management of insomnia among older adults. Key PointsAlthough insomnia is common in the elderly, little is known about its reasons and their associations with prescription patterns.  The most commonly reported reasons for insomnia symptoms in th...
Source: Primary Care - May 2, 2020 Category: Primary Care Authors: Hollsten I, Foldbo BM, Kousgaard Andersen MK, Nexøe J Tags: Scand J Prim Health Care Source Type: research

Characteristics of patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare.
Conclusion: Post-diagnostic support tailored to patients diagnosed with dementia in primary healthcare should consider their poor cognitive function and limitations in ADL and that these people often live alone, have BPSD and depression.Key pointsPeople diagnosed in Norwegian primary healthcare had more needs than people diagnosed in specialist healthcare.  • They were older, less educated, had poorer cognitive functioning and activity limitations, more often lived alone, and had more BPSD and depression.  • Depression was associated with being female, older, having cognitive decline...
Source: Primary Care - May 2, 2020 Category: Primary Care Authors: Michelet M, Lund A, Strand BH, Engedal K, Selbaek G, Bergh S Tags: Scand J Prim Health Care Source Type: research

Do patients or their physicians more accurately assess long-term risk associated with hypertension? A population-based study.
jellgren KI Abstract Objective: To compare the assessments of 10-year probability by patients and their physicians of cardiovascular complications of hypertension with actual outcomes.Design: Patients with uncomplicated hypertension treated with at least one antihypertensive drug at inclusion were followed for 10 years through mandatory national health registers.Setting: 55 primary health care centres, 11 hospital outpatient clinics in SwedenPatients: 848 patient, 212 physicians.Main outcome measures: Patients and physicians estimated the probability of hypertension-related complications with treatment (dea...
Source: Primary Care - May 2, 2020 Category: Primary Care Authors: Hoffmann M, Nilsson PM, Ahlner J, Dahllöf B, Fredrikson M, Säljö R, Kjellgren KI Tags: Scand J Prim Health Care Source Type: research

Two-year weight, risk and health factor outcomes of a weight-reduction intervention programme: Primary prevention for overweight in a multicentre primary healthcare setting.
Conclusion: The total population lost weight, and the high-intensity and low-intensity programmes did not result in significant differences in terms of weight. The high-intensity programme reported health benefits linked to lower levels of anxiety and depression, increased activity and intake of greens and reduced visits to physicians and nurses.Key pointsBoth groups had a consisting weight- reduction after two years.High intensity did not lead to a significant difference in weight reduction between the groups.The high-intensity group reported more health effects, such as better quality of life, reduced anxiety, and increa...
Source: Primary Care - May 2, 2020 Category: Primary Care Authors: Bräutigam-Ewe M, Lydell M, Bergh H, Hildingh C, Baigi A, Månsson J Tags: Scand J Prim Health Care Source Type: research

Staff experiences of a new tool for comprehensive geriatric assessment in primary care (PASTEL): a focus group study.
Conclusion: The participants reported that PASTEL, a tool for CGA, gave a holistic picture of the older person and was helpful in care planning.Key pointsTo manage frailty using comprehensive geriatric assessment (CGA) in primary care, there is a need for tools that are efficient, user-friendly and which support patient involvement and teamwork•This study found that the Primary care Assessment tool for Elderly (PASTEL) is regarded as both valuable and feasible by primary care professionals•Use of carefully selected items in the tool and allowing enough time for dialogue may enhance patient-centeredness•The P...
Source: Primary Care - April 29, 2020 Category: Primary Care Authors: Nord M, Östgren CJ, Marcusson J, Johansson M Tags: Scand J Prim Health Care Source Type: research

Postpartum maternal distress: a multidimensional illness requiring a multilevel, multidiscipline response.
This study aimed to extend the postpartum literature by: (1) comparing the levels of depression, anxiety and stress (i.e. distress indicators) in a non-clinical sample of postpartum mothers to those in the general non-clinical population; (2) comparing the prevalence of anxiety and stress to that of depression in postpartum mothers; and (3) examining the consequences of negative social exchange, alongside perceived social support, on postpartum distress indicators. A self-report survey was completed by 242 postpartum women assessing levels of perceived social support, frequency of negative social exchange and distress indi...
Source: Primary Care - April 28, 2020 Category: Primary Care Authors: Elliott AE, Elliott PC, Cook R Tags: Aust J Prim Health Source Type: research

Do you know how COVID-19 is changing general practice/family medicine education?
PMID: 32339073 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - April 27, 2020 Category: Primary Care Authors: Michels NRM, Scherpbier N, Karppinen H, Buchanan J, Windak A Tags: Educ Prim Care Source Type: research

Prim Care; +179 new citations
179 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: Prim Care These pubmed results were generated on 2020/04/24PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites. (Source: Primary Care)
Source: Primary Care - April 24, 2020 Category: Primary Care Tags: Report Source Type: research

Associations between lifestyle, erectile dysfunction and healthcare seeking: a population-based study.
Conclusion: Reporting ED and GP contact were significantly associated with age. Furthermore, lifestyle was significantly associated with reporting ED, but largely not associated with healthcare seeking. These findings are important for future interventions aiming to improve diagnosis and treatment of ED.Key pointsExperiencing erectile dysfunction is frequent in the general population, especially among older men.  • In this large-scale national survey, age and lifestyle were significantly associated with reporting erectile dysfunction.  • Healthcare seeking with erectile dysfunction w...
Source: Primary Care - April 21, 2020 Category: Primary Care Authors: Paulsen LH, Sørensen Bakke L, Jarbøl DE, Balasubramaniam K, Hansen DG Tags: Scand J Prim Health Care Source Type: research

GPs' perspectives of the patient encounter - in the context of standardized cancer patient pathways.
Conclusions: Interacting with patients is vital for assigning meaning to presented symptoms. However, nowadays GPs are not only required to interact with patients, they are also required to interact with CPPs. These standardized routines might create pressure and demands on GPs, especially for those experiencing a lack of information about CPPs. Beside of carrying out the challenging patient/person-centered dialogues and interpreting presented symptoms, GPs also need to link the interpreted symptoms to CPPs. Therefore, it is essential that GPs are given opportunities at their workplaces to continuously be informed and be s...
Source: Primary Care - April 21, 2020 Category: Primary Care Authors: Hultstrand C, Coe AB, Lilja M, Hajdarevic S Tags: Scand J Prim Health Care Source Type: research

Primary care physicians' concerned voices on sickness certification after a period of reorganization. Focus group interviews in Sweden.
Conclusions: Political decisions on laws and regulations for sickness certification impacted the primary health care making the physicians' work difficult and burdensome. Their views and suggestions should be carefully considered in future organization of primary care. KEY POINTSIn 2005 Swedish government introduced reforms to decrease the inequalities and costs of sickness certification and facilitate the physicians' work. Focus group interviews with Swedish primary care physicians revealed that sickness certification was challenging due to differing demands from authorities, management and patients.Coping strategies for ...
Source: Primary Care - April 21, 2020 Category: Primary Care Authors: Bengtsson Boström K, Starzmann K, Östberg AL Tags: Scand J Prim Health Care Source Type: research

Point-of-care ultrasound (POCUS) in Norwegian general practice.
Conclusions: The number of Norwegian GPs using POCUS and the number of scans have increased substantially from 2009 to 2016. The use of the various scans, based on the use of reimbursement claims, have evolved differently. The reasons for this are not known. The low number of scans carried out by most GPs raises a concern when it comes to the quality of the performed scans.KEY POINTS30% of Norwegian general practitioners (GPs) used point-of-care ultrasound (POCUS) in 2016.The use of POCUS increased six-fold from 2009 to 2016.Three out of four scanning GPs performed less than 10 scans annually.Male GPs performed 80% of the ...
Source: Primary Care - April 21, 2020 Category: Primary Care Authors: Myklestul HC, Skonnord T, Brekke M Tags: Scand J Prim Health Care Source Type: research

A primary care database study of asthma among patients with and without opioid use disorders.
Abstract Substance misuse is associated with poor asthma outcome and death. People with opioid use disorder (OUD) may be at particular risk, however, there have been no case-control studies of asthma care and outcomes in this patient group. A primary care database study of patients with asthma aged 16-65 years was conducted using a matched case-control methodology. The dataset comprised 275,151 adults with asthma, of whom 459 had a clinical code indicating a lifetime history of OUD. Cases with a history of OUD were matched to controls 1:3 by age, gender, smoking status and deprivation index decile. Attendance at a...
Source: Primary Care - April 20, 2020 Category: Primary Care Authors: Oliver P, Hulin J, Mitchell C Tags: NPJ Prim Care Respir Med Source Type: research

GP services in Australia: presentation profiles during usual practice hours and after-hours periods.
Abstract After-hours general practitioner (GP) services can reduce emergency department demand, which is currently increasing in Australia. Understanding GP after-hours care may assist in service planning. From April 2014 to March 2015, 986 GPs recorded 38275 consultations with start and finish times in the Bettering the Evaluation and Care of Health (BEACH) study, a national, cross-sectional, representative study of GP activity. GP and patient characteristics and the content of encounters in usual-hours and after-hours were compared. Significantly more after-hours than usual-hours encounters were with: GPs aged 6...
Source: Primary Care - April 20, 2020 Category: Primary Care Authors: Baker J, Britt H, Harrison C Tags: Aust J Prim Health Source Type: research

Access to Home and Community Health Services for Older Adults With Serious, Life-Limiting Illness: A Study Protocol.
This study includes an environmental scan, grey literature review, qualitative interviews, and health-care utilization analysis. This study is a subproject of the Grudzen et al. Primary Palliative Care for Emergency Medicine (PRIM-ER) study. SETTINGS/LOCATION: Analysis will include data collection from 17 health systems implementing the PRIM-ER intervention. PARTICIPANTS: For the qualitative interviews, one emergency medicine (EM) physician and one EM nurse will be interviewed from each of the 17 participating health systems. For the health-care utilization analysis, we will use the Senior Care Services Scale (SC...
Source: Primary Care - April 20, 2020 Category: Primary Care Authors: Hill JD, Cuthel AM, Grudzen CR Tags: Am J Hosp Palliat Care Source Type: research

Clinical utility and cost modelling of the phi test to triage referrals into image-based diagnostic services for suspected prostate cancer: the PRIM (Phi to RefIne Mri) study.
CONCLUSION: phi as a triaging test may be an effective way to reduce mpMRI and biopsies without compromising detection of significant prostate cancers. PMID: 32299423 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - April 17, 2020 Category: Primary Care Authors: Kim L, Boxall N, George A, Burling K, Acher P, Aning J, McCracken S, Page T, Gnanapragasam VJ Tags: BMC Med Source Type: research

Effect of health professional intervention on adherence to statin use according to the cause of patient non-adherence.
o I, Goyenechea E Abstract Background Non-adherence is a problem that particularly affects those with chronic diseases. Studying causes for not following the treatment is necessary to choose the best intervention to improve non-adherence. Objective Analyze how the intentionality of non-adherence modulates the effects of professional intervention in patients with hypercholesterolemia. Setting: Community pharmacies and primary care centres in Spain. Methods A 6-month randomized controlled trial was conducted in 46 community pharmacies and 50 primary care centres in Spain. Adherence to statin therapy was me...
Source: Primary Care - April 16, 2020 Category: Primary Care Authors: Oñatibia-Astibia A, Malet-Larrea A, Gastelurrutia MÁ, Calvo B, Ramírez D, Cantero I, Goyenechea E Tags: Int J Clin Pharm Source Type: research

Should GPs ask patients about their financial concerns? Exploration through collaborative research.
Conclusion: Our results suggest that GPs can be early discoverers of financial problems interacting with their patients' health. When there are no clear medical explanations for the health problems that prompted the consultation, the best therapy may thus be financial counselling.Key pointsMany people live on the edge of financial ruin and struggle to keep track of their finances, but limited research exists that investigates associations between finance and health.In a collaborative health services research experiment 11% of the patients at a Norwegian GP office had health problems that caused them financial concerns, or ...
Source: Primary Care - April 16, 2020 Category: Primary Care Authors: Ose SO, Bøyum LS, Kaspersen SL, Vestad A, Gjelsvik PA Tags: Scand J Prim Health Care Source Type: research