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Total 250 results found since Jan 2013.

Implementing guidelines to routinely prevent chronic vascular disease in primary care: the Preventive Evidence into Practice cluster randomised controlled trial
Conclusions This intervention was associated with improved recording of some risk factors but no change in the level of risk at the follow-up audit. Trial registration number Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000578808, results.
Source: BMJ Open - December 11, 2015 Category: Journals (General) Authors: Harris, M. F., Parker, S. M., Litt, J., van Driel, M., Russell, G., Mazza, D., Jayasinghe, U. W., Del Mar, C., Lloyd, J., Smith, J., Zwar, N., Taylor, R., Powell Davies, G., On behalf of the Preventive Evidence into Practice (PEP) Partnership Group, On be Tags: Open access, Cardiovascular medicine, Evidence based practice, General practice / Family practice, Health services research, Public health, Diabetes and Endocrinology Source Type: research

Evaluating quality and its determinants in lipid control for secondary prevention of heart disease and stroke in primary care: a study in an inner London Borough
Conclusions In this study, the key factor that explained poor lipid control in people with CVD was having no current prescription record of a statin. Women were more likely to have poorly controlled cholesterol (independent of comorbid risk factors and after adjusting for age, ethnicity, deprivation index and practice-level variation). Women with CVD should be offered statin prescription and may require higher statin dosage for improved control.
Source: BMJ Open - December 9, 2015 Category: Journals (General) Authors: Dodhia, H., Kun, L., Logan Ellis, H., Crompton, J., Wierzbicki, A. S., Williams, H., Hodgkinson, A., Balazs, J. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Health services research Source Type: research

Primary Care Atrial Fibrillation Service: outcomes from consultant-led anticoagulation assessment clinics in the primary care setting in the UK
Conclusions Systematic identification of patients with AF with high stroke-risk and consultation in PCAF consultant-led clinics effectively delivers oral anticoagulation to high-risk patients with AF in the community.
Source: BMJ Open - December 9, 2015 Category: Journals (General) Authors: Das, M., Panter, L., Wynn, G. J., Taylor, R. M., Connor, N., Mills, J. D., Kirchhof, P., Gupta, D. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Pharmacology and therapeutics Research Source Type: research

PURLs: Should you bypass anticoagulant "bridging" before and after surgery?
Abstract Skipping perioperative use of LMWH in low- and moderate-risk patients on warfarin for atrial fibrillation doesn't increase their risk of stroke or bleeding. PMID: 26845002 [PubMed - in process]
Source: The Journal of Family Practice - December 1, 2015 Category: Practice Management Authors: Jarrett JB, Schaffer T, Rowland K Tags: J Fam Pract Source Type: research

GPs' adherence to guidelines for structured assessments of stroke survivors in the community and care homes
Conclusions. This survey suggests that at least one-third of GPs provide no formal review of the needs of stroke patients and that in only a minority are identified needs addressed in a structured way. Standardization is required for what is included in reviews and how needs are being identified and met.
Source: Family Practice - November 19, 2015 Category: Primary Care Authors: Goncalves-Bradley, D. C., Boylan, A.-M., Koshiaris, C., Vazquez Montes, M., Ford, G. A., Lasserson, D. S. Tags: Health Service Research Source Type: research

Systematic review of rehabilitation programmes initiated within 90 days of a transient ischaemic attack or 'minor' stroke: a protocol
Discussion This review will be of value to clinicians and healthcare professionals working in TIA and stroke services as well as to general practitioners/family physicians who care for these patients in the community and to researchers involved in designing and evaluating rehabilitation interventions. Trial registration number CRD42015016450.
Source: BMJ Open - June 18, 2015 Category: Journals (General) Authors: Heron, N., Kee, F., Donnelly, M., Cupples, M. E. Tags: Open access, Cardiovascular medicine, General practice / Family practice, Neurology, Rehabilitation medicine, Sports and exercise medicine Protocol Source Type: research

Does pragmatically structured outpatient dietary counselling reduce sodium intake in hypertensive patients? Study protocol for a randomized controlled trial
DiscussionThough decreasing sodium intake has been reported to be efficacious in lowering blood pressure, there exists a gap in the evidence for an effective intervention that could be easily translated into clinical practice. If successful, our intervention would be suitable for outpatient programs such as hypertension clinics or interprofessional family practices (family health teams). A negative, or partially negative (positive effect at four weeks with attrition by 12 months) trial outcome also has significant implications for healthcare delivery and use of resources.Trial registrationThe trial was registered with Cli...
Source: Epidemiologic Perspectives and Innovations - June 16, 2015 Category: Epidemiology Authors: Marcel RuzickaTim RamsayAnn BugejaCedric EdwardsGeorge FodorAnne KirbyPeter MagnerBrendan McCormickGigi van der HoefJessica WagnerSwapnil Hiremath Source Type: research

GP detection of health risk factors among general practice patients at risk of primary and secondary stroke
Conclusion. Given low sensitivity and specificity of GP detection of risk factors among patients, alternate methods of identification are needed. Research is required to determine strategies to facilitate secondary care of patients with a history of stroke or heart disease by GPs.
Source: Family Practice - May 27, 2015 Category: Primary Care Authors: Grady, A., Carey, M., Oldmeadow, C., Bryant, J., Mazza, D., Sanson-Fisher, R. Tags: Health Service Research Source Type: research

A retrospective cohort study to investigate fatigue, psychological or cognitive impairment after TIA: protocol paper
Introduction Transient ischaemic attack (TIA) is defined by short-lasting, stroke-like symptoms, and is recognised as a medical emergency. Symptoms are assumed to completely resolve, and treatment is focused on secondary stroke/TIA prevention. However, evidence suggests that patients with TIA may experience ongoing residual impairments, which they do not receive therapy for as standard practice. TIA-induced sequelae could impact on patients’ quality of life and ability to return to work or social activities. We aim to investigate whether TIA is associated with subsequent consultation for fatigue, psychological or cog...
Source: BMJ Open - May 3, 2015 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Ryan, R., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice Protocol Source Type: research

Does hospitalist directed care reduce the length of stay for acute ischemic stroke patients and improve adherence to the "Get with the Guidelines" inpatient quality measures? (P5.153)
CONCLUSIONS: There is a significant improvement in adherence to the GWTG-ISPM when an AIS patient is admitted under the care of a hospitalist. Prospective databases are recommended to evaluate if this leads to better long-term outcomes.Disclosure: Dr. Tekle has nothing to disclose. Dr. Hassan has nothing to disclose. Dr. Sanchez has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Abantao has nothing to disclose. Dr. Sanchez has nothing to disclose. Dr. Jones-Fillingum has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Tekle, W., Hassan, A., Sanchez, C., Malik, A., Abantao, E., Sanchez, O., Jones-Fillingum, L., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Quality Research and Initiatives Source Type: research

Impact of Community Stroke Education and Comprehensive Stroke Care in South Texas (P2.300)
CONCLUSIONS: Intensified public stroke education and establishment of comprehensive stroke care significantly increased intravenous thrombolytic and endovascular treatment utilization in a South Texas border town over four fold within 18 months.Disclosure: Dr. Hassan has nothing to disclose. Dr. Tekle has nothing to disclose. Dr. Sanchez has nothing to disclose. Dr. Jani has nothing to disclose. Dr. Jones-Fullingim has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Hassan, A., Tekle, W., Sanchez, C., Jani, V., Jones-Fullingim, L. Tags: Cerebrovascular Disease and Interventional Neurology: Education and TIA Source Type: research

Quality of Disease Management and Risk of Mortality in English Primary Care Practices
ConclusionsThe panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions.
Source: Health Services Research - January 19, 2015 Category: Health Management Authors: Mark Dusheiko, Hugh Gravelle, Stephen Martin, Peter C. Smith Tags: Research Article 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

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 - November 25, 2014 Category: Primary Care Authors: Nahal MavaddatJose ValderasRianne van der LindeKay KhawAnn Kinmonth Source Type: research

Absolute cardiovascular risk and GP decision making in TIA and minor stroke
Conclusion. In patients presenting with transient or minor neurological symptoms, calculation of ACVR did not improve diagnostic accuracy for TIAMS beyond that of age and sex.
Source: Family Practice - November 18, 2014 Category: Primary Care Authors: Clarey, J., Lasserson, D., Levi, C., Parsons, M., Dewey, H., Barber, P. A., Quain, D., McElduff, P., Sales, M., Magin, P. Tags: Epidemiology Source Type: research