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Total 250 results found since Jan 2013.

Retrospective case review of missed opportunities for primary prevention of stroke and TIA in primary care: protocol paper
This study will investigate: (1) the proportion of strokes/TIAs with prior missed opportunities for prevention in primary care; (2) the influence of patient characteristics on missed prevention opportunities and (3) how the proportion of missed prevention opportunities has changed over time. Methods and analysis A retrospective case review will identify first-ever stroke and patients with TIA between 2000 and 2013 using anonymised electronic medical records extracted from the health improvement network (THIN) database. Four categories of missed opportunities for stroke/TIA prevention will be sought: untreated high blood p...
Source: BMJ Open - November 11, 2014 Category: Journals (General) Authors: Moran, G. M., Calvert, M., Feltham, M. G., Marshall, T. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Global health Protocol Source Type: research

Approach to the new oral anticoagulants in family practice: Part 2: addressing frequently asked questions.
CONCLUSION: Management of "what if" scenarios for patients taking NOACs have been proposed, but additional study is needed to address these issues, especially periprocedural management and bleeding. PMID: 25392439 [PubMed - as supplied by publisher]
Source: Canadian Family Physician Medecin de Famille Canadien - November 1, 2014 Category: Primary Care Authors: Douketis J, Bell AD, Eikelboom J, Liew A Tags: Can Fam Physician Source Type: research

Approach to the new oral anticoagulants in family practice: Part 1: comparing the options.
CONCLUSION: The NOACs represent important alternatives in the management of patients with AF and VTE, especially for patients who have difficulty accessing regular coagulation monitoring. The companion to this article addresses common "what if" questions that arise in the long-term clinical follow-up and management of patients receiving NOACs. PMID: 25392438 [PubMed - as supplied by publisher]
Source: Canadian Family Physician Medecin de Famille Canadien - November 1, 2014 Category: Primary Care Authors: Douketis J, Bell AD, Eikelboom J, Liew A Tags: Can Fam Physician 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 - October 29, 2014 Category: Primary Care Authors: Elizabeth CrootTony RyanJennifer ReadFiona CampbellAlicia O¿CathainGraham Venables Source Type: research

The performance of seven QPrediction risk scores in an independent external sample of patients from general practice: a validation study
Conclusions Each of the algorithms performed practically as well in the external independent CPRD validation cohorts as they had in the original published QResearch validation cohorts.
Source: BMJ Open - August 28, 2014 Category: Journals (General) Authors: Hippisley-Cox, J., Coupland, C., Brindle, P. Tags: Open access, Epidemiology, General practice / Family practice, Health informatics Research Source Type: research

Prevalence and predictors of resistant hypertension in a primary care setting: a cross-sectional study
We examined the control of blood pressure in a randomly selected sample of patients with hypertension in a primary care clinic. Demographic data, blood pressure and anti-hypertensive drug use were captured from patient records at the end of 2007. Resistant hypertension is defined as failure to achieve target blood pressure of
Source: BMC Family Practice - July 5, 2014 Category: Primary Care Authors: Yook ChiaSiew Ching Source Type: research

Point-of-Care Cluster Randomized Trial in Stroke Secondary Prevention Using Electronic Health Records Clinical Sciences
Conclusions— Large pragmatic intervention studies may be implemented at low cost by using electronic health records. The intervention used in this trial was not found to be effective, and further research is needed to develop more effective intervention strategies. Clinical Trial Registration— URL: http://www.controlled-trials.com. Current Controlled Trials identifier: ISRCTN35701810.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Dregan, A., van Staa, T. P., McDermott, L., McCann, G., Ashworth, M., Charlton, J., Wolfe, C. D. A., Rudd, A., Yardley, L., Gulliford, M. C., Meredith, Kerry, Murray, Mant, Robson, Haywood, Pursani Tags: Other Stroke Treatment - Medical Clinical Sciences Source Type: research

Quality of cardiovascular disease care in Ontario's primary care practices: a cross sectional study examining differences in guideline adherence by patient sex
Conclusions: Sex disparities exist in the quality of cardiovascular care in Canadian primary care practices, which tend to favour men. Women with PVD have a particularly high risk of not receiving appropriate medications. Our findings indicate that improvements in care delivery should be made to address these issues, particularly with regard to the prescribing of recommended medications for women, and preventive measures for men.
Source: BMC Family Practice - June 18, 2014 Category: Primary Care Authors: Kiyuri NaickerClare LiddyJatinderpreet SinghMonica TaljaardWilliam Hogg Source Type: research

Quality of cardiovascular disease care in Ontario¿s primary care practices: a cross sectional study examining differences in guideline adherence by patient sex
Conclusions: Sex disparities exist in the quality of cardiovascular care in Canadian primary care practices, which tend to favour men. Women with PVD have a particularly high risk of not receiving appropriate medications. Our findings indicate that improvements in care delivery should be made to address these issues, particularly with regard to the prescribing of recommended medications for women, and preventive measures for men.
Source: BMC Family Practice - June 18, 2014 Category: Primary Care Authors: Kiyuri NaickerClare LiddyJatinderpreet SinghMonica TaljaardWilliam Hogg 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 - May 21, 2014 Category: Primary Care Authors: Chantelle WisemanRichard Baker Source Type: research

Is screening for AF worthwhile? Stroke risk in a screened population from the SAFE study
Conclusion. Stroke risk profiles of patients detected via opportunistic and systematic screenings were similar. Data derived from the SAFE study suggest that active screening for AF in patients aged ≥65 years in primary care is a useful screening programme with 78–83% of patients identified eligible for anticoagulation treatment according to the CHADS2 criteria.
Source: Family Practice - May 17, 2014 Category: Primary Care Authors: Fitzmaurice, D. A., McCahon, D., Baker, J., Murray, E. T., Jowett, S., Sandhar, H., Holder, R. L., Hobbs, F. D. R. Tags: Epidemiology 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 - May 6, 2014 Category: Primary Care Authors: Annemarei RantaChwan-Fen YangMichael FunnellPietro CarigaCatherine Murphy-RahalNaomi Cogger Source Type: research

Atrial fibrillation anticoagulation care in a large urban family medicine practice.
CONCLUSION: When assessed using the 2012 Canadian Cardiovascular Society AF guidelines, the proportion of patients receiving appropriate SPAF therapy in this primary care setting decreased substantially. All patients with CHADS2 scores of 0 or 1 should be reassessed to ensure that they are receiving optimal stroke prevention treatment. PMID: 24627401 [PubMed - in process]
Source: Canadian Family Physician Medecin de Famille Canadien - March 1, 2014 Category: Primary Care Authors: Valentinis A, Ivers N, Bhatia S, Meshkat N, Leblanc K, Ha A, Morra D Tags: Can Fam Physician Source Type: research

Agreement between self-reported and general practitioner-reported chronic conditions among multimorbid patients in primary care - results of the MultiCare cohort study
Conclusions: For multimorbidity research, the knowledge of diseases with high disagreement levels between the patients' perceived illnesses and their physicians' reports is important. The analysis shows that different patient characteristics have an impact on the agreement. Findings from this study should be included in the development of clinical guidelines for multimorbidity aiming to optimize health care. Further research is needed to identify more reasons for disagreement and their consequences in health care.Trial registration: ISRCTN89818205.
Source: BMC Family Practice - March 1, 2014 Category: Primary Care Authors: Heike HansenIngmar SchäferGerhard SchönSteffi Riedel-HellerJochen GensichenSiegfried WeyererJuliana PetersenHans-Helmut KönigHorst BickelAngela FuchsSusanne HöfelsBirgitt WieseKarl WegscheiderHendrik van den BusscheMartin Scherer Source Type: research

Cost-effectiveness of a universal strategy of brief dietary intervention for primary prevention in primary care: population-based cohort study and Markov model
Conclusions: A universal strategy to promote healthy diet through brief intervention in primary care is unlikely to be cost-effective, even when delivered at low unit cost. A targeted strategy aimed at older individuals at higher risk of disease might be more cost-effective. More effective dietary change interventions are needed.
Source: BioMed Central - February 2, 2014 Category: Journals (General) Authors: Martin C GullifordNawaraj BhattaraiJudith CharltonCaroline Rudisill Source Type: research