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Total 326 results found since Jan 2013.

Cluster randomized trials utilizing primary care electronic health records: methodological issues in design, conduct, and analysis (eCRT Study)
Conclusions: Cluster randomized trials may be performed efficiently in large samples from UK general practices using the electronic health records of a primary care database. The geographical dispersal of trial sites presents a difficulty for research governance approval and intervention implementation. Pretrial data analyses should inform trial design and analysis plans.Trial registration: Current Controlled Trials ISRCTN 47558792 and ISRCTN 35701810 (both registered on 17 March 2010).
Source: BioMed Central - June 11, 2014 Category: Journals (General) Authors: Martin C GullifordTjeerd P van StaaLisa McDermottGerard McCannJudith CharltonAlex Dregan Source Type: research

'BeAWARE': supporting non-clinical staff within general practice to promptly identify patients presenting with warning signs of heart attack or stroke.
DISCUSSION: BeAWARE fulfils a practice gap in patient safety by improving non-clinical staff's knowledge, confidence and intended action in response to patients presenting with heart attack or stroke warning signs. PMID: 24897991 [PubMed - in process]
Source: Australian Family Physician - June 1, 2014 Category: Primary Care Authors: Poulter C, Stewart M, Fitzpatrick C, Keech W, Stavreski B, Grenfell R Tags: Aust Fam Physician Source Type: research

Smoking cessation interventions following acute coronary syndrome: a missed opportunity?
Conclusions: Whilst a high proportion of patients with ACS are smokers, there is a low level of GP cessation intervention following hospital discharge. This missed opportunity of patient care is important given the decreased risk of mortality and MACE found amongst those who quit.
Source: European Journal of Preventive Cardiology - May 27, 2014 Category: Cardiology Authors: Boggon, R., Timmis, A., Hemingway, H., Raju, S., Malvestiti, F. M., Van Staa, T. P. Tags: Original scientific paper 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

Neither ibuprofen nor steam improves symptom control compared with paracetamol in patients with acute respiratory tract infections in primary care
Commentary on: Little P, Moore M, Kelly J, et al.. Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ 2013;347:f6041. Context The achievement of symptom control in patients with respiratory infections is an ongoing challenge, particularly within primary care. Patients and clinicians often view antibiotics, alongside other supportive medication, as the most expeditious intervention to achieve this goal. While we have learnt that antibiotics provide only very limited benefit in cases when bacterial infection is not suspected,1 2 the effe...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Schuetz, P. Tags: General practice / family medicine, Influenza, Otitis, Pain (neurology), Stroke, Ischaemic heart disease, Pain (palliative care), Drugs: musculoskeletal and joint diseases, Ear, nose and throat/otolaryngology Therapeutics 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

Receptionist rECognition and rEferral of patients with stroke (RECEPTS) study - protocol of a mixed methods study
This study therefore aims to understand the role of General Practice receptionists, with particular interest in receptionist's ability to recognise people who may be suffering from a stroke and to handle such patients as a medical emergency. Methods: The Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study will be a Primary Care based mixed methods study. 60 General Practices in the West Midlands will be recruited. Each practice will receive 10 unannounced simulated patient telephone calls, after the 10 calls questionnaires will be administered to each receptionist. These will examine the behaviour...
Source: Epidemiologic Perspectives and Innovations - May 12, 2014 Category: Epidemiology Authors: James P SheppardSatinder SinghJanet JonesElizabeth BatesJohn SkeltonConnie WiskinRichard J McManusRuth M Mellor Source Type: research

Improving anticoagulation in atrial fibrillation: observational study in three primary care trusts.
CONCLUSIONS: The APEL programme supports improvement in clinical managing AF by a combined programme of education around agreed guidance, computer aids to facilitate decision-making and patient review and feedback of locally identifiable results. If replicated nationally over 3 years, such a programme could result in approximately 1600 fewer strokes every year. PMID: 24771841 [PubMed - in process]
Source: The British Journal of General Practice - May 1, 2014 Category: Primary Care Authors: Robson J, Dostal I, Mathur R, Sohanpal R, Hull S, Antoniou S, Maccallum P, Schilling R, Ayerbe L, Boomla K Tags: Br J Gen Pract Source Type: research

Improving cardiovascular disease using managed networks in general practice: an observational study in inner London.
CONCLUSION: Managed geographical practice networks delivered a step-change in key CVD performance indicators in comparison with England, London, or similar PCT/CCGs. PMID: 24771840 [PubMed - in process]
Source: The British Journal of General Practice - May 1, 2014 Category: Primary Care Authors: Robson J, Hull S, Mathur R, Boomla K Tags: Br J Gen Pract Source Type: research

iPhone ECG screening by practice nurses and receptionists for atrial fibrillation in general practice: the GP-SEARCH qualitative pilot study.
DISCUSSION: AF screening in general practice is feasible. A promising model is likely to be one delivered by a practice nurse, but depends on relevant contextual factors for each practice. PMID: 24791776 [PubMed - in process]
Source: Australian Family Physician - May 1, 2014 Category: Primary Care Authors: Orchard J, Freedman SB, Lowres N, Peiris D, Neubeck L Tags: Aust Fam Physician Source Type: research

Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012
Approximately half of patients with atrial fibrillation and with risk factors for stroke are not treated with oral anticoagulation (OAC), whether it be with vitamin K antagonists (VKAs) or novel OACs (NOACs); and of those treated, many discontinue treatment. Leaders from academia, government, industry, and professional societies convened in Washington, DC, on December 3-4, 2012, to identify barriers to optimal OAC use and adherence and to generate potential solutions. Participants identified a broad range of barriers, including knowledge gaps about stroke risk and the relative risks and benefits of anticoagulant therapies;...
Source: American Heart Journal - April 25, 2014 Category: Cardiology Authors: Paul L. Hess, Michael J. Mirro, Hans-Christoph Diener, John W. Eikelboom, Sana M. Al-Khatib, Elaine M. Hylek, Hayden B. Bosworth, Bernard J. Gersh, Daniel E. Singer, Greg Flaker, Jessica L. Mega, Eric D. Peterson, John S. Rumsfeld, Benjamin A. Steinberg, Tags: Results of Expert Meetings Source Type: research

Assessing awareness of appropriate responses to symptoms of stroke
Conclusion: There appears to be high awareness of the appropriate response to take for stroke symptoms among this sample, however this does not translate into actions when individuals experience a potential stroke symptom.Practice implications: Education campaigns should be targeted towards individuals without a family history of stroke.
Source: Patient Education and Counseling - April 2, 2014 Category: Global & Universal Authors: Alice Grady, Mariko Carey, Rob Sanson-Fisher Tags: Patient Perception, Preference and Participation Source Type: research

Clinical prediction rules in practice: review of clinical guidelines and survey of GPs.
CONCLUSION: GPs use CPRs to guide management but also to comply with local policy requirements. Future research could focus on which clinical areas clinicians would most benefit from CPRs and promoting the use of robust, externally validated CPRs. PMID: 24686888 [PubMed - in process]
Source: The British Journal of General Practice - April 1, 2014 Category: Primary Care Authors: Plüddemann A, Wallace E, Bankhead C, Keogh C, Van der Windt D, Lasserson D, Galvin R, Moschetti I, Kearley K, O'Brien K, Sanders S, Mallett S, Malanda U, Thompson M, Fahey T, Stevens R Tags: Br J Gen Pract Source Type: research

Stroke.
Abstract In 2012, about 50 000 Australians had a stroke (cerebrovascular accident (CVA)). The risk of stroke is associated with increased age, previous stroke or transient ischaemic attack, hypertension, smoking, diabetes mellitus (DM), hypercholesterolaemia and atrial fibrillation/flutter (AF). Australian general practice data from the national BEACH program between April 2000 and March 2013 inclusive (1 276 200 GP-patient encounters) were analysed to determine the patient characteristics, associated conditions and management options at those encounters where a CVA was recorded, and detect changes in the annual m...
Source: Australian Family Physician - March 1, 2014 Category: Primary Care Authors: Pollack A, Harrison C, Henderson J, Miller G Tags: Aust Fam Physician Source Type: research

Flu jab "may cut" stroke risk by a quarter
ConclusionThis research finds that, overall, having the flu vaccine reduced the risk of a person experiencing a stroke by about 25%. The reduction in risk seemed to be greatest within the first three months of vaccination, but remained for up to 12 months.  However, the effect lasted only if the vaccine was given early in the flu season (September to mid-November); giving the vaccine late in the flu season (mid-November to February) was not associated with significantly reduced risk.The research benefits from using data coded within the General Practice Research Database for England and Wales for almost 50,000 people with...
Source: NHS News Feed - February 21, 2014 Category: Consumer Health News Tags: Heart/lungs Neurology Older people Source Type: news