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Specialty: Internal Medicine
Management: General Practices
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Total 19 results found since Jan 2013.
Incidence of nonvalvular atrial fibrillation and oral anticoagulant prescribing in England, 2009 to 2019: A cohort study
ConclusionsThe incidence of NVAF increased between 2009 and 2015, before plateauing. Underprescribing of OACs in NVAF is associated with a range of comorbidities, ethnicity, and socioeconomic factors, demonstrating the need for initiatives to reduce inequalities in the care for AF patients.
Source: PLoS Medicine - June 7, 2022 Category: Internal Medicine Authors: Alyaa M. Ajabnoor Source Type: research
Association between cardiometabolic disease multimorbidity and all-cause mortality in 2 million women and men registered in UK general practices
We examined if their combined impact on mortality is proportional, amplified or less than...
Source: BMC Medicine - October 28, 2021 Category: Internal Medicine Authors: Dexter Canoy, Jenny Tran, Mariagrazia Zottoli, Rema Ramakrishnan, Abdelaali Hassaine, Shishir Rao, Yikuan Li, Gholamreza Salimi-Khorshidi, Robyn Norton and Kazem Rahimi Tags: Research article Source Type: research
Prescribing of direct oral anticoagulants and warfarin to older people with atrial fibrillation in UK general practice: a cohort study
Anticoagulation for stroke prevention in atrial fibrillation (AF) has, historically, been under-used in older people. The aim of this study was to investigate prescribing of oral anticoagulants (OACs) for peop...
Source: BMC Medicine - August 31, 2021 Category: Internal Medicine Authors: Anneka Mitchell, Julia Snowball, Tomas J. Welsh, Margaret C. Watson and Anita McGrogan Tags: Research article Source Type: research
Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: A cross-sectional feasibility study
ConclusionsThis study demonstrates that AF screening performed by GP practice –based pharmacists was feasible, economically viable, and positively endorsed by participants. Furthermore, diagnosis of AF by the clinical pharmacist using anSLECG was more sensitive and more specific than the use of pulse palpation alone. Future research should explore the key barriers preventing the adoption of national screening programmes.
Source: PLoS Medicine - July 16, 2020 Category: Internal Medicine Authors: Vilius Savickas Source Type: research
Patterns and temporal trends of comorbidity among adult patients with incident cardiovascular disease in the UK between 2000 and 2014: A population-based cohort study
ConclusionsThe burden of multimorbidity and comorbidity in patients with incident non-fatal CVD increased between 2000 and 2014. On average, older patients, women, and socioeconomically deprived groups had higher numbers of comorbidities, but the type of comorbidities varied by age and sex. Cardiometabolic conditions contributed substantially to the burden, but 4 out of the 10 top comorbidities were non-cardiometabolic. The current single-disease paradigm in CVD management needs to broaden and incorporate the large and increasing burden of comorbidities.
Source: PLoS Medicine - March 6, 2018 Category: Internal Medicine Authors: Jenny Tran Source Type: research
Burden of Atrial Fibrillation in M āori and Pacific People in New Zealand: A Cohort Study
ConclusionAF screening and stroke thromboprophylaxis in Māori and Pacific people could start below the age of 65 years in NZ.
Source: Internal Medicine Journal - October 16, 2017 Category: Internal Medicine Authors: Yulong Gu, Robert N Doughty, Ben Freedman, John Kennelly, Jim Warren, Matire Harwood, Richard Hulme, Chris Paltridge, Ruth Teh, Anna Rolleston, Natalie Walker Tags: Original Article Source Type: research
Under-prescribing of Prevention Drugs and Primary Prevention of Stroke and Transient Ischaemic Attack in UK General Practice: A Retrospective Analysis
ConclusionsIn our study, over half of people eligible for lipid-lowering, anticoagulant, or antihypertensive drugs were not prescribed them prior to first stroke/TIA. We estimate that approximately 12,000 first strokes could potentially be prevented annually in the UK through optimal prescribing of these drugs. Improving prescription of lipid-lowering, anticoagulant, and antihypertensive drugs is important to reduce the incidence and burden of stroke and TIA.
Source: PLoS Medicine - November 14, 2016 Category: Internal Medicine Authors: Grace M. Turner Source Type: research
Risk score developed from routinely collected data by primary healthcare practitioners is useful to rule out dementia in 60-79 year-olds
Commentary on: Walters K, Hardoon S, Petersen I, et al.. Predicting dementia risk in primary care: development and validation of the Dementia Risk Score using routinely collected data. BMC Medicine 2016;14:6 . Context In spite of major repercussions on the life of patients and caregivers, dementia remains a neglected domain in primary care setting. Previous studies have shown that only a third of new dementia cases occurring in the general population were referred to a specialist1 and that too at a severe stage of the disease, 25% of cases were ignored.2 A great proportion of primary care practitioners (PCPs) consider deme...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Dartigues, J. F., Helmer, C. Tags: EBM Diagnosis, Health policy, General practice / family medicine, Drugs: cardiovascular system, Dementia, Drugs: CNS (not psychiatric), Stroke, Memory disorders (psychiatry), Psychiatry of old age, Health service research Source Type: research
Low to moderate quality evidence demonstrates the potential benefits and adverse events of cannabinoids for certain medical indications
Commentary on: Whiting PF, Wolff RF, Deshpande S, et al.. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA 2015;313:2456–73. Context As of September 2015, 23 states and the District of Columbia in the USA legalised the medicinal use of marijuana, underscoring the need for physicians to understand the science underlying medical marijuana as well as the practical issues associated with it. For years policymakers, scientists and physicians alike have debated the potential risks associated with marijuana use.1 Now marijuana's utility as a treatment for certain medical indications has taken focus....
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Hill, K. P., Hurley-Welljams-Dorof, W. M. Tags: Sexual transmitted infections (viral), Clinical trials (epidemiology), General practice / family medicine, Genetics, Immunology (including allergy), HIV/AIDS, Drugs: CNS (not psychiatric), Pain (neurology), Sleep disorders (neurology), Stroke, Ophthalmolo Source Type: research
Combined oral contraceptives and risk of venous thromboembolism: there is higher risk in new generations compared to second generations, but paradoxically not in norgestimate-containing-pills
This study examines the VTE risk associated with COC use in two large UK databases. Methods...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: Plu-Bureau, G. Tags: Smoking and tobacco, Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Contraception, Drugs: obstetrics and gynaecology, Family planning, Alcohol, Health education, Smoking Aetiology/Harm Source Type: research
The mortality rate in England between 2007 and 2012 was not associated with the quality of primary care in an established pay for performance programme
This study aimed to examine the relationship between primary care performance of quality indicators included in the QOF and changes in mortality. Methods This was an analysis of a longitudinal data...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Fleetcroft, R. Tags: EBM Quality improvement, Medical management, Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Drugs: cardiovascular system, Stroke, Hypertension, Diet, Ischaemic heart disease, Renal medicine, Guidelines Source Type: research
The 'surprise' question may improve the accuracy of GPs in identifying death in patients with advanced stage IV solid-cell cancer
Commentary on: Moroni M, Zocchi D, Bolognesi D, et al.; on behalf of the SUQ-P group. The ‘surprise’ question in advanced cancer patients: a prospective study among general practitioners. Palliat Med 2014;28:,959–64. Context The ‘surprise’ question has been developed in order to improve the ability of clinicians to identify patients who are at risk of dying in the near future. The question, ‘Would I be surprised if this patient died in the next year?’ shifts the focus away from precise identification of dying patients to identifying patients who might be dying.1 This may enable mor...
Source: Evidence-Based Medicine - March 17, 2015 Category: Internal Medicine Authors: Rhee, J., Clayton, J. M. Tags: EBM Prognosis, Pancreas and biliary tract, Palliative care, Epidemiologic studies, General practice / family medicine, Stroke, Prostate Source Type: research
Gender differences in stroke prevention in atrial fibrillation in general practice: using the GRASP‐AF audit tool
ConclusionWomen with AF are at higher risk of stroke than men without OAC. The gender‐related differences in risk of stroke disappear if OAC is used. Despite this, women are more likely not to receive OAC.
Source: International Journal of Clinical Practice - March 1, 2015 Category: Internal Medicine Authors: E. Shantsila, A. Wolff, G. Y. H. Lip, D. A. Lane Tags: Original Paper 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
Limited impact of omega-3 fatty acids in patients with multiple cardiovascular risk factors
Commentary on: Roncaglioni MC, Tombesi M, et al.. Risk and Prevention Study Collaborative Group. n-3 fatty acids in patients with multiple cardiovascular risk factors. N Engl J Med 2013;368:1800–8 Context Ecological, case–control and prospective studies consistently demonstrate reduced cardiovascular morbidity and mortality associated with higher intake of fish and their constituent omega-3 fatty acids and with higher omega-3 fatty acid status.1 This effect has been ascribed to improvement of the cardiovascular risk profile resulting in disease prevention.1 Trials in patients following myocardial infarction (MI...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Calder, P. Tags: Clinical trials (epidemiology), Epidemiologic studies, General practice / family medicine, Immunology (including allergy), Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Arrhythmias Therapeutics Source Type: research
