2,201 results match your criteria BMC Family Practice[Journal]


Perspectives from primary health care providers on their roles for supporting adolescents and young adults transitioning from pediatric services.

BMC Fam Pract 2020 Jul 13;21(1):140. Epub 2020 Jul 13.

Department of Pediatrics, Cumming School of Medicine, University of Calgary, 28 Oki Drive, Calgary, Alberta, Canada.

Background: Transitioning from pediatric care to adult-oriented care at age 18 (the age of transfer in most countries and jurisdictions) is a complex process for adolescents and young adults affected by chronic physical health and/or mental health conditions. The role of primary health care (PHC) providers for this population is poorly understood. Perspectives from these providers, such as family physicians and other members of the primary care team, have not been explored in depth. Read More

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http://dx.doi.org/10.1186/s12875-020-01189-8DOI Listing

A pay for performance scheme in primary care: Meta-synthesis of qualitative studies on the provider experiences of the quality and outcomes framework in the UK.

BMC Fam Pract 2020 Jul 13;21(1):142. Epub 2020 Jul 13.

Centre for Health Services Studies, University of Kent, Kent, Canterbury, CT2 7NF, UK.

Background: The Quality and Outcomes Framework (QOF) is an incentive scheme for general practice, which was introduced across the UK in 2004. The Quality and Outcomes Framework is one of the biggest pay for performance (P4P) scheme in the world, worth £691 million in 2016/17. We now know that P4P is good at driving some kinds of improvement but not others. Read More

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http://dx.doi.org/10.1186/s12875-020-01208-8DOI Listing

What is the role of the practice nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)?: a systematic review.

BMC Fam Pract 2020 Jul 13;21(1):141. Epub 2020 Jul 13.

Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.

Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged. Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published literature to identify existing and potential roles of Practice Nurse's in the delivery of care to people affected by dementia and to describe the characteristics and effectiveness of nurse interventions in dementia models of care. Read More

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http://dx.doi.org/10.1186/s12875-020-01177-yDOI Listing

A quantitative assessment of the parameters of the role of receptionists in modern primary care using the work design framework.

BMC Fam Pract 2020 Jul 10;21(1):138. Epub 2020 Jul 10.

Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Background: Amidst increased pressures on General Practice across England, the receptionist continues to fulfil key administrative and clinically related tasks. The need for more robust support for these key personnel to ensure they stay focussed and motivated is apparent, however, to be effective a more systematic understanding of the parameters of their work is required. Here we present a valuable insight into the tasks they fulfil, their relationship with colleagues and their organisation and their attitudes and behaviour at work collectively defined as their 'work design'. Read More

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http://dx.doi.org/10.1186/s12875-020-01204-yDOI Listing

Blood pressure control in patients with a previous stroke/transient ischaemic attack in primary care in Ireland: a cross sectional study.

BMC Fam Pract 2020 Jul 10;21(1):139. Epub 2020 Jul 10.

Graduate Entry Medical School, University of Limerick, Limerick, Ireland.

Background: Uncontrolled blood pressure (BP) is an important modifiable risk factor for recurrent stroke. Secondary prevention measures when implemented can reduce stroke re-occurrence by 80%. However, hypertension control rates remain sub-optimal, and little data is available from primary care where most management occurs. Read More

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http://dx.doi.org/10.1186/s12875-020-01211-zDOI Listing

Reconstructing family doctors' psychological well-being and motivation for effective performance in China: the intervening role of psychological capital.

BMC Fam Pract 2020 Jul 10;21(1):137. Epub 2020 Jul 10.

School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu, P.R. China.

Background: Family practice and family doctors are critical part of China's primary healthcare delivery in a constantly evolving society. As the first point of contact with the medical system, family practices require physically and psychologically sound and a well-motivated family doctors at all times. This is because an error can lead to loss of lives as gatekeepers of the medical system. Read More

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http://dx.doi.org/10.1186/s12875-020-01182-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351555PMC

Patient and caregiver perspectives on early identification for advance care planning in primary healthcare settings.

BMC Fam Pract 2020 Jul 9;21(1):136. Epub 2020 Jul 9.

Cancer Outcomes Research Program, Department of Surgery, Dalhousie University and Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.

Background: As part of a broader study to improve the capacity for advance care planning (ACP) in primary healthcare settings, the research team set out to develop and validate a computerized algorithm to help primary care physicians identify individuals at risk of death, and also carried out focus groups and interviews with relevant stakeholder groups. Interviews with patients and family caregivers were carried out in parallel to algorithm development and validation to examine (1) views on early identification of individuals at risk of deteriorating health or dying; (2) views on the use of a computerized algorithm for early identification; and (3) preferences and challenges for ACP.

Methods: Fourteen participants were recruited from two Canadian provinces. Read More

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http://dx.doi.org/10.1186/s12875-020-01206-wDOI Listing

Antimicrobial stewardship in the primary care setting: from dream to reality?

BMC Fam Pract 2020 Jul 8;21(1):134. Epub 2020 Jul 8.

Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia.

Background: Clinicians who work in primary care are potentially the most influential healthcare professionals to address the problem of antibiotic resistance because this is where most antibiotics are prescribed. Despite a number of evidence based interventions targeting the management of community infections, the inappropriate antibiotic prescribing rates remain high.

Discussion: The question is how can appropriate prescribing of antibiotics through the use of Antimicrobial Stewardship (AMS) programs be successfully implemented in primary care. Read More

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http://dx.doi.org/10.1186/s12875-020-01191-0DOI Listing

Do primary and secondary care doctors have a different experience and perception of cross-level clinical coordination? Results of a cross-sectional study in the Catalan National Health System (Spain).

BMC Fam Pract 2020 Jul 8;21(1):135. Epub 2020 Jul 8.

Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, Spain.

Background: Clinical coordination across care levels is a priority for health systems around the world, especially for those based on primary health care. The aim of this study is to analyse the degree of clinical information and clinical management coordination across healthcare levels in the Catalan national health system experienced by primary (PC) and secondary care (SC) doctors and explore the associated factors.

Methods: Cross-sectional study based on an online survey using the self-administered questionnaire COORDENA-CAT. Read More

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http://dx.doi.org/10.1186/s12875-020-01207-9DOI Listing

Effects of a work stress intervention on healthcare use and treatment compared to treatment as usual: a randomised controlled trial in Swedish primary healthcare.

BMC Fam Pract 2020 Jul 6;21(1):133. Epub 2020 Jul 6.

Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Background: Work stress is an increasing burden in society. Identifying early symptoms of work stress in primary healthcare (PHC) could result in earlier and better-targeted care. The Work Stress Questionnaire (WSQ) was developed in PHC for this task. Read More

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http://dx.doi.org/10.1186/s12875-020-01210-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339485PMC

Management of work-related common mental disorders in general practice: a cross-sectional study.

BMC Fam Pract 2020 Jul 2;21(1):132. Epub 2020 Jul 2.

Université de Versailles Saint-Quentin, Université Paris Saclay, CESP, Team DevPsy, 94807, Villejuif, France.

Background: General practitioners (GPs) often manage individuals with work-related common mental disorders (CMD: depressive disorders, anxiety and alcohol abuse). However, little is known about the ways in which they proceed. The aim of this study is to analyze GPs' management and patterns of referral to other health professionals of patients with work-related CMD and associated factors. Read More

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http://dx.doi.org/10.1186/s12875-020-01203-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331173PMC

Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study.

BMC Fam Pract 2020 Jul 1;21(1):128. Epub 2020 Jul 1.

Abia State University Teaching Hospital, Aba, Nigeria.

Background: Due to the perennial shortage of diabetes specialists, primary care physicians (PCPs) constitute the largest diabetes care manpower in Nigeria. However, the competence of the PCPs to undertake this task is not known. This study was aimed at evaluating diabetes care knowledge and practice among PCPs in Southeastern part of Nigeria. Read More

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http://dx.doi.org/10.1186/s12875-020-01202-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330977PMC

General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research.

BMC Fam Pract 2020 Jul 1;21(1):131. Epub 2020 Jul 1.

Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001.

Background: General practitioners (GPs) increasingly manage patients with multimorbidity but report challenges in doing so. Patients describe poor experiences with health care systems that treat each of their health conditions separately, resulting in fragmented, uncoordinated care. For GPs to provide the patient-centred, coordinated care patients need and want, research agendas and health system structures and policies will need to adapt to address this epidemiologic transition. Read More

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http://dx.doi.org/10.1186/s12875-020-01197-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331183PMC

The use of ultrasound in primary care: longitudinal billing and cross-sectional survey study in Switzerland.

BMC Fam Pract 2020 Jul 1;21(1):127. Epub 2020 Jul 1.

Instiute of Primary and Community Care, 6004, Lucerne, Switzerland.

Background: Ultrasound imaging is utilized in Swiss primary care; however, little is known regarding the extent to which it is performed. With this study, we aim to (1) provide an overview of ultrasound use by general practitioners (GPs), and (2) determine the clinical indications of ultrasound in Swiss general practice.

Methods: This is a quantitative study, analyzing 15 years of billing data from 213 GPs in Central Switzerland, and cross-sectional survey data completed by 61 GPs attending 26 certification and refresher courses offered by the Swiss Society of Ultrasound in Medicine (SGUM). Read More

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http://dx.doi.org/10.1186/s12875-020-01209-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330951PMC

Management and treatment of HIV: are primary care clinicians prepared for their new role?

BMC Fam Pract 2020 Jul 1;21(1):130. Epub 2020 Jul 1.

College of Graduate Health Studies, A. T. Still University, 5850 East Still Circle, Mesa, AZ, 85206, USA.

Background: Current literature suggests the number of HIV clinicians in the United States is diminishing. There are 294,834 primary care providers (PCP) in the United States, and, of these, 3101 provide care to HIV-positive patients. More PCPs to treat and manage HIV patients may be the solution to alleviate the HIV provider shortage. Read More

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http://dx.doi.org/10.1186/s12875-020-01198-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330969PMC

Treatment of urinary tract infections in Swiss primary care: quality and determinants of antibiotic prescribing.

BMC Fam Pract 2020 Jul 1;21(1):125. Epub 2020 Jul 1.

Institute of Primary Care, University and University Hospital of Zurich, Pestalozzistrasse 24, 8071, Zurich, Switzerland.

Background: Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim - sulfamethoxazol as empiric first line antimicrobial agents in uncomplicated infections. However, there is evidence that the use of fluoroquinolones, which are no longer recommended, is still inappropriate high. Read More

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http://dx.doi.org/10.1186/s12875-020-01201-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329427PMC

Interrelationships between symptom burden and health functioning and health care utilization among veterans with persistent physical symptoms.

BMC Fam Pract 2020 Jul 1;21(1):124. Epub 2020 Jul 1.

Interdisciplinary Affective Science Laboratory, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA.

Background: Between 10 and 50% of primary care patients present with persistent physical symptoms (PPS). Patients with PPS tend to utilize excessive or inappropriate health care services, while being stuck in a deleterious cycle of inactivity, deconditioning, and further worsening of symptoms and disability. Since military deployment (relative to non-deployment) is associated with greater likelihood of PPS, we examined the interrelationships of health care utilization, symptom burden and functioning among a sample of recently deployed Veterans with new onset persistent physical symptoms. Read More

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http://dx.doi.org/10.1186/s12875-020-01193-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329405PMC

The Strengths and Difficulties Questionnaire is a usable way to address mental health at well-child visits in general practice - a qualitative study of feasibility.

BMC Fam Pract 2020 Jul 1;21(1):126. Epub 2020 Jul 1.

Department of Public Health, The Research Unit for General Practice and Section of General Practice, Faculty of Health Sciences, University of Copenhagen, Denmark, Copenhagen, Denmark.

Background: Mental health problems is frequent among children and psychopathology in early childhood seems to predict mental disorders in adulthood. All Danish children are offered seven free well-child visits at their General Practitioner (GP) during their first 5 years of life. GPs have a unique position to address mental health problems at the well-child visits, but they lack a systematic approach when assessing children's mental health. Read More

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http://dx.doi.org/10.1186/s12875-020-01156-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329505PMC

Patient-reported and doctor-reported symptoms when faecal immunochemical tests are requested in primary care in the diagnosis of colorectal cancer and inflammatory bowel disease: a prospective study.

BMC Fam Pract 2020 Jul 1;21(1):129. Epub 2020 Jul 1.

Department of Public Health and Clinical Medicine, Unit of Research, Education and Development - Östersund, Östersund Hospital, Umeå University, Umeå, Sweden.

Background: Rectal bleeding and a change in bowel habits are considered to be alarm symptoms for colorectal cancer and they are also common symptoms for inflammatory bowel disease. However, most patients with these symptoms do not have any of these diseases. Faecal immunochemical tests (FITs) for haemoglobin are used as triage tests in Sweden and other countries but little is known about the symptoms patients have when FITs are requested. Read More

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http://dx.doi.org/10.1186/s12875-020-01194-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331274PMC

Mental health of postgraduate trainees in primary care: a cross-sectional study.

BMC Fam Pract 2020 Jun 27;21(1):123. Epub 2020 Jun 27.

Department of General Practice and Health Services Research, University Hospital Heidelberg, Marsilius Arkaden, INF 130.3, Turm West, 69120, Heidelberg, Germany.

Background: General Practitioners (GPs) are increasingly affected by stress-related complaints and burnout. Although many studies have addressed this issue, little is known about the stress burden and burnout rates of postgraduate trainees specialising in General Practice (GP). This cross-sectional study was performed to explore the prevalence and risk of depression, stress and burnout in a large cohort of GP trainees. Read More

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http://dx.doi.org/10.1186/s12875-020-01199-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321542PMC

Reliability and validity of the Greek translation of the patient assessment of chronic illness care + (PACIC-PLUS GR) survey.

BMC Fam Pract 2020 Jun 25;21(1):122. Epub 2020 Jun 25.

Department of Nursing, Cyprus University of Technology, 30 Archbishop Street, 3036, Limassol, Cyprus.

Background: This study aimed to investigate the Patient Assessment of Chronic Illness Care+ (PACIC+) which is a tool to assess care for Chronic Conditions combining PACIC items with an overall 5As score derived from the '5As' model (ask, advise, agree, assist, and arrange), and is congruent with the Chronic Care Model. In addition, the study at hand aimed to translate the PACIC+ tool into Greek and test its psychometric properties to the Greek patients.

Methods: Questionnaires were collected from 268 chronic patients. Read More

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http://dx.doi.org/10.1186/s12875-020-01192-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315532PMC
June 2020
1.735 Impact Factor

'Very brief advice' (VBA) on smoking in family practice: a qualitative evaluation of the tobacco user's perspective.

BMC Fam Pract 2020 Jun 24;21(1):121. Epub 2020 Jun 24.

Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, P.O. Box: 2208, 71003, Heraklion, Crete, Greece.

Background: Very Brief Advice on smoking (VBA) is an evidence-based intervention designed to increase quit attempts among patients who smoke. VBA has been widely disseminated in general practice settings in the United Kingdom, however its transferability to Southern European settings is not well established. This study sought to document the perspectives of Greek general practice patients in terms of the acceptability and satisfaction with receiving VBA from their general practitioner (GP) and its influence on patients' motivation to make a quit attempt. Read More

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http://dx.doi.org/10.1186/s12875-020-01195-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315478PMC

Organised and opportunistic prevention in primary health care: estimation of missed opportunities by population based health interview surveys in Hungary.

BMC Fam Pract 2020 Jun 24;21(1):120. Epub 2020 Jun 24.

Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai26, Debrecen, 4026, Hungary.

Background: Improvement of preventive services for adults can be achieved by opportunistic or organised methods in primary care. The unexploited opportunities of these approaches were estimated by our investigation.

Methods: Data from the Hungarian implementation of European Health Interview Surveys in 2009 (N = 4709) and 2014 (N = 5352) were analysed. Read More

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http://dx.doi.org/10.1186/s12875-020-01200-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315493PMC

Understanding determinants of patients' decisions to attend their family physician and to take antibiotics for upper respiratory tract infections: a qualitative descriptive study.

BMC Fam Pract 2020 Jun 24;21(1):119. Epub 2020 Jun 24.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.

Background: Although antibiotics have little or no benefit for most upper respiratory tract infections (URTIs), they continue to be prescribed frequently in primary care. Physicians perceive that patients' expectations influence their antibiotic prescribing practice; however, not all patients seek antibiotic treatment despite having similar symptoms. In this study, we explored patients' views about URTIs, and the ways patients manage them (including attendance in primary care and taking antibiotics). Read More

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http://dx.doi.org/10.1186/s12875-020-01196-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313109PMC

Minor surgery in general practice in Ireland- a report of workload and safety.

BMC Fam Pract 2020 Jun 23;21(1):115. Epub 2020 Jun 23.

Research Department, Irish College of General Practitioners, 4-5 Lincoln Place, Dublin 2, Ireland.

Background: The provision of minor surgical services is an established part of the task profile of general practitioners (GPs) in many countries in Europe and elsewhere. This study aimed to collect data on the clinical process and outcomes for specified minor surgical procedures undertaken in Irish general practice by GPs experienced in minor surgery in order to document the scope and safety of minor surgery being undertaken.

Methods: Over a six-month period, 24 GPs in 20 practices recorded data on a pre-determined list of procedures undertaken in adults (aged 18 and older); procedures for ingrown toenails were also recorded for those aged 12-18 years. Read More

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http://dx.doi.org/10.1186/s12875-020-01186-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310463PMC

Do Polish primary care physicians meet the expectations of their patients? An analysis of Polish QUALICOPC data.

BMC Fam Pract 2020 Jun 23;21(1):118. Epub 2020 Jun 23.

Department of Family Medicine, Jagiellonian University Medical College, 4 Bochenska Street, 31-061, Krakow, Poland.

Background: Meeting the expectations of patients is one of the most crucial criteria when assessing the quality of a healthcare system. This study aimed to compare the expectations and experiences of patients of primary care in Poland and to identify key patient characteristics affecting these outlooks.

Methods: The study was performed within the framework of the international Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. Read More

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http://dx.doi.org/10.1186/s12875-020-01190-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313208PMC

Sharing reports about domestic violence and abuse with general practitioners: a qualitative interview study.

BMC Fam Pract 2020 Jun 23;21(1):117. Epub 2020 Jun 23.

Bristol Medical School (Population Health Sciences), University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.

Background: Domestic violence and abuse (DVA) is common and damaging to health. UK national guidance advocates a multi-agency response to DVA, and domestic homicide reviews consistently recommend improved information-sharing between agencies. Identification of patients experiencing DVA in general practice may come from external information shared with the practice, such as police incident reports and multi-agency risk assessment conference (MARAC) reports. Read More

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http://dx.doi.org/10.1186/s12875-020-01171-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313185PMC
June 2020
1.735 Impact Factor

Barriers and facilitators of medicines reconciliation at transitions of care in Ireland - a qualitative study.

BMC Fam Pract 2020 Jun 23;21(1):116. Epub 2020 Jun 23.

HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland.

Background: Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process. Read More

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http://dx.doi.org/10.1186/s12875-020-01188-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313163PMC

Barriers to and facilitators of the implementation of multi-disciplinary care pathways in primary care: a systematic review.

BMC Fam Pract 2020 Jun 19;21(1):113. Epub 2020 Jun 19.

Centre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany.

Background: Care pathways (CPWs) are complex interventions that have the potential to reduce treatment errors and optimize patient outcomes by translating evidence into local practice. To design an optimal implementation strategy, potential barriers to and facilitators of implementation must be considered. The objective of this systematic review is to identify barriers to and facilitators of the implementation of CPWs in primary care (PC). Read More

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http://dx.doi.org/10.1186/s12875-020-01179-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305630PMC

Investigation and analysis of standardized training for residents of general practitioners of Gansu Province in China.

BMC Fam Pract 2020 Jun 19;21(1):112. Epub 2020 Jun 19.

Gansu Provincial Hospital, Lanzhou, Gansu, China.

Background: China's standardized training for residents of General Practitioners (GPs) is aimed at providing the postgraduate training for family doctors who will serve the primary health care institutions. The aim of this paper is to investigate the standardized training situation, satisfaction with standardized training, work situation, intention, satisfaction and attitude of GPs who have finished standardized training.

Methods: This study was undertaken in 6 training hospitals in Gansu province using a questionnaire with 45 questions. Read More

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http://dx.doi.org/10.1186/s12875-020-01185-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7304171PMC

The Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) protocol: a non-randomised controlled trial of personalised care and support planning for persons living with diabetes.

BMC Fam Pract 2020 Jun 19;21(1):114. Epub 2020 Jun 19.

Division of Endocrinology, University Medicine Cluster, National University Health System, Singapore, Singapore.

Background: Personalised care and support planning (CSP) has been shown to improve diabetes outcomes, patient experience and provider morale in the care of persons living with diabetes. However, this has not been confirmed in controlled studies. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) is a pragmatic controlled trial that evaluates the effectiveness of personalised CSP in persons living with diabetes in the public primary care setting in Singapore. Read More

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http://dx.doi.org/10.1186/s12875-020-01173-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305581PMC

Weight assessment and the provision of weight management advice in primary care: a cross-sectional survey of self-reported practice among general practitioners and practice nurses in the United Kingdom.

BMC Fam Pract 2020 Jun 19;21(1):111. Epub 2020 Jun 19.

Cancer Policy Research Centre, Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK.

Background: Although primary care settings provide a large-scale and high-reach opportunity for weight management and obesity prevention, the proportion of adults in the United Kingdom (UK) who report receiving weight management advice is limited. This study examines the self-reported frequency of assessing weight and providing weight management advice by General Practitioners (GPs) and Practice Nurses (PNs) working in primary care in the UK, and differences by practitioner characteristics.

Methods: Cross-sectional survey with GPs and PNs in the UK (n = 2020), conducted January-March 2017. Read More

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http://dx.doi.org/10.1186/s12875-020-01184-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7304118PMC

Regional and patient-related factors influencing the willingness to use general practitioners as coordinators of the treatment in northern Germany - results of a cross-sectional observational study.

BMC Fam Pract 2020 Jun 17;21(1):110. Epub 2020 Jun 17.

Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Martinistr, 52 20246, Hamburg, Germany.

Background: In most countries, the general practitioner (GP) is the first point of contact in the healthcare system and coordinator of healthcare. However, in Germany it is possible to consult an outpatient specialist even without referral. Coordination by a GP might thus reduce health expenditures and inequalities in the healthcare system. Read More

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http://dx.doi.org/10.1186/s12875-020-01180-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302141PMC

Response to "understanding the behavioural determinants of opioid prescribing among family physicians: a qualitative study".

BMC Fam Pract 2020 Jun 13;21(1):109. Epub 2020 Jun 13.

Department of Anesthesia, Michael G. DeGroote School of Medicine, McMaster University, HSC-2V9, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada.

The 2017 Canadian opioid Guideline made both strong recommendations, indicating that all or almost all fully informed patients would choose the recommended course of action, and weak recommendations, in which different choices are appropriate for individual patients based on their values and preferences. The Guideline's recommendation to taper legacy patients prescribed high-dose opioid therapy is weak, and mandatory tapering is expressly discouraged. Read More

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http://dx.doi.org/10.1186/s12875-020-01187-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293785PMC

Incorporating the patient-centered approach into clinical practice helps improve quality of care in cases of hypertension: a retrospective cohort study.

BMC Fam Pract 2020 Jun 12;21(1):108. Epub 2020 Jun 12.

Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand.

Background: Treating hypertensive patients by integrating the patient-centered approach would influence the practice and outcome of treatment. Our purpose was to determine whether the implementation of a patient-centered approach in health care delivery can improve adhering to guidelines and the quality-of-care.

Methods: A retrospective study was conducted using secondary data from the electronic medical records of the patients treated in the two primary care outpatient settings at the Family Medicine (FM) and Social Security (SS) clinics. Read More

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http://dx.doi.org/10.1186/s12875-020-01183-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293111PMC

Person-centred and efficient care delivery for high-need, high-cost patients: primary care professionals' experiences.

BMC Fam Pract 2020 Jun 11;21(1):106. Epub 2020 Jun 11.

Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Background: High-need, high-cost (HNHC) patients, who typically have complex and long-term care demands, contribute considerably to the high work pressure of primary care professionals (PCPs). To improve patient as well as provider experiences, it is crucial to take into account the PCPs' perspective in designing health care strategies for HNHC patients. Therefore, this study aimed to create insight into PCPs' experienced barriers and possible solutions with regards to person-centred, efficient care delivery to HNHC patients. Read More

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http://dx.doi.org/10.1186/s12875-020-01172-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291469PMC

Patients' preferences in selecting family physician in primary health centers: a qualitative-quantitative approach.

BMC Fam Pract 2020 Jun 11;21(1):107. Epub 2020 Jun 11.

Department of Family Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: The role of family physicians (FPs) in the metropolitan area is critical in identifying risk factors for disease prevention/control and health promotion in various age groups. Understanding patients' preferences and interests in choosing a FP can be an effective and fundamental step in the success of this program. In this study factors affecting the FP selection by Iranian patients referred to health centers in the most populous areas in the south of Tehran were assessed and ranked. Read More

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http://dx.doi.org/10.1186/s12875-020-01181-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291526PMC

Predicting GP visits: A multinomial logistic regression investigating GP visits amongst a cohort of UK patients living with Myalgic encephalomyelitis.

BMC Fam Pract 2020 Jun 10;21(1):105. Epub 2020 Jun 10.

Manchester Metropolitan University, Manchester, UK.

Background: Myalgic Encephalomyelitis (ME) is a chronic condition whose status within medicine is the subject of on-going debate. Some medical professionals regard it as a contentious illness. Others report a lack of confidence with diagnosis and management of the condition. Read More

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http://dx.doi.org/10.1186/s12875-020-01160-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285543PMC

Self-reported screening practices of family physicians participating in the colorectal cancer screening program of the canton of Vaud: a cross-sectional study.

BMC Fam Pract 2020 Jun 10;21(1):103. Epub 2020 Jun 10.

Center for Primary Care and Public Health (Unisanté), University of Lausanne, Rue de Bugnon 44, 1011, Lausanne, Switzerland.

Background: The organized colorectal cancer (CRC) screening program in the canton of Vaud, Switzerland offers citizens the choice of the faecal immunochemical test (FIT) or colonoscopy via a visit with a family physician (FP). Given the central role of FPs in the program, this study aimed to compare their self-reported preventive practices with the objectives of the program, namely to inform patients about CRC screening and present the choice of colonoscopy and FIT, and to identify factors associated with presenting a choice of tests.

Methods: Mixed-methods study using an online survey and semi-structured interviews. Read More

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http://dx.doi.org/10.1186/s12875-020-01176-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285614PMC

GP awareness, practice, knowledge and confidence: evaluation of the first nation-wide dementia-focused continuing medical education program in Australia.

BMC Fam Pract 2020 Jun 10;21(1):104. Epub 2020 Jun 10.

Dementia Centre for Research Collaboration, University of New South Wales (UNSW) Sydney, AGSM Building, Sydney, NSW, 2052, Australia.

Background: Dementia is under-diagnosed in primary care. Timely diagnosis and care management improve outcomes for patients and caregivers. This research evaluated the effectiveness of a nationwide Continuing Medical Education (CME) program to enhance dementia-related awareness, practice, knowledge and confidence of general practitioners (GPs) in Australia. Read More

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http://dx.doi.org/10.1186/s12875-020-01178-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285709PMC
June 2020
1.735 Impact Factor

Supporting anticoagulant treatment decision making to optimise stroke prevention in complex patients with atrial fibrillation: a cluster randomised trial.

BMC Fam Pract 2020 Jun 8;21(1):102. Epub 2020 Jun 8.

Department of Neurology, Institute for Clinical Neurosciences, Neuroscience Research, Royal Prince Alfred Hospital, Missenden Road, Sydney Local Health District, Camperdown (Sydney), New South Wales, 2050, Australia.

Background: Anticoagulation for preventing stroke in atrial fibrillation is under-utilised despite evidence supporting its use, resulting in avoidable death and disability. We aimed to evaluate an intervention to improve the uptake of anticoagulation.

Methods: We carried out a national, cluster randomised controlled trial in the Australian primary health care setting. Read More

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http://dx.doi.org/10.1186/s12875-020-01175-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281948PMC

Context matters: a qualitative study of the practicalities and dilemmas of delivering integrated chronic care within primary and secondary care settings in a rural Malawian district.

BMC Fam Pract 2020 Jun 8;21(1):101. Epub 2020 Jun 8.

Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rossellón 132, ES-08036, Barcelona, Spain.

Background: With the increasing double burden of communicable and non-communicable diseases (NCDs) in sub-Saharan Africa, health systems require new approaches to organise and deliver services for patients requiring long-term care. There is increasing recognition of the need to integrate health services, with evidence supporting integration of HIV and NCD services through the reorganisation of health system inputs, across system levels. This study investigates current practices of delivering and implementing integrated care for chronically-ill patients in rural Malawi, focusing on the primary level. Read More

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http://dx.doi.org/10.1186/s12875-020-01174-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282183PMC

Evidence for deprescription in primary care through an umbrella review.

BMC Fam Pract 2020 Jun 8;21(1):100. Epub 2020 Jun 8.

Andalusian School of Public Health (Spanish acronym EASP), Granada, Spain.

Background: There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effectiveness of deprescription interventions in primary care, and to describe the barriers and enablers of the process from the point of view of patients and healthcare professionals. Read More

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http://dx.doi.org/10.1186/s12875-020-01166-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278115PMC

Recent trends and variations in general practitioners' involvement in accident care in Switzerland: an analysis of claims data.

BMC Fam Pract 2020 Jun 5;21(1):99. Epub 2020 Jun 5.

Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland.

Background: As in other countries, there is concern and some fragmentary evidence that GPs' central role in the Swiss healthcare system as the primary provider of care might be changing or even be in decline. Our study gives a systematic account of GPs' involvement in accident care from 2008 to 2016 and identifies changes in GPs' involvement in this typical field of primary care: how frequently GPs were involved along the care pathway, to what extent they figured as initial care provider, and what their role in the care pathway was.

Methods: Using a claims dataset from the largest Swiss accident insurer with two million accident cases, we constructed individual care pathways, i. Read More

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http://dx.doi.org/10.1186/s12875-020-01170-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275559PMC

Patient's travel distance to specialised cancer diagnostics and the association with the general practitioner's diagnostic strategy and satisfaction with the access to diagnostic procedures: an observational study in Denmark.

BMC Fam Pract 2020 May 31;21(1):97. Epub 2020 May 31.

Research Unit for General Practice, Aarhus, Bartholins Allé 2, 8000, Aarhus C, Denmark.

Background: Research indicate that when general practitioners (GPs) refer their patients for specialist care, the patient often has long distance. This study had a twofold aim: in accordance to the GP's suspicion of cancer, we investigated the association between: 1) cancer patient's travel distance to the first specialised diagnostic facility and the GP's diagnostic strategy and 2) cancer patient's travel distance to the first specialised diagnostic facility and satisfaction with the waiting time and the availability of diagnostic investigations.

Method: This combined questionnaire- and registry-based study included incident cancer patients diagnosed in the last 6 months of 2016 where the GP had been involved in the diagnostic process of the patients prior to their diagnosis of cancer (n = 3455). Read More

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http://dx.doi.org/10.1186/s12875-020-01169-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262770PMC

Population segments as a tool for health care performance reporting: an exploratory study in the Canadian province of British Columbia.

BMC Fam Pract 2020 May 31;21(1):98. Epub 2020 May 31.

Centre for Health Services and Policy Research, The University of British Columbia (UBC), 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.

Background: Primary care serves all age groups and individuals with health states ranging from those with no chronic conditions to those who are medically complex, or frail and approaching the end of life. For information to be actionable and guide planning, there must be some population disaggregation based on differences in expected needs for care. Promising approaches to segmentation in primary care reflect both the breadth and severity of health states, the types and amounts of health care utilization that are expected, and the roles of the primary care provider. Read More

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http://dx.doi.org/10.1186/s12875-020-01141-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262753PMC

More that unites us than divides us? A qualitative study of integration of community health and social care services.

BMC Fam Pract 2020 May 29;21(1):96. Epub 2020 May 29.

Alliance Manchester Business School, University of Manchester and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Greater Manchester, Booth Street West, Manchester, M15 6PB, UK.

Background: The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. Read More

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http://dx.doi.org/10.1186/s12875-020-01168-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260839PMC

Preference of blood pressure measurement methods by primary care doctors in Hong Kong: a cross-sectional survey.

BMC Fam Pract 2020 May 26;21(1):95. Epub 2020 May 26.

Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.

Background: Hypertension is the most common chronic disease and is the leading cause of morbidity and mortality. Its screening, diagnosis, and management depend heavily on accurate blood pressure (BP) measurement. It is recommended that the diagnosis of hypertension should be confirmed or corroborated by out-of-office BP values, measured using ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM). Read More

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http://dx.doi.org/10.1186/s12875-020-01153-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251842PMC

Exploring patient-reported barriers to advance care planning in family practice.

BMC Fam Pract 2020 May 25;21(1):94. Epub 2020 May 25.

Department of Family Medicine, McMaster University, DBHSC 100 Main Street West, 5th floor, Hamilton, Ontario, L8P 1H6, Canada.

Background: Although patient-centred care has become increasingly important across all medical specialties, when it comes to end of life care, research has shown that treatments ordered are not often concordant with people's expressed preferences. Patient and family engagement in Advance Care Planning (ACP) in the primary care setting could improve the concordance between patients' wishes and the healthcare received when patients cannot speak for themselves. The aim of this study was to better understand the barriers faced by older patients regarding talking to their family members and family physicians about ACP. Read More

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http://dx.doi.org/10.1186/s12875-020-01167-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7249389PMC

Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.

BMC Fam Pract 2020 May 20;21(1):93. Epub 2020 May 20.

Department of Family Medicine and Population Health, Virginia Commonwealth University, One Capitol Square, Room 637, 830 East Main Street, Richmond, VA, 23219, USA.

Background: Unhealthy alcohol use is the third leading cause of preventable death in the United States. Evidence demonstrates that screening for unhealthy alcohol use and providing persons engaged in risky drinking with brief behavioral and counseling interventions improves health outcomes, collectively termed screening and brief interventions. Medication assisted therapy (MAT) is another effective method for treatment of moderate or severe alcohol use disorder. Read More

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http://dx.doi.org/10.1186/s12875-020-01147-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240919PMC