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    General practitioners can increase participation in cervical cancer screening - a model program in Hungary.
    BMC Fam Pract 2018 May 19;19(1):67. Epub 2018 May 19.
    Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Kassai út 26, Debrecen, H-4028, Hungary.
    Background: Cervical cancer is a preventable disease. Unfortunately, its mortality is high in Hungary: 9.2 deaths /100000 women/year in 2015. Read More

    Health care provider experiences in primary care memory clinics: a phenomenological study.
    BMC Fam Pract 2018 May 19;19(1):68. Epub 2018 May 19.
    School of Public and Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
    Background: There is a growing need for community-based services for persons with Alzheimer's disease and related dementias (ADRD). Memory clinic (MC) teams in primary care settings have been established to provide care to people with ADRD. To consider wider adoption of these MC teams, insight is needed into the experiences of practitioners working in these models. Read More

    Multimorbidity: can general practitioners identify the health conditions most important to their patients? Results from a national cross-sectional study in Switzerland.
    BMC Fam Pract 2018 May 17;19(1):66. Epub 2018 May 17.
    Institute of Family Medicine, University of Lausanne, 44 rue du Bugnon, 1011, Lausanne, Switzerland.
    Background: Faced with patients suffering from more than one chronic condition, or multimorbidity, general practitioners (GPs) must establish diagnostic and treatment priorities. Patients also set their own priorities to handle the everyday burdens associated with their multimorbidity and these may be different from the priorities established by their GP. A shared patient-GP agenda, driven by knowledge of each other's priorities, would seem central to managing patients with multimorbidity. Read More

    Cost-effectiveness of a multicomponent primary care program targeting frail elderly people.
    BMC Fam Pract 2018 May 16;19(1):62. Epub 2018 May 16.
    Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.
    Background: Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. Read More

    Use of diagnostic tests and the appropriateness of the treatment decision in patients with suspected urinary tract infection in primary care in Denmark - observational study.
    BMC Fam Pract 2018 May 16;19(1):65. Epub 2018 May 16.
    The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.
    Background: Inappropriate prescription of antibiotics is the leading driver of antimicrobial resistance (AMR). The majority of antibiotics are prescribed in primary care. Understanding how general practitioners (GPs) use diagnostic tests and the effect on treatment decision under daily practice conditions is important to reduce inappropriate prescription of antibiotics. Read More

    Development and validation of a Malawian version of the primary care assessment tool.
    BMC Fam Pract 2018 May 16;19(1):63. Epub 2018 May 16.
    Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
    Background: Malawi does not have validated tools for assessing primary care performance from patients' experience. The aim of this study was to develop a Malawian version of Primary Care Assessment Tool (PCAT-Mw) and to evaluate its reliability and validity in the assessment of the core primary care dimensions from adult patients' perspective in Malawi.

    Methods: A team of experts assessed the South African version of the primary care assessment tool (ZA-PCAT) for face and content validity. Read More

    A cross-sectional investigation of the health needs of asylum seekers in a refugee clinic in Germany.
    BMC Fam Pract 2018 May 16;19(1):64. Epub 2018 May 16.
    General Medicine Division, MK3, Technical University Dresden, Carus School of Medicine, Fetscherstrasse 74, 01307, Dresden, Germany.
    Background: Over one million asylum seekers were registered in Germany in 2016, most from Syria and Afghanistan. The Refugee Convention guarantees access to healthcare, however delivery mechanisms remain heterogeneous. There is an urgent need for more data describing the health conditions of asylum seekers to guide best practices for healthcare delivery. Read More

    Identifying frailty in primary care: a qualitative description of family physicians' gestalt impressions of their older adult patients.
    BMC Fam Pract 2018 May 14;19(1):61. Epub 2018 May 14.
    Women's College Hospital, 76 Grenville Street, Toronto, ON, Canada.
    Background: Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. Read More

    Burnout syndrome and its prevalence in primary care nursing: a systematic review and meta-analysis.
    BMC Fam Pract 2018 May 10;19(1):59. Epub 2018 May 10.
    Nursing Department, University of Granada, Granada, Spain.
    Background: burnout syndrome is a significant problem in nursing professionals. Although, the unit where nurses work may influence burnout development. Nurses that work in primary care units may be at higher risk of burnout. Read More

    Assessing treatment fidelity and contamination in a cluster randomised controlled trial of motivational interviewing and cognitive behavioural therapy skills in type 2 diabetes.
    BMC Fam Pract 2018 May 10;19(1):60. Epub 2018 May 10.
    Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
    Background: Competencies in psychological techniques delivered by primary care nurses to support diabetes self-management were compared between the intervention and control arms of a cluster randomised controlled trial as part of a process evaluation. The trial was pragmatic and designed to assess effectiveness. This article addresses the question of whether the care that was delivered in the intervention and control trial arms represented high fidelity treatment and attention control, respectively. Read More

    Knowledge, practices and expectations of preventive care: a qualitative study of patients attending government general outpatient clinics in Hong Kong.
    BMC Fam Pract 2018 May 9;19(1):58. Epub 2018 May 9.
    Department of Family Medicine and Primary Healthcare, Hong Kong West Cluster, Hospital Authority, North Wing, Room 601, 6/F, Tsan Yuk Hospital, 30 Hospital Road, Hong Kong, Hong Kong.
    Background: Evidence-based preventive care recommendations have been well established, but studies have persistently reported gaps between these recommendations and general practitioners' practices in providing preventive care. Many studies have explored factors that affect the delivery of preventive care from the perspectives of the practitioners, but relatively few have evaluated the patients' point of view. The purpose of this study was to explore patients' understanding of preventive care, the actions they were taking in terms of preventive health and their expectations from family doctors in providing preventive care. Read More

    Keys to success of a community of clinical practice in primary care: a qualitative evaluation of the ECOPIH project.
    BMC Fam Pract 2018 May 9;19(1):56. Epub 2018 May 9.
    Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona. Av. Tibidabo, 39-43, 08035, Barcelona, Spain.
    Background: The current reality of primary care (PC) makes it essential to have telemedicine systems available to facilitate communication between care levels. Communities of practice have great potential in terms of care and education, and that is why the Online Communication Tool between Primary and Hospital Care was created. This tool enables PC and non-GP specialist care (SC) professionals to raise clinical cases for consultation and to share information. Read More

    Shifting hospital care to primary care: An evaluation of cardiology care in a primary care setting in the Netherlands.
    BMC Fam Pract 2018 May 9;19(1):55. Epub 2018 May 9.
    Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
    Background: In an attempt to deal with the pressures on the healthcare system and to guarantee sustainability, changes are needed. This study is focused on a cardiology Primary Care Plus intervention in which cardiologists provide consultations with patients in a primary care setting in order to prevent unnecessary referrals to the hospital. This study explores which patients with non-acute and low-complexity cardiology-related health complaints should be excluded from Primary Care Plus and referred directly to specialist care in the hospital. Read More

    Exploring current and potential roles of Australian community pharmacists in gout management: a qualitative study.
    BMC Fam Pract 2018 May 9;19(1):54. Epub 2018 May 9.
    Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, NSW, Australia.
    Background: Gout is an increasingly prevalent form of inflammatory arthritis. Although effective treatments for gout exist, current management is suboptimal due to low medication adherence rates and treatments that are non-concordant with guidelines. Medications are the mainstay and most effective form of gout management. Read More

    Difficult medical encounters and job satisfaction - results of a cross sectional study with general practitioners in Germany.
    BMC Fam Pract 2018 May 9;19(1):57. Epub 2018 May 9.
    Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
    Background: In primary care 15% of patient encounters are perceived as challenging by general practitioners (GP). However it is unknown what impact these encounters have regarding job satisfaction. The aim of this study was to evaluate which encounters are perceived as challenging by German GPs and whether they were associated with job satisfaction. Read More

    Barriers and facilitators to HPV vaccination in primary care practices: a mixed methods study using the Consolidated Framework for Implementation Research.
    BMC Fam Pract 2018 May 7;19(1):53. Epub 2018 May 7.
    Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
    Background: In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2-3 dose HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting could inform effective implementation strategies. Read More

    Participation in medical activities beyond standard consultations by Swiss general practitioners: a cross-sectional study.
    BMC Fam Pract 2018 May 3;19(1):52. Epub 2018 May 3.
    Department of Ambulatory Care and Community Medicine, Lausanne University, Rue du Bugnon 44, 1011, Lausanne, Switzerland.
    Background: Few data exist to support the observation that general practitioners (GPs) occupy many important positions in our communities or to characterize which GPs devote more of their time to such activities. We sought to characterize community-based complementary medical activities performed by GPs in the canton Vaud, Switzerland.

    Methods: All GPs in a region were invited to participate in a cross-sectional study (n = 600) examining engagement in complementary activities beyond standard ambulatory consultations. Read More

    Skill mix change between general practitioners, nurse practitioners, physician assistants and nurses in primary healthcare for older people: a qualitative study.
    BMC Fam Pract 2018 May 2;19(1):51. Epub 2018 May 2.
    Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud university medical center, P.O. box 9101, 114 6500, HB, Nijmegen, The Netherlands.
    Background: More and more older adults desire to and are enabled to grow old in their own home, regardless of their physical and mental capabilities. This change, together with the growing number of older adults, increases the demand for general practitioners (GPs). However, care for older people lacks prestige among medical students and few medical students are interested in a career in care for older people. Read More

    How general practitioners understand and handle medically unexplained symptoms: a focus group study.
    BMC Fam Pract 2018 May 2;19(1):50. Epub 2018 May 2.
    LEFO, Institute for studies of the medical profession, Oslo, Norway.
    Background: Medically unexplained symptoms (MUS) are a common yet challenging encounter in primary care. The aim of this study was to explore how general practitioners (GPs) understand and handle MUS.

    Methods: Three focus group interviews were conducted with a total of 23 GPs. Read More

    Mobility concepts and access to health care in a rural district in Germany: a mixed methods approach.
    BMC Fam Pract 2018 May 2;19(1):47. Epub 2018 May 2.
    Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23552, Lübeck, Germany.
    Background: Western countries are facing the challenges of an imminent shortage of physicians, especially general practitioners. As a consequence longer travel times to doctors' practices may arise. This study aimed to investigate the mobility behavior of a rural population in terms of medical consultations. Read More

    Implementation of the SMART MOVE intervention in primary care: a qualitative study using normalisation process theory.
    BMC Fam Pract 2018 May 2;19(1):48. Epub 2018 May 2.
    Discipline of General Practice, National University of Ireland, Galway, Ireland.
    Background: Problematic translational gaps continue to exist between demonstrating the positive impact of healthcare interventions in research settings and their implementation into routine daily practice. The aim of this qualitative evaluation of the SMART MOVE trial was to conduct a theoretically informed analysis, using normalisation process theory, of the potential barriers and levers to the implementation of a mhealth intervention to promote physical activity in primary care.

    Methods: The study took place in the West of Ireland with recruitment in the community from the Clare Primary Care Network. Read More

    General practitioners' attitudes towards patients with poorly controlled type 2 diabetes: a qualitative study.
    BMC Fam Pract 2018 May 2;19(1):49. Epub 2018 May 2.
    Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Werdener Str. 4, 40227, Düsseldorf, Germany.
    Background: Patients with type 2 diabetes mellitus (T2DM) with poor glycaemic control can represent a challenge from the perspective of the general practitioner (GP). Apart from patient-sided factors, the understanding of GPs' attitudes may provide ideas for improved management in these patients. The aim of this study is to reveal attitudes of GPs towards T2DM patients with poor metabolic control. Read More

    Are low and high utilization related to the way GPs manage their practices? An observational study.
    BMC Fam Pract 2018 Apr 25;19(1):46. Epub 2018 Apr 25.
    NIVEL: Netherlands Institute for Health Service Research, PO Box 1568, 3500, BN, Utrecht, The Netherlands.
    Background: General practice care plays a key role in keeping healthcare effective and cost-efficient. However, variation in the utilization rates of practices may reveal variation in practice performance. Our research goal is to investigate whether the socio-demographic profile of the patients' area of residence and practice organization characteristics influence the low or high utilization of general practice care. Read More

    Analytical typology of multiprofessional primary care models.
    BMC Fam Pract 2018 Apr 5;19(1):44. Epub 2018 Apr 5.
    School of Nursing, Université du Québec à Rimouski, 300, allée des Ursulines, C. P. 3300, succ. A, Rimouski, Québec, G5L 3A1, Canada.
    Background: There is only limited evidence to support care redefinition and role optimization processes needed for scaling up of a stronger primary care capacity.

    Methods: Data collection was based on a keyword search in MEDLINE, EMBASE and CINAHL databases. Three thousand, two hundred and twenty-nine documents were identified, 1851 met our inclusion criteria, 71 were retained for full-text assessment and 52 included in the final selection. Read More

    Implementation of a multidisciplinary psychoeducational intervention for Parkinson's disease patients and carers in the community: study protocol.
    BMC Fam Pract 2018 Apr 5;19(1):45. Epub 2018 Apr 5.
    NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton Highfield Campus, University Road, Southampton, SO17 1BJ, UK.
    Background: Parkinson's disease progressively limits patients at different levels and as a result family members play a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment to Parkinson's disease and the quality of life in patients and family carers in a Primary Care setting. Read More

    Diagnostic behaviour of general practitioners when suspecting Lyme disease: a database study from 2010-2015.
    BMC Fam Pract 2018 Apr 3;19(1):43. Epub 2018 Apr 3.
    Department of General Practice & Elderly Care Medicine and Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081, BT, Amsterdam, The Netherlands.
    Background: Due to the raised public awareness of Lyme Borreliosis (LB), its increased incidence and the increased availability of serological tests, the demand for diagnostic testing on LB has increased. This may affect the diagnostic behaviour of general practitioners (GPs). Aim of our study was to describe GPs' diagnostic behaviour when suspecting LB. Read More

    Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia.
    BMC Fam Pract 2018 Apr 2;19(1):42. Epub 2018 Apr 2.
    School of Medicine, Griffith University, Gold Coast, QLD, Australia.
    Background: Encouraging early child development and the early identification of developmental difficulties is a priority. The Ministry of Health in the Australian State of New South Wales (NSW), has recommended a program of developmental surveillance using validated screening questionnaires, namely, the Parents' Evaluation of Development Status (PEDS) and Ages and Stages Questionnaire (ASQs), however, the use of these tools has remained sub-optimal. A longitudinal prospective birth cohort "Watch Me grow" study was carried out in the South Western Sydney (SW) region of NSW to ascertain the uptake as well as the strategies and the resources required to maximise engagement in the surveillance program. Read More

    Identification, description and appraisal of generic PROMs for primary care: a systematic review.
    BMC Fam Pract 2018 Mar 15;19(1):41. Epub 2018 Mar 15.
    Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
    Background: Patients attend primary care with many types of problems and to achieve a range of possible outcomes. There is currently a lack of patient-reported outcome measures (PROMs) designed to capture these diverse outcomes. The objective of this systematic review was to identify, describe and appraise generic PROMs suitable for measuring outcomes from primary care. Read More

    The relationship between health literacy and patient activation among frequent users of healthcare services: a cross-sectional study.
    BMC Fam Pract 2018 Mar 9;19(1):38. Epub 2018 Mar 9.
    Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada.
    Background: Frequent users of healthcare services are a vulnerable population that deserves attention due to high costs and negative outcomes such as lower quality of life and higher mortality. Healthcare systems should offer interventions tailored to their needs and to their level of health literacy, including strategies to promote activation. The relationship between health literacy and patient activation remains to be explored. Read More

    The role of the general practitioner in multidisciplinary teams: a qualitative study in elderly care.
    BMC Fam Pract 2018 Mar 10;19(1):40. Epub 2018 Mar 10.
    Department of Primary and Community Care, Radboud University Medical Center, route 119, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
    Background: In the western world, a growing number of the older people live at home. In the Netherlands, GPs are expected to play a pivotal role in the organization of integrated care for this patient group. However, little is known about how GPs can play this role best. Read More

    Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting.
    BMC Fam Pract 2018 Mar 9;19(1):39. Epub 2018 Mar 9.
    Discipline of Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia.
    Background: Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control. Read More

    Development and evaluation of a blended educational programme for general practitioners' trainers to stimulate proactive HIV testing.
    BMC Fam Pract 2018 Mar 7;19(1):36. Epub 2018 Mar 7.
    Department of General Practice, Academic Medical Center, Amsterdam, The Netherlands.
    Background: In the Netherlands, a substantial proportion of newly diagnosed HIV patients present late for care, therefore, we investigated the effectiveness of a blended educational programme for trainers of GPs designed to stimulate proactive HIV testing.

    Methods: GP trainers at the Academic Medical Center in Amsterdam were invited to participate in a two days training programme incorporating evidence-based practice guidelines and multiple teaching strategies, including interactive lectures, discussion groups, e-learning and quality improvement targets. The GP trainers completed questionnaires before and after the programme to evaluate the effect of the programme. Read More

    Perception of quality health care delivery under capitation payment: a cross-sectional survey of health insurance subscribers and providers in Ghana.
    BMC Fam Pract 2018 Mar 7;19(1):37. Epub 2018 Mar 7.
    Radboud Institute for Health Science, Department for Primary and Community Health, Radboud University Medical Centre, Nijmegen, Netherlands.
    Background: Ghana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care. This paper assesses National Health Insurance Scheme subscribers and care providers' perception of quality of care under the capitation payment method.

    Methods: This is a cross-sectional survey of subscribers and care providers perception of quality of care in three administrative regions of Ghana using a 5-point Likert scale for the assessment based on a set of quality of care measures. Read More

    Disentangling the effect of illness perceptions on health status in people with type 2 diabetes after an acute coronary event.
    BMC Fam Pract 2018 Mar 2;19(1):35. Epub 2018 Mar 2.
    Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
    Background: Chronically ill patients such as people with type 2 diabetes develop perceptions of their illness, which will influence their coping behaviour. Perceptions are formed once a health threat has been recognised. Many people with type 2 diabetes suffer from multimorbidity, for example the combination with cardiovascular disease. Read More

    How well do general practitioners know their elderly patients' social relations and feelings of loneliness?
    BMC Fam Pract 2018 Feb 26;19(1):34. Epub 2018 Feb 26.
    Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Background: Social relationships are important to people and affect their quality of life, morbidity and mortality. The aim of this study was to examine the correlation between elderly patients' descriptions of their social relations and feelings of loneliness, and their general practitioners' assessments of these.

    Methods: Cross-sectional study in 12 general practices in the Capital Region of Denmark. Read More

    Prevalence, aetiologies and prognosis of the symptom dizziness in primary care - a systematic review.
    BMC Fam Pract 2018 Feb 20;19(1):33. Epub 2018 Feb 20.
    Department of General Practice / Family Medicine, University of Marburg, Karl-von-Frisch-Str, 435043, Marburg, Germany.
    Background: Dizziness is a common reason for consulting a general practitioner and there is a broad range of possible underlying aetiologies. There are few evidence-based data about prevalence, aetiology and prognosis in primary care. We aimed to conduct a systematic review of symptom-evaluating studies on prevalence, aetiology or prognosis of dizziness in primary care. Read More

    The increasing importance of a continence nurse specialist to improve outcomes and save costs of urinary incontinence care: an analysis of future policy scenarios.
    BMC Fam Pract 2018 Feb 17;19(1):31. Epub 2018 Feb 17.
    Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
    Background: In an ageing population, it is inevitable to improve the management of care for community-dwelling elderly with incontinence. A previous study showed that implementation of the Optimum Continence Service Specification (OCSS) for urinary incontinence in community-dwelling elderly with four or more chronic diseases results in a reduction of urinary incontinence, an improved quality of life, and lower healthcare and lower societal costs. The aim of this study was to explore future consequences of the OCSS strategy of various healthcare policy scenarios in an ageing population. Read More

    Perceptions about screening for prostate cancer using genetic lifetime risk assessment: a qualitative study.
    BMC Fam Pract 2018 Feb 17;19(1):32. Epub 2018 Feb 17.
    Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark.
    Background: Most health authorities do not recommend screening for prostate cancer with PSA tests in asymptomatic patients who are not at increased risk. However, opportunistic screening for prostate cancer is still wanted by many patients and it is widely used in primary care clinics, with potential for overdiagnosis and overtreatment. Better tools for risk assessment have been called for, to better target such opportunistic screening. Read More

    The use of public performance reporting by general practitioners: a study of perceptions and referral behaviours.
    BMC Fam Pract 2018 Feb 12;19(1):29. Epub 2018 Feb 12.
    Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3010, Australia.
    Background: Public performance reporting (PPR) of hospital data aims to improve quality of care in hospitals and to inform consumer choice. In Australia, general practitioners (GPs) are gatekeepers to secondary care with patients requiring their referral for non-emergency access. Despite their intermediary role, GPs have been generally overlooked as potential users of PPR of hospital data, with the majority of the PPR research focussing on consumers, surgeons and hospitals. Read More

    Is problem alcohol use being detected and treated in Irish general practice?
    BMC Fam Pract 2018 Feb 12;19(1):30. Epub 2018 Feb 12.
    Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
    Background: The pattern of alcohol consumption in Ireland has serious societal and health consequences. General practice is well placed to screen for problem alcohol use and to carry out brief interventions. The aims of this study were to investigate the prevalence of documentation of problem alcohol use in patient records in Irish general practice, and to describe the documentation of its diagnosis and treatment. Read More

    Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial.
    BMC Fam Pract 2018 Feb 9;19(1):28. Epub 2018 Feb 9.
    Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Background: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Read More

    Coping better with health problems after a visit to the family physician: associations with patients and physicians characteristics.
    BMC Fam Pract 2018 Feb 7;19(1):27. Epub 2018 Feb 7.
    Institute of Family Medicine, Department of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, CH-1011, Lausanne, Switzerland.
    Background: Good patient experience is recognized as an important component of a strong primary care system. Among the dimensions related to experience in family medicine, the ability to cope better with health problems is considered to be a measure of the quality of a consultation with a family physician (FP). The objective is to identify factors related to patients, physicians and practice, associated with patients' ability to cope better with their health problems after a family medicine consultation. Read More

    Enhancing delivery of osteoarthritis care in the general practice consultation: evaluation of a behaviour change intervention.
    BMC Fam Pract 2018 Feb 6;19(1):26. Epub 2018 Feb 6.
    Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK.
    Background: Professionally-focussed behaviour change intervention (BCI) workshops were utilised in the Management of OsteoArthritis in Consultations (MOSAICS) trial investigating the feasibility of implementing the National Institute for Health and Care Excellence (NICE) Osteoarthritis (OA) Guideline in general practice. The workshops aimed to implement the general practitioner (GP) component of the trial intervention: an enhanced consultation for patients presenting with possible OA. This study presents an evaluation of the BCI workshops on GP competency in conducting these enhanced consultations. Read More

    What gives rise to clinician gut feeling, its influence on management decisions and its prognostic value for children with RTI in primary care: a prospective cohort study.
    BMC Fam Pract 2018 Feb 5;19(1):25. Epub 2018 Feb 5.
    Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
    Background: The objectives were to identify 1) the clinician and child characteristics associated with; 2) clinical management decisions following from, and; 3) the prognostic value of; a clinician's 'gut feeling something is wrong' for children presenting to primary care with acute cough and respiratory tract infection (RTI).

    Methods: Multicentre prospective cohort study where 518 primary care clinicians across 244 general practices in England assessed 8394 children aged ≥3 months and < 16 years for acute cough and RTI. The main outcome measures were: Self-reported clinician 'gut feeling'; clinician management decisions (antibiotic prescribing, referral for acute admission); and child's prognosis (reconsultation with evidence of illness deterioration, hospital admission in the 30 days following recruitment). Read More

    The perceived impact of family physicians on the district health system in South Africa: a cross-sectional survey.
    BMC Fam Pract 2018 Feb 5;19(1):24. Epub 2018 Feb 5.
    Biostatistics Unit, Centre for Evidence-based Health Care, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
    Background: Evidence from first world contexts support the notion that strong primary health care teams contain family physicians (FPs). African leaders are looking for evidence from their own context. The roles and scope of practice of FPs are also contextually defined. Read More

    Patients' experiences of living with medically unexplained symptoms (MUS): a qualitative study.
    BMC Fam Pract 2018 Feb 2;19(1):23. Epub 2018 Feb 2.
    Department of Psychology and Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, ul. Gagarina 39, 87-100, Toruń, Poland.
    Background: Patients with medically unexplained symptoms (MUS) are common in primary care, and pose a communicative and therapeutic challenge to GPs. Although much has been written about GPs' frustration and difficulties while dealing with these patients, research presenting the patients' perspectives on MUS still seems to be scarce. Existing studies have demonstrated the patients' desire to make sense of symptoms, addressed the necessity for appropriate and acceptable explanation of MUS, and revealed stigmatization of patients with symptoms of mental origin. Read More

    General practitioner contributions to achieving sustained healthcare for offenders: a qualitative study.
    BMC Fam Pract 2018 Feb 2;19(1):22. Epub 2018 Feb 2.
    Plymouth University, Drake Circus, Plymouth, Devon, PL4 8AA, UK.
    Background: Offenders frequently have substantial healthcare needs and, like many other socially marginalised groups, often receive healthcare in inverse proportion to their needs. Improved continuity of healthcare over time could contribute to addressing these needs. General Practitioners need to be able to support people with complex social and medical problems, even in systems that are not specifically designed to manage individuals with such degrees of complexity. Read More

    Al Kharj diabetic patients' perception about diabetes mellitus using revised-illness perception questionnaire (IPQ-R).
    BMC Fam Pract 2018 Feb 2;19(1):21. Epub 2018 Feb 2.
    College of Medicine, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia.
    Background: Illness perception questionnaires for various medical conditions have become more useful in recent years. However, very few have addressed this issue for Type 2 diabetes in Saudi Arabia.

    Methods: A self-administered questionnaire was distributed to Type 2 diabetic patients attendees of primary health care centers and Al Kharj Military Industries Corporation Hospital in Al Kharj, Saudi Arabia, from November 24th 2016 to April 24th, 2017. Read More

    Factors associated with the use of dietary supplements and over-the-counter medications in Japanese elderly patients.
    BMC Fam Pract 2018 Jan 24;19(1):20. Epub 2018 Jan 24.
    Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan.
    Background: The use of dietary supplements and over-the-counter (OTC) drugs is increasing, and there is adequate concern about potential harmful effects. However, there are limited reports on the concurrent use of nonprescription medications with prescription medications in elderly patients. Therefore, this study was conducted to describe the use of dietary supplements and OTC drugs, and to identify predictors for their use in elderly patients using medications prescribed for chronic diseases. Read More

    The Mini-International Neuropsychiatric Interview is useful and well accepted as part of the clinical assessment for depression and anxiety in primary care: a mixed-methods study.
    BMC Fam Pract 2018 Jan 24;19(1):19. Epub 2018 Jan 24.
    Department of Medicine, Clinical Epidemiology Unit T2, 14, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
    Background: Psychiatric complaints are common among primary care patients, with depression and anxiety being the most frequent. Diagnosis of anxiety and depression can be difficult, potentially leading to over- as well as under-diagnosis. The diagnostic process can be facilitated by incorporating structured interviews as part of the assessment. Read More

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