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    1653 results match your criteria BMC Family Practice[Journal]

    1 OF 34

    "I can't bend it and it hurts like mad": direct observation of gout consultations in routine primary health care.
    BMC Fam Pract 2017 Oct 18;18(1):91. Epub 2017 Oct 18.
    Department Primary Health Care & General Practice, University of Otago, 23a Mein Street, Wellington, New Zealand.
    Background: Gout is the most common form of inflammatory arthritis and is associated with considerable co-morbidity. It is usually managed in the primary care setting with a combination of lifestyle modification and pharmacological therapy. This study describes patterns of communication about gout observed in interactions between patients and primary care practitioners during routine consultations. Read More

    A qualitative study of employees' opinions on establishing a generic call-centre.
    BMC Fam Pract 2017 Oct 17;18(1):90. Epub 2017 Oct 17.
    Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
    Background: To investigate opinions among employees at an Out-of-Hours general practitioner (OOH-GP) service and a safety alarm service about the establishment of a generic call-centre.

    Methods: Qualitative study using individual and group interviews with 14 employees and managers involved in preparation of a merge into a new generic call-centre. They were asked about their opinions towards establishing a generic call-centre where all contact about unplanned health inquiries from the public had to be done by telephone and how to solve more requests on the phone. Read More

    External validation study of a clinical decision aid to reduce unnecessary antibiotic prescriptions in women with acute cystitis.
    BMC Fam Pract 2017 Oct 2;18(1):89. Epub 2017 Oct 2.
    Department of Microbiology, Mount Sinai Hospital and University Health Network, Toronto, Canada.
    Background: Empirical prescribing of antibiotics to women with symptoms of acute cystitis prior to culture results is common, but subsequent culture results are often negative. A clinical decision aid for prescribing decisions in acute cystitis was previously developed that could reduce these unnecessary antibiotic prescriptions but has not been validated. This study sought to validate this decision aid for empirical antibiotic prescribing decisions in a new cohort of women with suspected acute cystitis. Read More

    Family-centered depression treatment for older men in primary care: a qualitative study of stakeholder perspectives.
    BMC Fam Pract 2017 Sep 29;18(1):88. Epub 2017 Sep 29.
    Betty Irene School of Nursing, University of California Davis, 4610 X Street, Sacramento, CA, 95817, USA.
    Background: Family members often play important roles in the lives of depressed older men and frequently attend primary care visits with their loved ones, yet surprisingly little is known about how to most effectively engage and include family members in depression treatment. However, including family in depression treatment may be difficult due to several factors, such as depression stigma and family conflicts. The objective of this study was to describe challenges in engaging family members in older men's depression treatment and potential strategies to overcome those challenges. Read More

    Correlation between patients' reasons for encounters/health problems and population density in Japan: a systematic review of observational studies coded by the International Classification of Health Problems in Primary Care (ICHPPC) and the International Classification of Primary care (ICPC).
    BMC Fam Pract 2017 Sep 13;18(1):87. Epub 2017 Sep 13.
    Division of Clinical Epidemiology, Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan.
    Background: The Japanese health care system has yet to establish structured training for primary care physicians; therefore, physicians who received an internal medicine based training program continue to play a principal role in the primary care setting. To promote the development of a more efficient primary health care system, the assessment of its current status in regard to the spectrum of patients' reasons for encounters (RFEs) and health problems is an important step. Recognizing the proportions of patients' RFEs and health problems, which are not generally covered by an internist, can provide valuable information to promote the development of a primary care physician-centered system. Read More

    An after hours gp clinic in regional Australia: appropriateness of presentations and impact on local emergency department presentations.
    BMC Fam Pract 2017 Sep 11;18(1):86. Epub 2017 Sep 11.
    Bathurst Rural Clinical School, School of Medicine, Western Sydney University, Bathurst, NSW, Australia.
    Background: After hours general practice clinics provide medical attention for clients with non-emergency situations but are seeking immediate treatment and unable to wait for a general practitioner during routine opening hours. Evidence on the impact that after hours clinics have on emergency department presentations is equivocal. This study explored outcomes of the Bathurst After Hours General Practice Clinic (BAHGPC). Read More

    General practitioners' perspectives on a proposed new model of service delivery for primary care management of knee osteoarthritis: a qualitative study.
    BMC Fam Pract 2017 Sep 7;18(1):85. Epub 2017 Sep 7.
    Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia.
    Background: Effective management of people with knee osteoarthritis (OA) requires development of new models of care, and successful implementation relies on engagement of general practitioners (GPs). This study used a qualitative methodology to identify potential factors influencing GPs' engagement with a proposed new model of service delivery to provide evidence-based care for patients with knee OA and achieve better patient outcomes.

    Methods: Semi-structured telephone interviews with 11 GPs were conducted. Read More

    Telephone counselling by nurses in Norwegian primary care out-of-hours services: a cross-sectional study.
    BMC Fam Pract 2017 Sep 6;18(1):84. Epub 2017 Sep 6.
    National Centre for Emergency Primary Health Care, Uni Research Health, Box 7810, NO 5020, Bergen, Norway.
    Background: The primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly staffed by registered nurses. When assessment by a medical doctor is not required, the nurse often handles the contact solely by nurse telephone counselling. Read More

    The diagnostic pathway of Parkinson's disease: a cross-sectional survey study of factors influencing patient dissatisfaction.
    BMC Fam Pract 2017 Aug 25;18(1):83. Epub 2017 Aug 25.
    Department of Primary and Community Care, Radboud university medical center, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
    Background: The diagnostic pathway of Parkinson's disease (PD) is often complicated. Experiences during this pathway can affect patients' satisfaction and their confidence and trust in healthcare providers. Although healthcare providers cannot influence the impact of the diagnosis, they can influence how patients experience the pathway. Read More

    Reasons for missed appointments linked to a public-sector intervention targeting patients with stable chronic conditions in South Africa: results from in-depth interviews and a retrospective review of medical records.
    BMC Fam Pract 2017 Aug 24;18(1):82. Epub 2017 Aug 24.
    School of Pharmacy, University of the Western Cape, Bellville, South Africa.
    Background: Missed appointments serve as a key indicator for adherence to therapy and as such, identifying patient reasons for this inconsistency could assist in developing programmes to improve health outcomes. In this article, we explore the reasons for missed appointments linked to a centralised dispensing system in South Africa. This system dispenses pre-packed, patient-specific medication parcels for clinically stable patients to health facilities. Read More

    Strengthening general practice/family medicine in Europe-advice from professionals from 30 European countries.
    BMC Fam Pract 2017 Aug 22;18(1):80. Epub 2017 Aug 22.
    Department of General Practice, Institute of Health and Society, University of Oslo, P.O. Box 1132 018, Blindern, Norway.
    Background: Substantial variations are still to be found in the strength of general practice/family medicine (GP/FM) across Europe regarding governance, workforce competence and performance, as well as academic development and position. Governments are encouraged by the WHO to secure high quality primary health care to their population, a necessity for reaching the goal "Health for all". The present study aimed at investigating the opinions of council members of the European Academy of Teachers in General Practice (EURACT) on necessary actions to strengthen the position of GP/FM in their country. Read More

    Primary care physician referral patterns in Ontario, Canada: a descriptive analysis of self-reported referral data.
    BMC Fam Pract 2017 Aug 22;18(1):81. Epub 2017 Aug 22.
    Department of Medicine, University of Ottawa, 75 Laurier Ave E, Ottawa, ON, Canada.
    Background: In many countries, the referral-consultation process faces a number of challenges from inefficiencies and rising demand, resulting in excessive wait times for many specialties. We collected referral data from a sample of family doctors across the province of Ontario, Canada as part of a larger program of research. The purpose of this study is to describe referral patterns from primary care to specialist and allied health services from the primary care perspective. Read More

    Managing diagnostic uncertainty in primary care: a systematic critical review.
    BMC Fam Pract 2017 Aug 7;18(1):79. Epub 2017 Aug 7.
    Medical School, Department Social Medicine, Aristotle University, Thessaloniki, Greece.
    Background: Diagnostic uncertainty is one of the largest contributory factors to the occurrence of diagnostic errors across most specialties in medicine and arguably uncertainty is greatest in primary care due to the undifferentiated symptoms primary care physicians are often presented with. Physicians can respond to diagnostic uncertainty in various ways through the interplay of a series of cognitive, emotional and ethical reactions. The consequences of such uncertainty however can impact negatively upon the primary care practitioner, their patients and the wider healthcare system. Read More

    Prevalence of anal symptoms in general practice: a prospective study.
    BMC Fam Pract 2017 Aug 3;18(1):78. Epub 2017 Aug 3.
    Sorbonne Paris Cité, General practice department, University Paris Diderot, F-75018 Paris, France ; REMES, F-75018, Paris, France.
    Background: Anal disorders are largely underestimated in general practice. Studies have shown patients conceal anal symptoms leading to late diagnosis and treatment. Management by general practitioners is poorly described. Read More

    Developing a community-based psycho-social intervention with older people and third sector workers for anxiety and depression: a qualitative study.
    BMC Fam Pract 2017 Jul 12;18(1):77. Epub 2017 Jul 12.
    Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, ST5 5BG, UK.
    Background: One-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). Read More

    Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners' attitudes.
    BMC Fam Pract 2017 Jul 11;18(1):76. Epub 2017 Jul 11.
    CHU de Rennes, Service de gériatrie, Rennes, France.
    Background: Blood transfusion in chronic anemia is not covered by guidelines specific to older adults. When they consider that this treatment is necessary in elderly patients, French general practitioners (GPs) contact a hospital specialist to plan a transfusion.

    Methods: Twenty French GPs were questioned individually regarding their approach to blood transfusion using semi-structured interviews. Read More

    Equitable resourcing of primary health care in remote communities in Australia's Northern Territory: a pilot study.
    BMC Fam Pract 2017 Jun 29;18(1):75. Epub 2017 Jun 29.
    Psychology Department, Macquarie University, Sydney, Australia.
    Background: Improved Primary Health Care (PHC) utilisation is central to reducing the unacceptable morbidity and mortality rates characterising populations living in remote communities. Despite poorer health, significant inequity characterises the funding of PHC services in Australia's most remote areas. This pilot study sought to ascertain what funding is required to ensure equitable access to sustainable, high quality primary health care irrespective of geographical remoteness of communities. Read More

    Effectiveness of a motivational intervention on overweight/obese patients in the primary healthcare: a cluster randomized trial.
    BMC Fam Pract 2017 Jun 20;18(1):74. Epub 2017 Jun 20.
    Cardiovascular Research Center, CSIC-ICCC, Hospital de la Santa Creu i Sant Pau (UAB), IIB-Sant Pau, Barcelona, Spain.
    Background: Overweight and obesity are common health problems which increase the risk of developing several serious health conditions. The main difficulty in the management of weight-loss lies in its maintenance, once it is achieved. The aim of this study was to investigate whether a motivational intervention, together with current clinical practice, was more efficient than a traditional intervention, in the treatment of overweight and obesity and whether this intervention reduces cardiovascular risk factors associated with overweight and obesity. Read More

    Moderate mental illness as a predictor of chronic disease prevention and screening.
    BMC Fam Pract 2017 Jun 17;18(1):73. Epub 2017 Jun 17.
    Ginetta Salvalaggio, University of Alberta, Edmonton, Canada.
    Background: Primary care plays a pivotal role in the provision of both mental health care and chronic disease prevention and screening (CDPS). Unfortunately, moderate mental illness (MMI) is associated with poorer general health outcomes. Part of this burden of illness may be due to reduced CDPS uptake. Read More

    'Doing the right thing': factors influencing GP prescribing of antidepressants and prescribed doses.
    BMC Fam Pract 2017 Jun 17;18(1):72. Epub 2017 Jun 17.
    Nursing Midwifery and Allied Health Professionals Research Unit, University of Stirling, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK.
    Background: Antidepressant prescribing continues to increase, with 5-16% of adults receiving antidepressants annually. Total prescribing growth is due in part to increased long-term use, greater selective serotonin re-uptake inhibitor (SSRI) use and the use of higher SSRI doses. Evidence does not support routine use of higher SSRI doses for depression treatment, and factors influencing the use of such doses are not well known. Read More

    Factors associated with general practitioners' awareness of depression in primary care patients with heart failure: baseline-results from the observational RECODE-HF study.
    BMC Fam Pract 2017 Jun 9;18(1):71. Epub 2017 Jun 9.
    Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
    Background: Depression is more prevalent in patients with heart failure (HF) than in those without, but its detection is complicated by the symptom overlap between the two diseases. General practitioners (GPs) are the first point of contact for patients with HF. Therefore, this study aims to investigate GPs' awareness of depression in their HF patients and factors associated with this awareness. Read More

    Current and future perspectives on the management of polypharmacy.
    BMC Fam Pract 2017 Jun 6;18(1):70. Epub 2017 Jun 6.
    Department of Primary Care and Public Health, Imperial College London, W6 8RP, London, UK.
    Background: Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correct drug treatment in patients with complex medical problems can improve clinical outcomes, quality of life and life expectancy, polypharmacy is also associated with an increased risk of adverse drug events, some severe enough to result in hospital admission and even death. Hence, having systems in place to ensure that medications are started only when there is a suitable indication, ensuring patients are fully aware of the benefits and complications that may arise from their treatment, and reviewing patients regularly to ensure their medication regime remains appropriate, are essential. Read More

    Learning to use electronic health records: can we stay patient-centered? A pre-post intervention study with family medicine residents.
    BMC Fam Pract 2017 May 26;18(1):69. Epub 2017 May 26.
    Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, rue Gabrielle Perret-Gentil, CH-1211, Geneva, Switzerland.
    Background: The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the "patient-centered" use of the EHR have been published. However, the impact of training to improve EHR use during clinical encounters is not well known. Read More

    How do population, general practice and hospital factors influence ambulatory care sensitive admissions: a cross sectional study.
    BMC Fam Pract 2017 May 25;18(1):67. Epub 2017 May 25.
    School of Social and Community Medicine, University of Bristol, BS8 2PS, Bristol, UK.
    Background: Reducing unplanned hospital admissions is a key priority within the UK and other healthcare systems, however it remains uncertain how this can be achieved. This paper explores the relationship between unplanned ambulatory care sensitive condition (ACSC) admission rates and population, general practice and hospital characteristics. Additionally, we investigated if these factors had a differential impact across 28 conditions. Read More

    Regional variations of perceived problems in ambulatory care from the perspective of general practitioners and their patients - an exploratory focus group study in urban and rural regions of northern Germany.
    BMC Fam Pract 2017 May 25;18(1):68. Epub 2017 May 25.
    Department of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Background: Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i. Read More

    "We're certainly not in our comfort zone": a qualitative study of GPs' dementia-care educational needs.
    BMC Fam Pract 2017 May 22;18(1):66. Epub 2017 May 22.
    Department of General Practice, Western Gateway Building, University College Cork, Cork, Ireland.
    Background: Rising dementia prevalence rates rise combined with the policy objective of enabling people with dementia to remain living at home, means that there will be a growing demand for dementia care in the community setting. However, GPs are challenged by dementia care and have identified it as an area in which further training is needed. Previous studies of GPs dementia care educational needs have explored the views of GPs alone, without taking the perspectives of people with dementia and family carers into account. Read More

    Practices of Lyme disease diagnosis and treatment by general practitioners in Quebec, 2008-2015.
    BMC Fam Pract 2017 May 22;18(1):65. Epub 2017 May 22.
    Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, 20045, chemin Sainte-Marie, Sainte-Anne-de-Bellevue, H9X 3R5, Canada.
    Background: Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. Read More

    The linguistic validation of the gut feelings questionnaire in three European languages.
    BMC Fam Pract 2017 Apr 20;18(1):54. Epub 2017 Apr 20.
    Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
    Background: Physicians' clinical decision-making may be influenced by non-analytical thinking, especially when perceiving uncertainty. Incidental gut feelings in general practice have been described, namely, as "a sense of alarm" and "a sense of reassurance". A Dutch Gut Feelings Questionnaire (GFQ) was developed, validated and afterwards translated into English following a linguistic validation procedure. Read More

    Patient and care characteristics of self-referrals treated by the general practitioner cooperative at emergency-care-access-points in the Netherlands.
    BMC Fam Pract 2017 May 12;18(1):62. Epub 2017 May 12.
    Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Geert Grooteplein 21, 6525 EZ, Nijmegen, The Netherlands.
    Background: In the Netherlands, out-of-hours primary care is provided in general practitioner-cooperatives (GPCs). These are increasingly located on site and in collaboration with emergency departments of hospitals (ED). At such sites, also called emergency-care-access-points (ECAP), the GPC is generally responsible for the triage and treatment of self-referrals who used to attend the ED. Read More

    Occupational burnout and empathy influence blood pressure control in primary care physicians.
    BMC Fam Pract 2017 May 12;18(1):63. Epub 2017 May 12.
    Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
    Background: Good physician-patient communication can favor the adoption of healthy lifestyle habits, which is essential in high blood pressure (BP) management. More empathic physicians tend to have lower burnout and better communication skills. We analyzed the association between burnout and empathy among primary care physicians and nurses and investigated the influence on BP control performance. Read More

    Health care resource use by patients before and after a diagnosis of chronic fatigue syndrome (CFS/ME): a clinical practice research datalink study.
    BMC Fam Pract 2017 May 5;18(1):60. Epub 2017 May 5.
    Psychological Medicine, Wolfson Institute of Preventive Medicine, Barts, London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
    Background: Our aim was to investigate patterns of health care resource use by patients before and after a diagnosis of CFS/ME, as recorded by Clinical Practice Research Datalink (CPRD) GP practices in the UK.

    Methods: We used a case-control study design in which patients who had a first recorded diagnosis of CFS/ME during the period 01/01/2001 to 31/12/2013 were matched 1:1 with controls by age, sex, and GP practice. We compared rates of GP consultations, diagnostic tests, prescriptions, referrals, and symptoms between the two groups from 15 years (in adults) or 10 years (in children) before diagnosis to 10 years after diagnosis. Read More

    The effects of family structure and function on mental health during China's transition: a cross-sectional analysis.
    BMC Fam Pract 2017 May 5;18(1):59. Epub 2017 May 5.
    Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
    Background: Social change, intensified by industrialization and globalization, has not only changed people's work lives but also their personal lives, especially in developing countries. The aim of this study was to provide evidence and recommendations regarding family structure, function, and mental health to actively respond to rapid social change.

    Methods: A cross-sectional survey was conducted face-to-face and door-to-door from July 2011 to September 2012 in Hubei Province, central China. Read More

    Effectiveness of an individual, online e-learning program about sexually transmitted infections: a prospective cohort study.
    BMC Fam Pract 2017 Apr 24;18(1):57. Epub 2017 Apr 24.
    Department of General Practice, Academic Medical Centre-University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
    Background: Primary health-care professionals play an important role in the treatment and prevention of Sexually Transmitted Infections (STI). Continuing Medical Education (CME)-courses can influence the knowledge and behavior of health-care professionals concerning STI. We performed a prospective cohort study to evaluate if the individual and online e-learning program "The STI-consultation", which uses the Commitment-to-Change (CtC)-method, is able to improve the knowledge, attitude and behavior of Dutch General Practitioners (GPs), concerning the STI-consultation. Read More

    Recognition of depression by primary care clinicians in rural Ethiopia.
    BMC Fam Pract 2017 Apr 21;18(1):56. Epub 2017 Apr 21.
    Department of Psychiatry, Addis Ababa University, College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia.
    Background: Depression is a common health condition affecting up to a third of patients attending primary care, where most of the care for people with depression is provided. Adequate recognition of depression is the critical step in the path to effective care, particularly in low income countries. As part of the Programme for Improving Mental healthcare (PRIME), a project supporting the implementation of integrated mental healthcare in primary care, we evaluated the level of recognition of depression by clinicians working in primary care in rural Ethiopia prior to in service training. Read More

    'Working is out of the question': a qualitative text analysis of medical certificates of disability.
    BMC Fam Pract 2017 Apr 20;18(1):55. Epub 2017 Apr 20.
    Departement of Community Medicine and Global Health, University of Oslo, Faculty of Medicine; Institute of Health and Society, Postboks 1130, Blindern, 0318, OSLO, Norway.
    Background: Medical certificates influence the distribution of economic benefits in welfare states; however, the qualitative aspects of these texts remain largely unexplored. The present study is the first systematic investigation done of these texts. Our aim was to investigate how GPs select and mediate information about their patients' health and how they support their conclusions about illness, functioning and fitness for work in medical certificates. Read More

    Effect of audit and feedback with peer review on general practitioners' prescribing and test ordering performance: a cluster-randomized controlled trial.
    BMC Fam Pract 2017 Apr 13;18(1):53. Epub 2017 Apr 13.
    School for Public Health and Primary Care (CAPHRI), Department of Family Medicine, Maastricht University, PO Box 616, , 6200 MD, Maastricht, The Netherlands.
    Background: Much research worldwide is focussed on cost containment and better adherence to guidelines in healthcare. The research focussing on professional behaviour is often performed in a well-controlled research setting. In this study a large-scale implementation of a peer review strategy was tested on both test ordering and prescribing behaviour in primary care in the normal quality improvement setting. Read More

    Provider and patient perspectives on opioids and alternative treatments for managing chronic pain: a qualitative study.
    BMC Fam Pract 2017 Mar 24;17(1):164. Epub 2017 Mar 24.
    Oregon Health & Science University, 3181S.W. Sam Jackson Park Rd, Portland, OR, 97239, USA.
    Background: Current literature describes the limits and pitfalls of using opioid pharmacotherapy for chronic pain and the importance of identifying alternatives. The objective of this study was to identify the practical issues patients and providers face when accessing alternatives to opioids, and how multiple parties view these issues.

    Methods: Qualitative data were gathered to evaluate the outcomes of acupuncture and chiropractic (A/C) services for chronic musculoskeletal pain (CMP) using structured interview guides among patients with CMP (n = 90) and primary care providers (PCPs) (n = 25) purposively sampled from a managed care health care system as well as from contracted community A/C providers (n = 14). Read More

    Multimorbidity, clinical decision making and health care delivery in New Zealand Primary care: a qualitative study.
    BMC Fam Pract 2017 Apr 5;18(1):51. Epub 2017 Apr 5.
    Otago Business School, University of Otago, Dunedin, New Zealand.
    Background: Multimorbidity is a major issue for primary care. We aimed to explore primary care professionals' accounts of managing multimorbidity and its impact on clinical decision making and regional health care delivery.

    Methods: Qualitative interviews with 12 General Practitioners and 4 Primary Care Nurses in New Zealand's Otago region. Read More

    Internists' career choice towards primary care: a cross-sectional survey.
    BMC Fam Pract 2017 Apr 5;18(1):52. Epub 2017 Apr 5.
    Institute of Primary Care, University Hospital of Zurich, University of Zurich, Pestalozzistrasse 24, 8091, Zurich, Switzerland.
    Background: Swiss primary care (PC) is facing workforce shortage. Up to 2011 this workforce was supplied by two board certifications: general medicine and internal medicine. To strengthen them against subspecialties, they were unified into one: general internal medicine. Read More

    Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study.
    BMC Fam Pract 2017 Apr 4;18(1):50. Epub 2017 Apr 4.
    VA Ann Arbor Healthcare System, 2800 Plymouth Road, Building 14, Room G100-36, Ann Arbor, MI, 48109-2800, USA.
    Background: Early diagnosis and treatment of prediabetes and type 2 diabetes mellitus (T2DM) can prevent future health problems, yet many individuals with these conditions are undiagnosed. This could be due, in part, to primary care physicians' (PCP) screening practices, about which little is known. The objectives of this study were to identify factors that influence PCPs' decisions to screen patients for T2DM and to characterize their interpretation and communication of screening test results to patients. Read More

    From good health to illness with post-infectious fatigue syndrome: a qualitative study of adults' experiences of the illness trajectory.
    BMC Fam Pract 2017 Mar 27;18(1):49. Epub 2017 Mar 27.
    Department of Nursing Science, Institute of Health and Society, University of Oslo, P.O.B. 1130 Blindern, 0318, Oslo, Norway.
    Background: Municipal drinking water contaminated with the parasite Giardia lamblia in Bergen, Norway, in 2004 caused an outbreak of gastrointestinal infection in 2500 people, according to the Norwegian Prescription Database. In the aftermath a minor group subsequently developed post-infectious fatigue syndrome (PIFS). Persons in this minor group had laboratory-confirmed parasites in their stool samples, and their enteritis had been cured by one or more courses of antibiotic treatment. Read More

    Association of general psychological factors with frequent attendance in primary care: a population-based cross-sectional observational study.
    BMC Fam Pract 2017 Mar 24;18(1):48. Epub 2017 Mar 24.
    Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Background: Whereas several studies have examined the association between frequent attendance in primary care and illness-specific psychological factors, little is known about the relation between frequent attendance and general psychological factors. Thus, the aim of this study was to investigate the association between being a frequent attender in primary care and general psychological factors.

    Methods: Data were used from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany in 2014 (n = 7,446). Read More

    Promoting independence, health and well-being for older people: a feasibility study of computer-aided health and social risk appraisal system in primary care.
    BMC Fam Pract 2017 Mar 24;18(1):47. Epub 2017 Mar 24.
    Department Primary Care & Population Health, University College London (UCL), Royal Free Campus, Rowland Hill St, London, NW3 2PF, UK.
    Background: With population ageing, research is needed into new low-cost, scalable methods of effective promotion of health and wellbeing for older people. We aimed to assess feasibility, reach and costs of implementing a new tailored computer-aided health and social risk appraisal system in primary care.

    Methods: Design: Feasibility study. Read More

    Exercising alcohol patients don't lack motivation but struggle with structures, emotions and social context - a qualitative dropout study.
    BMC Fam Pract 2017 Mar 23;18(1):45. Epub 2017 Mar 23.
    Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
    Background: Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Read More

    A systematic review of primary care models for non-communicable disease interventions in Sub-Saharan Africa.
    BMC Fam Pract 2017 Mar 23;18(1):46. Epub 2017 Mar 23.
    Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
    Background: Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed.

    Methods: A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA. Read More

    Impact of a continuing medical education meeting on the use and timing of urgent cancer referrals among general practitioners - a before-after study.
    BMC Fam Pract 2017 Mar 21;18(1):44. Epub 2017 Mar 21.
    Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus, DK-8000, Denmark.
    Background: Detection of cancer in general practice is challenging because symptoms are diverse. Even so-called alarm symptoms have low positive predictive values of cancer. Nevertheless, appropriate referral is crucial. Read More

    Exploring why a complex intervention piloted in general practices did not result in an increase in chlamydia screening and diagnosis: a qualitative evaluation using the fidelity of implementation model.
    BMC Fam Pract 2017 Mar 21;18(1):43. Epub 2017 Mar 21.
    Primary Care Unit, National Infection Service, Public Health England, Microbiology Dept, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN, UK.
    Background: Chlamydia trachomatis (chlamydia) is the most commonly diagnosed sexually transmitted infection (STI) in England; approximately 70% of diagnoses are in sexually active young adults aged under 25. To facilitate opportunistic chlamydia screening in general practice, a complex intervention, based on a previously successful Chlamydia Intervention Randomised Trial (CIRT), was piloted in England. The modified intervention (3Cs and HIV) aimed to encourage general practice staff to routinely offer chlamydia testing to all 15-24 year olds regardless of the type of consultation. Read More

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