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    1695 results match your criteria BMC Family Practice[Journal]

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    Assessing predictors of intention to prescribe sick leave among primary care physicians using the theory of planned behaviour.
    BMC Fam Pract 2018 Jan 16;19(1):18. Epub 2018 Jan 16.
    Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50586, Kuala Lumpur, Malaysia.
    Background: Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians. Read More

    Identifying enablers and barriers to individually tailored prescribing: a survey of healthcare professionals in the UK.
    BMC Fam Pract 2018 Jan 15;19(1):17. Epub 2018 Jan 15.
    Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Anson Building, Central Avenue, Chatham Maritime, Chatham Kent, ME4 4TB, Canada.
    Background: Many people now take multiple medications on a long-term basis to manage health conditions. Optimising the benefit of such polypharmacy requires tailoring of medicines use to the needs and circumstances of individuals. However, professionals report barriers to achieving this in practice. Read More

    Effects of primary care clinician beliefs and perceived organizational facilitators on the delivery of preventive care to individuals with mental illnesses.
    BMC Fam Pract 2018 Jan 12;19(1):16. Epub 2018 Jan 12.
    Kaiser Permanente Northwest Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA.
    Background: Although many studies have documented patient-, clinician-, and organizational barriers/facilitators of primary care among people with mental illnesses, few have examined whether these factors predict actual rates of preventive service use. We assessed whether clinician behaviors, beliefs, characteristics, and clinician-reported organizational characteristics, predicted delivery of preventive services in this population.

    Methods: Primary care clinicians (n = 247) at Kaiser Permanente Northwest (KPNW) or community health centers and safety-net clinics (CHCs), in six states, completed clinician surveys in 2014. Read More

    Interprofessional collaboration in nursing homes (interprof): development and piloting of measures to improve interprofessional collaboration and communication: a qualitative multicentre study.
    BMC Fam Pract 2018 Jan 11;19(1):14. Epub 2018 Jan 11.
    Department of General Practice, University Medical Center Göttingen, Humboldtallee 38, 37073, Göttingen, Germany.
    Background: Given both the increase of nursing home residents forecast and challenges of current interprofessional interactions, we developed and tested measures to improve collaboration and communication between nurses and general practitioners (GPs) in this setting. Our multicentre study has been funded by the German Federal Ministry of Education and Research (FK 01GY1124).

    Methods: The measures were developed iteratively in a continuous process, which is the focus of this article. Read More

    Factors associated with low patient satisfaction in out-of-hours primary care in Denmark - a population-based cross-sectional study.
    BMC Fam Pract 2018 Jan 11;19(1):15. Epub 2018 Jan 11.
    Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.
    Background: Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telephone triage. This study aimed to identify patient-related, GP-related and organizational factors associated with low patient satisfaction. Read More

    Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement.
    BMC Fam Pract 2018 Jan 10;19(1):13. Epub 2018 Jan 10.
    Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, Department of Medicine, Johns Hopkins University School of Medicine, 2024 E. Monument St, 2-600, Baltimore, MD, 21205, USA.
    Background: The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. Read More

    Parental reassurance concerning a feverish child: determinant factors in rural general practice.
    BMC Fam Pract 2018 Jan 9;19(1). Epub 2018 Jan 9.
    Univ Rennes, CHU Rennes, Inserm, CIC 1414 [(Centre d'Investigation Clinique de Rennes)], F-35000, Rennes, France.
    Background: Acute fever is the most common pediatric condition encountered in general practice and a source of parental concern that can result in inappropriate behavior. The main objective of this study was to describe and quantify parental reassurance concerning their feverish child in the context of visits to rural general practitioners (GPs).

    Method: The study included the parents of 202 feverish children, aged from 3 months to 6 years, consulting 13 representative rural GPs. Read More

    Influence of mental health and alcohol or other drug use risk on adolescent reported care received in primary care settings.
    BMC Fam Pract 2018 Jan 9;19(1):10. Epub 2018 Jan 9.
    RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA.
    Background: To describe patterns of alcohol and other drug (AOD) use risk and adolescent reported primary care (PC) screening and intervention, and examine associations of AOD risk and mental health with reported care received.

    Methods: We analyzed data from cross-sectional surveys collected from April 3, 2013 to November 24, 2015 from 1279 diverse adolescents ages 12-18 who reported visiting a doctor at least once in the past year. Key measures were AOD risk using the Personal Experience Screening Questionnaire; mental health using the 5-item Mental Health Inventory; binary measures of adolescent-reported screening and intervention. Read More

    Substitution of care for chronic heart failure from the hospital to the general practice: patients' perspectives.
    BMC Fam Pract 2018 Jan 9;19(1). Epub 2018 Jan 9.
    NIVEL, Otterstraat 118-124, 3518 CR, Utrecht, Netherlands.
    Background: Shifting care from the secondary to the primary system may present an opportunity to ensure that the increasing number of patients with chronic heart failure (CHF) receive high-quality care while containing costs. However, shifting from secondary to primary care might seem radical to patients. A qualitative insight into patients' issues, preferences, expectations and needs may help arrange a smooth transition from secondary to primary care for CHF patients. Read More

    Access to primary and specialized somatic health care for persons with severe mental illness: a qualitative study of perceived barriers and facilitators in Swedish health care.
    BMC Fam Pract 2018 Jan 9;19(1):12. Epub 2018 Jan 9.
    Department of Research, Södra Älvsborgs Hospital, Brämhultsvägen 52, 501 82, Borås, Sweden.
    Background: Persons with severe mental illness (e.g. schizophrenia, bipolar disorder) have a high prevalence of somatic conditions compared to the general population. Read More

    A conceptual model of treatment burden and patient capacity in stroke.
    BMC Fam Pract 2018 Jan 9;19(1). Epub 2018 Jan 9.
    Institute of Health and Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, Scotland.
    Background: Treatment burden is the workload of healthcare experienced by those with long-term conditions and the impact that this has on well-being. Treatment burden can negatively impact on quality of life and adherence to treatments. Individuals are likely to differ in their ability to manage health problems and follow treatments, defined as patient capacity. Read More

    A systematic review of chronic disease management interventions in primary care.
    BMC Fam Pract 2018 Jan 9;19(1):11. Epub 2018 Jan 9.
    UNSW, Sydney, Australia.
    Background: Primary and community care are key settings for the effective management of long term conditions. We aimed to evaluate the pattern of health outcomes in chronic disease management interventions for adults with physical health problems implemented in primary or community care settings.

    Methods: The methods were based on our previous review published in 2006. Read More

    Support needs of patients with obesity in primary care: a practice-list survey.
    BMC Fam Pract 2018 Jan 8;19(1). Epub 2018 Jan 8.
    Institute of Health & Society, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
    Background: UK guidelines recommend that patients with obesity in primary care receive opportunistic weight loss advice from health care professionals, but there is a lack of research into the characteristics and existing weight management practices of these patients. The aim of this study was to characterise primary care patients with obesity in England, to inform the screening, support, and referral options appropriate to this group.

    Methods: We surveyed 1309 patients registered at 15 GP practices in North East England, aged ≥18 years and with objectively recorded obesity (BMI ≥ 30 kg/m2). Read More

    Key attributes of patient centered medical homes associated with patient activation of diabetes patients.
    BMC Fam Pract 2018 Jan 5;19(1). Epub 2018 Jan 5.
    Department of Health Services Research, Management & Policy, College of Public Health and Health Professions, University of Florida, PO Box 100195, Gainesville, FL, 32610, USA.
    Background: Approximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. Read More

    Optional part-time and longer GP training modules in GP practices associated with more trainees becoming GPs - a cohort study in Switzerland.
    BMC Fam Pract 2018 Jan 5;19(1). Epub 2018 Jan 5.
    Institute of Primary Health Care Bern (BIHAM), University of Bern, Gesellschaftsstrasse 49, 3012, Bern, Switzerland.
    Background: Switzerland, like many other countries, has a shortage of General Practitioners (GPs). Optional GP training modules in GP practices were offered during the at least 5-year GP training program to increase student and trainee interest in becoming a GP. The training modules had not yet been evaluated. Read More

    Patient-perceived barriers and facilitators to the implementation of a medication review in primary care: a qualitative thematic analysis.
    BMC Fam Pract 2018 Jan 5;19(1). Epub 2018 Jan 5.
    Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
    Background: Although polypharmacy can cause adverse health outcomes, patients often know little about their medication. A regularly conducted medication review (MR) can help provide an overview of a patient's medication, and benefit patients by enhancing their knowledge of their drugs. As little is known about patient attitudes towards MRs in primary care, the objective of this study was to gain insight into patient-perceived barriers and facilitators to the implementation of an MR. Read More

    A qualitative study on older primary care patients' perspectives on depression and its treatments - potential barriers to and opportunities for managing depression.
    BMC Fam Pract 2018 Jan 3;19(1). Epub 2018 Jan 3.
    Institute of General Practice/Primary Care, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
    Background: Depression is one of the most common mental disorders in old age and is associated with various negative health consequences for the affected individual. Studies suggest that patients' views on depression have an impact on help-seeking behaviour and treatment. It is thus important to investigate the patient's perspective in order to ascertain optimum management of depression in late life. Read More

    Impact of an integrated care program on glycemic control and cardiovascular risk factors in patients with type 2 diabetes in Saudi Arabia: an interventional parallel-group controlled study.
    BMC Fam Pract 2018 Jan 2;19(1). Epub 2018 Jan 2.
    Family and Community Medicine Department, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia.
    Background: Long intervals between patient visits and limited time with patients can result in clinical inertia and suboptimal achievement of treatment goals. These obstacles can be improved with a multidisciplinary care program. The present study aimed to assess the impact of such a program on glycemic control and cardiovascular risk factors. Read More

    Primary care multidisciplinary teams in practice: a qualitative study.
    BMC Fam Pract 2017 Dec 29;18(1):115. Epub 2017 Dec 29.
    Department of Community and Family Medicine, Duke University School of Medicine, Durham, NC, USA.
    Background: Current recommendations for strengthening the US healthcare system consider restructuring primary care into multidisciplinary teams as vital to improving quality and efficiency. Yet, approaches to the selection of team designs remain unclear. This project describes current primary care team designs, primary care professionals' perceptions of ideal team designs, and perceived facilitating factors and barriers to implementing ideal team-based care. Read More

    Changes of the perceived quality of care for older patients with hypertension by community health centers in shanghai.
    BMC Fam Pract 2017 Dec 29;18(1):114. Epub 2017 Dec 29.
    The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
    Background: Monitoring and evaluating changes of quality of primary care for older adult hypertensive patients is part of effective delivery of primary care. This study aimed to investigate changes of older adult hypertensive patients' perceived quality of primary care over time in Shanghai.

    Methods: Two rounds of cross-sectional questionnaire surveys were conducted in Shanghai in November 2011 and June 2013. Read More

    Clinical drug trials in general practice: how well are external validity issues reported?
    BMC Fam Pract 2017 Dec 29;18(1):113. Epub 2017 Dec 29.
    Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Postbox 1130 Blindern, N-0318, Oslo, Norway.
    Background: When reading a report of a clinical trial, it should be possible to judge whether the results are relevant for your patients. Issues affecting the external validity or generalizability of a trial should therefore be reported. Our aim was to determine whether articles with published results from a complete cohort of drug trials conducted entirely or partly in general practice reported sufficient information about the trials to consider the external validity. Read More

    Preschool children in out-of-hours primary care - a questionnaire-based cross-sectional study of factors related to the medical relevance of health problems.
    BMC Fam Pract 2017 Dec 28;18(1):112. Epub 2017 Dec 28.
    Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Alle 2, 8000, Aarhus, Denmark.
    Background: Out-of-hours primary care (OOH-PC) is intended to provide medical care services for health problems that cannot wait until normal office hours. Children under five years of age represent about 19% of all OOH-PC contacts in Denmark, and the frequency of calls assessed as severe by health professionals is markedly lower for children than for other age groups. Several studies have questioned the appropriateness of the parents' use of OOH-PC. Read More

    Who is on the primary care team? Professionals' perceptions of the conceptualization of teams and the underlying factors: a mixed-methods study.
    BMC Fam Pract 2017 Dec 28;18(1):111. Epub 2017 Dec 28.
    Erasmus School of Health Policy and Management (ESHPM), Erasmus University Rotterdam, PO Box 1738, Rotterdam, 3000, DR, The Netherlands.
    Background: Due to the growing prevalence of elderly patients with multi-morbidity living at home, there is an increasing need for primary care professionals from different disciplinary backgrounds to collaborate as primary care teams. However, it is unclear how primary care professionals conceptualize teams and what underlying factors influence their perception of being part of a team. Our research question is: What are primary care professionals' perceptions of teams and team membership among primary care disciplines and what factors influence their perceptions?

    Methods: We conducted a mixed-methods study in the Dutch primary care setting. Read More

    An overview of systematic reviews on the collaboration between physicians and nurses and the impact on patient outcomes: what can we learn in primary care?
    BMC Fam Pract 2017 12 22;18(1):110. Epub 2017 Dec 22.
    University of Antwerp, Campus Drie Eiken DR334, Universiteitsplein 1, 2610, Wilrijk, Belgium.
    Background: Primary care needs to be strengthened in order to address the many societal challenges. Group practices in primary care foster collaboration with other health care providers, which encourages care co-ordination and leads to a higher quality of primary care. Nursing roles and responsibilities expanded over time and nurses have been found to often provide equal high-quality chronic patient care compared to physicians, even with higher patient satisfaction. Read More

    How general practitioners perceive and assess self-care in patients with multiple chronic conditions: a qualitative study.
    BMC Fam Pract 2017 12 22;18(1):109. Epub 2017 Dec 22.
    The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. box 2099, DK-1014, Copenhagen K, Denmark.
    Background: It is not known how general practitioners (GPs) perceive the concept of self-care and how they assess self-care ability in patients with multiple chronic conditions. As a part of the strategy to improve the care of people living with chronic conditions, disease management programs in Denmark require GPs and other health care workers to assess and support patients' self-care ability. The aim of the present study was to explore GPs' perceptions and assessment of self-care ability in patients with multiple chronic conditions who have difficulty following a given treatment. Read More

    Missed opportunities for improving practice performance in adult immunizations: a meta-narrative review of the literature.
    BMC Fam Pract 2017 12 22;18(1):108. Epub 2017 Dec 22.
    American Academy of Family Physicians National Research Network, 11400 Tomahawk Creek Pkwy, Leawood, KS, 66211, USA.
    Background: We sought to characterize how the term "missed opportunities" is reported in the literature in the context of immunization rates and to assess how missed opportunities can be operationalized.

    Methods: Peer-reviewed literature searches were conducted in April - May, 2015, to answer: "What methods research studies used to operationalize missed opportunities to vaccinate?" A meta-narrative review methodology was used.

    Results: Seven studies met inclusion criteria. Read More

    The effectiveness of a primary care nursing-led dietary intervention for prediabetes: a mixed methods pilot study.
    BMC Fam Pract 2017 12 21;18(1):106. Epub 2017 Dec 21.
    School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, Australia.
    Background: Primary care nurse-led prediabetes interventions are seldom reported. We examined the implementation and feasibility of a 6-month multilevel primary care nurse-led prediabetes lifestyle intervention compared with current practice in patients with prediabetes, with weight and glycated haemoglobin (HbA1c) as outcomes.

    Methods: This study used a convergent mixed methods design involving a 6-month pragmatic non-randomised pilot study with a qualitative process evaluation, and was conducted in two neighbouring provincial cities in New Zealand, with indigenous Māori populations comprising 18. Read More

    Assessing and improving organizational readiness to implement substance use disorder treatment in primary care: findings from the SUMMIT study.
    BMC Fam Pract 2017 12 21;18(1):107. Epub 2017 Dec 21.
    RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
    Background: Millions of people with substance use disorders (SUDs) need, but do not receive, treatment. Delivering SUD treatment in primary care settings could increase access to treatment because most people visit their primary care doctors at least once a year, but evidence-based SUD treatments are underutilized in primary care settings. We used an organizational readiness intervention comprised of a cluster of implementation strategies to prepare a federally qualified health center to deliver SUD screening and evidence-based treatments (extended-release injectable naltrexone (XR-NTX) for alcohol use disorders, buprenorphine/naloxone (BUP/NX) for opioid use disorders and a brief motivational interviewing/cognitive behavioral -based psychotherapy for both disorders). Read More

    Partner notification and partner treatment for chlamydia: attitude and practice of general practitioners in the Netherlands; a landscape analysis.
    BMC Fam Pract 2017 Dec 20;18(1):103. Epub 2017 Dec 20.
    Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, RIVM, Bilthoven, The Netherlands.
    Background: Chlamydia prevalence remains high despite scaling-up control efforts. Transmission is not effectively interrupted without partner notification (PN) and (timely) partner treatment (PT). In the Netherlands, the follow-up of partners is not standardized and may depend on GPs' time and priorities. Read More

    Which strategies might improve local primary healthcare in Germany? An explorative study from a local government point of view.
    BMC Fam Pract 2017 Dec 20;18(1):105. Epub 2017 Dec 20.
    Medical School Hannover, Institute for Epidemiology, Social Medicine and Health Systems Research, OE 5410, Carl-Neuberg-Str. 1, D-30625, Hannover, Germany.
    Background: Facing rising inequities and poorer accessibility of physicians in rural areas, new healthcare delivery structures are being considered to support local healthcare in German communities. To better understand perspectives on and attitudes towards different supplementary models, we examined attitudes among local politicians in the German federal state of Lower Saxony towards the suitability of supplementary care models.

    Methods: As part of a cross-sectional study, we surveyed local politicians in Lower Saxony at the local authority and district levels (n = 449) by mail questionnaire. Read More

    Frequent attenders in late life in primary care: a systematic review of European studies.
    BMC Fam Pract 2017 Dec 20;18(1):104. Epub 2017 Dec 20.
    Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
    Background: High utilization of health care services is a costly phenomenon commonly observed in primary care practices. However, while frequent attendance in primary care has been broadly studied across age groups, aspects of high utilization by elderly patients have not been investigated in detail. The aim of this paper is to provide a systematic review of frequent attendance in primary care among elderly people. Read More

    At the dawn of delegation? Experiences and attitudes of general practitioners in Germany - a questionnaire survey.
    BMC Fam Pract 2017 Dec 19;18(1):102. Epub 2017 Dec 19.
    Institute of Family Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
    Background: In the future, 'delegation' as task shifting from general practitioners (GPs) to non-physicians will be important in primary care. Therefore, the aim of this study was to evaluate the attitudes towards the concept of task shifting and to identify predictors of a positive attitude towards task shifting from the perspective of GPs.

    Methods: This cross-sectional questionnaire study analysed attitudes towards the concept of task shifting and delegated tasks from the perspective of GPs who were recruited in the German federal state of Schleswig-Holstein. Read More

    How to choose the most appropriate cognitive test to evaluate cognitive complaints in primary care.
    BMC Fam Pract 2017 Dec 16;18(1):101. Epub 2017 Dec 16.
    Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
    Background: Despite the wealth of research devoted to the performance of individual cognitive tests for diagnosing cognitive impairment (including mild cognitive impairment and dementia), it can be difficult for general practitioners to choose the most appropriate test for a patient with cognitive complaints in daily practice. In this paper we present a diagnostic algorithm for the evaluation of cognitive complaints in primary care. The rationale behind this algorithm is that the likelihood of cognitive impairment -which can be determined after history taking and an informant interview- should determine which cognitive test is most suitable. Read More

    General practitioners' awareness of depressive symptomatology is not associated with quality of life in heart failure patients - cross-sectional results of the observational RECODE-HF Study.
    BMC Fam Pract 2017 Dec 8;18(1):100. Epub 2017 Dec 8.
    Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
    Background: Depression is a common comorbidity in patients with chronic heart failure (HF) and linked to a wider range of symptoms which, in turn, are linked to a decreased health-related quality of life (HRQOL). Treatment of depression might improve HRQOL but detecting depression is difficult due to the symptom overlap between HF and depression. Therefore, clinical guidelines recommend to routinely screen for depression in HF patients. Read More

    Medical overuse and quaternary prevention in primary care - A qualitative study with general practitioners.
    BMC Fam Pract 2017 Dec 8;18(1):99. Epub 2017 Dec 8.
    Institute of General Practice, Friedrich-Alexander-University Erlangen-Nuernberg (FAU), Universitaetsstr. 29, 91054, Erlangen, Germany.
    Background: Medical overuse is a topic of growing interest in health care systems and especially in primary care. It comprises both over investigation and overtreatment. Quaternary prevention strategies aim at protecting patients from unnecessary or harmful medicine. Read More

    Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease - a prospective cohort study; The HUNT Study, Norway.
    BMC Fam Pract 2017 Dec 7;18(1):98. Epub 2017 Dec 7.
    Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway.
    Background: Suggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in persons with diagnosed NCD has been shown for decades. Read More

    'Sussing that doctor out.' Experiences and perspectives of people affected by hepatitis C regarding engagement with private general practitioners in South Australia: a qualitative study.
    BMC Fam Pract 2017 Nov 29;18(1):97. Epub 2017 Nov 29.
    School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
    Background: Australians with chronic hepatitis C (HCV) can access affordable Direct Acting Antiviral (DAA) treatments with high cure rates (>90%), via General Practitioners (GPs). Benefits from this treatment will be maximised if people with HCV readily disclose and engage with private GPs regarding HCV-related issues. Investigating the perceptions and experiences of people affected by HCV with GPs can allow for this pathway to care for HCV to be improved. Read More

    Experiences and needs of carers of Aboriginal children with a disability: a qualitative study.
    BMC Fam Pract 2017 Nov 29;18(1):96. Epub 2017 Nov 29.
    Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia.
    Background: Australian parents/carers of a person with a disability experience higher rates of depression, more financial stress, and are twice as likely to be in poor physical health than the general population. Aboriginal and Torres Strait Islander peoples experience worse health, social and economic outcomes than other Australians, and those with a disability face 'double disadvantage'. This study aimed to better understand the experiences and needs of parents/carers/families of Aboriginal children with a disability. Read More

    Piloting electronic screening forms in primary care: findings from a mixed methods study to identify patients eligible for low dose CT lung cancer screening.
    BMC Fam Pract 2017 Nov 28;18(1):95. Epub 2017 Nov 28.
    Sunnybrook Research Institute, Toronto, ON, Canada.
    Background: Recent evidence suggests that screening with low dose computed tomography (LDCT) scans significantly reduces mortality from lung cancer. However, optimal methods to identify potentially eligible patients in primary care are not known. Using brief electronic screening forms administered prior to a primary care visit is a strategy to identify high risk, asymptomatic patients eligible for LDCT screening. Read More

    A qualitative evidence synthesis to explore healthcare professionals' experience of prescribing opioids to adults with chronic non-malignant pain.
    BMC Fam Pract 2017 Nov 25;18(1):94. Epub 2017 Nov 25.
    Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Windmill Road, Oxford, 0X3 7LD, UK.
    Background: Despite recent guidelines suggesting that patients with chronic non-malignant pain might not benefit, there has been a significant rise in opioid prescription for chronic non-malignant pain. This topic is important because an increasing number of HCPs are prescribing opioids despite very limited evidence for long-term opioid therapy for chronic non-malignant pain outside of end-of-life care. To better understand the challenges of providing effective treatment, we conducted the first qualitative evidence synthesis to explore healthcare professionals' experience of treating people with chronic non-malignant pain. Read More

    Experiences of adult patients using primary care services in Poland - a cross-sectional study in QUALICOPC study framework.
    BMC Fam Pract 2017 Nov 22;18(1):93. Epub 2017 Nov 22.
    Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, 4 Bochenska St., 31-061, Krakow, Poland.
    Background: Patients as real healthcare system users are important observers of primary care and are able to provide reliable information about the quality of care. The aim of this study was to explore the patients' experiences and their level of satisfaction with the process and outcomes of care provided by primary care physicians in Poland and to identify the characteristics of the patients, their physicians, and facilities associated with patient satisfaction.

    Methods: The study is based on data from the Polish part of the Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. Read More

    Migrants' motives and expectations for contacting out-of-hours primary care: a survey study.
    BMC Fam Pract 2017 Nov 21;18(1):92. Epub 2017 Nov 21.
    Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
    Background: Migrants are more likely to use out-of-hours primary care, especially for nonurgent problems. Their motives and expectations for help-seeking are as yet unknown. The objective of this study is to examine the motives and expectations of migrants for contacting out-of-hours primary care. Read More

    "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

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