Family Practice

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BACKGROUND: Adolescence and early adulthood are periods of experimentation during which health detrimental behaviours might be acquired. OBJECTIVE: This study's purpose is to evaluate physicians' likelihood of addressing health risk behaviours with youths depending on the youths' wishes, risk behaviours and personal characteristics. METHODS: Data were drawn from the third wave (2017-18) of the GenerationFRee longitudinal study carried out on a sample of 1970 youths aged 17-26 in Switzerland...

BACKGROUND: Use of health services is increasing in many countries. Most health service research exploring determinants of use has focused on adults and on secondary care. Less is known about factors associated with the use of the emergency department (ED) and general practice (GP) among young children. OBJECTIVE: To explore factors associated with GP consultations and ED attendances among children under 5 in a single UK city. METHODS: Cross-sectional exploratory study using anonymized individual-level health service use data for children aged 0-4 from 21 GPs in Southampton, UK, linked to ED data, over a 1-year period...

BACKGROUND: Mounting evidence suggests that loneliness increases the risk of poor health outcomes, including cardiovascular disease and premature mortality.Objective: This study examined the prevalence of loneliness in an urban, underserved family medicine residency clinic and the association of loneliness with health care utilization. METHODS: Adult patients (N = 330; M age = 42.1 years, SD = 14.9; 63% female; 58% African American) completed the 3-item UCLA Loneliness screener at their primary care visits between November 2018 and January 2019...

BACKGROUND: Various models exist to organize out-of-hours primary care (OOH-PC). We aimed to provide an up-to-date overview of prevailing organizational models in the European Union (EU), implemented changes over the last decade and future plans. This baseline overview may provide information for countries considering remodelling their OOH-PC system. METHODS: A cross-sectional web-based questionnaire among 93 key informants from EU countries, Norway and Switzerland...

BACKGROUND: Physicians often prescribe high numbers of medications for managing multiple cardiometabolic diseases. It is questionable whether polypharmacy (concurrent use of five or more medications) is beneficial or detrimental for older adults with cardiometabolic multimorbidity (co-occurrence of two or more diseases). OBJECTIVE: To examine combined effects of multimorbidity and polypharmacy on hospitalization and frailty and to determine whether effect sizes of polypharmacy vary with numbers of cardiometabolic diseases...

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BACKGROUND: Improving individuals' experience of care is now a critical goal of health care systems. Although a number of instruments have been developed to measure experience of care, few instruments measure family caregivers' experience of interprofessional care for patients and families. OBJECTIVE: To develop the Japanese version of the Caregivers' Experience Instrument (J-IEXPAC CAREGIVERS) and to investigate its validity in assessing quality of integrated care for both patients with chronic conditions and their family caregivers, from the caregivers' perspective, in Japan...

BACKGROUND: In China, the government has encouraged the participation of private sector facilities in primary care to improve health care quality. OBJECTIVE: We compare health care utilization patterns among patients who select private versus public community health centres (CHCs) for reimbursed outpatient services. METHODS: This paper uses data from the Urban Employee Basic Medical Insurance scheme from 2013 to 2016 in one of the largest cities in China...

BACKGROUND: Financial strain is a key social determinant of health. As primary care organizations begin to explore ways to address social determinants, peer-to-peer interventions hold promise. OBJECTIVE: Our objective was to evaluate a peer-to-peer intervention focussed on financial empowerment delivered in primary care, in partnership with a social enterprise. METHODS: This intervention was hosted by a large primary care organization in Toronto, Canada...

BACKGROUND: Minimal data are available on the clinical activity of general practitioners (GPs) in Africa. OBJECTIVE: To describe the health problems managed by GPs in Mali as compared with France where epidemiological transition is already advanced. METHODS: A retrospective, multicenter study, conducted in five Malian Community Health Centers. We compared their consultation data to those of the ECOGEN (Eléments de la COnsultation en médecine GENérale) study conducted in 128 French general practices, after data standardization for age and sex...

BACKGROUND: Diet and lifestyle intervention programs have been shown to be effective in decreasing obesity/overweight and many associated comorbidities in specialty research settings. There is very little information however as to the efficacy of such programs conducted in usual/typical primary care practices. We analysed effectiveness of the Medical Weight Loss Program (MWLP) designed to specifically address overweight/obesity in the setting of an urban academic primary care practice...

BACKGROUND: Differences between women and men play an important role in lung physiology and epidemiology of respiratory diseases, but also in the health care processes. OBJECTIVE: To analyse sex differences in patients encountering their general practitioner (GP) with respiratory symptoms with regard to incidence, GP's management and final diagnoses. METHODS: Retrospective cohort study, using data of the Dutch Practice Based Research Network...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

OBJECTIVE: We compared the performance of two tools to help general practitioners (GPs) identify patients in need of palliative care: the Surprise Question (SQ) and the Supportive and Palliative Care Indicators Tool (SPICT). METHODS: Prospective cohort study in two general practices in the Netherlands with a size of 3640 patients. At the start of the study the GPs selected patients by heart using the SQ. The SPICT was translated into a digital search in electronic patient records...

BACKGROUND: Patient feedback interventions are receiving increasing attention given their potential to improve health care provision. However, primary health care (PHC) professionals' acceptability and perceived utility of this type of interventions remain largely unexplored. OBJECTIVES: The aim of this study was to explore PHC professionals' perceptions, opinions and suggestions about a patient feedback intervention currently being designed to improve patient safety in Spanish PHC centres...

BACKGROUND: It is uncertain whether peak flow measurement is best done in the standing or sitting position. METHODS: In this cross-over study, study participants were randomized to perform the initial peak expiratory flow (PEF) measurement in either standing or sitting position. The highest of three readings in each position were compared using paired t-test. A mean difference of <±25 l/min was set as the equivalence limits. Test of equivalence of standing and sitting PEF measurements was done using MedCalc Software...

BACKGROUND: Intimate partner violence (IPV) is a well-known phenomenon, which affects mostly women. While IPV victims may attend emergency departments (EDs) seeking medical care, not all of them will make an allegation against their abusers. OBJECTIVE: The aim of this study was to examine the prevalence and the characteristics of the victims, who had made an allegation about the violent incident and had been examined by a forensic pathologist for judicial purposes, and had attended EDs seeking medical care, before the forensic examination...