Jennifer A Lucas, Miguel Marino, Sophia Giebultowicz, Dang Dinh, Roopradha Datta, David Boston, John Heintzman
BACKGROUND: Neighbourhood walkability can benefit cardiovascular health. Latino patients are more likely than non-Hispanic White patients to have diabetes, and evidence has shown better diabetes-related outcomes for patients living in neighbourhoods conducive to physical activity. Our objective was to determine whether neighbourhood walkability was associated with haemoglobin A1c (HbA1c) levels among English- and Spanish-preferring Latino patients compared to non-Hispanic White patients...
March 25, 2024: Family Practice
Hélène Dumesnil, Romain Lutaud, Julien Bellon-Curutchet, Aliénor Deffontaines, Pierre Verger
CONTEXT: The shortage of general practitioners (GPs) is a growing concern in Europe, especially in France. This problem is likely to continue until the end of the 2020s. OBJECTIVES: To study the GPs' perceptions of access to care in medically underserved areas (i.e. with low physician density), its consequences on their working conditions, and how they cope with the resulting difficulties. METHODS: Semi-structured individual interviews were conducted between May and August 2021 of 29 GPs practising in areas of southeastern France with a low physician density or at risk of a doctor shortage...
March 24, 2024: Family Practice
Marie-Morgane Veto, Julie Chazalon, Corinne Atallah-Seive, Rodolphe Charles, Angélique Savall
BACKGROUND: Speculum examination is an intrusive practice in the clinical care of women. It requires privacy and patients may experience discomfort or anxiety related to the procedure, which can result in delays or avoidance of necessary healthcare. Speculum self-insertion originated in the United States in the 1970s as part of the self-help movement. However, this clinical practice is largely unknown among healthcare providers and has rarely been assessed. AIM: This study investigates the women's views and healthcare providers' experiences of the self-insertion method...
March 22, 2024: Family Practice
Michelle Gooey, Haimanot Hailu, Elizabeth Sturgiss, Jenny Advocat, Heidi Bergmeier, Helen Skouteris
BACKGROUND: General practitioners (GPs) in Australia have an important role to play in preventing childhood obesity. Activities such as growth monitoring and promotion of healthy behaviours can contribute to obesity prevention efforts; however, the practicalities of how this is done are poorly documented. OBJECTIVES: Objectives were to understand current attitudes and practices regarding promoting healthy childhood growth and development and preventing childhood obesity in general practice, and identify practical barriers and enablers to routinely incorporating this into general practice based on the observations and personal experiences of general practice staff...
March 15, 2024: Family Practice
Kylie Vuong, Alamgir Kabir, Damian P Conway, Margaret Williamson, Mark F Harris, Margo L Barr
BACKGROUND: Primary care clinicians have key responsibilities in obesity prevention and weight management. AIMS: We aimed to identify risk factors for developing obesity among people aged ≥45 years. METHODS: We conducted a record linkage longitudinal study of residents of metropolitan Sydney, Australia using data from the: (1) 45 and Up Study at baseline (2005-2009) and first follow-up (2012-2015); (2) Medicare claims; (3) Pharmaceutical Benefits Scheme; and (4) deaths registry...
March 13, 2024: Family Practice
Mark H Ebell, Ariella Dale, Dan J Merenstein, Bruce Barrett, Cassie Hulme, Sarah Walters, Alea Sabry, Michelle Bentivegna
BACKGROUND: Testing for influenza in patients with acute lower respiratory tract infection (LRTI) is common and in some cases is performed for all patients with LRTI. A more selective approach to testing could be more efficient. METHODS: We used data from two prospective studies in the US primary and urgent care settings that enrolled patients with acute LRTI or influenza-like illness. Data were collected in the 2016, 2019, 2021, and 2022 flu seasons. All patients underwent polymerase chain reaction (PCR) testing for influenza and the FluScore was calculated based on patient-reported symptoms at their initial visit...
March 11, 2024: Family Practice
Stephanie Cowan, Lisa Moran, Rhonda Garad, Elizabeth Sturgiss, Siew Lim, Carolyn Ee
BACKGROUND: The international guideline on polycystic ovary syndrome (PCOS) provides evidence-based recommendations on the management of PCOS. Guideline implementation tools (GItools) were developed for general practitioner (GP) use to aid rapid translation of guidelines into practice. This mixed-methods study aimed to evaluate barriers and enablers of the uptake of PCOS GItools in general practice. DESIGN AND SETTING: A cross-sectional survey was distributed through professional networks and social media to GPs and GPs in training in Australia...
March 4, 2024: Family Practice
Mei-Lan Hsiao, Chen-Ying Su, Ching-Hui Loh, Sheng-Lun Kao
BACKGROUND: The effects of integrated care with case management and nutritional counselling for frail patients with nutritional risk are unclear. OBJECTIVES: To assess the impact of the integrated care model for frail patients with nutritional risk in the primary care setting. METHODS: This was a retrospective observational study. We enrolled 100 prefrail or frail patients according to Clinical Frailty Scale (CFS) aged ≥ 60 years with nutritional risk from the geriatric clinic...
February 29, 2024: Family Practice
Alasdair W Mayer, Dare Oladokun, Dipan Mistry
INTRODUCTION: Medication-related ear canal osteonecrosis (MRECO) is a growing concern linked to prolonged anti-resorptive medication use. Despite primary care providers being key prescribers of these medications, there is limited information about MRECO in primary care literature. This article presents a case of bisphosphonate-induced osteonecrosis of the external auditory canal (EAC), emphasizing the vital role of primary care providers in identifying this rare yet significant side effect of anti-resorptive medication...
February 27, 2024: Family Practice
Lan Zhu, Zhigang Pan, Fulai Shen, Yi Shen, Wei Zhang
BACKGROUND: The burden of type 2 diabetes mellitus (T2DM) in China continues to escalate. OBJECTIVE: To investigate the impact of family support system on the self-management behaviour of patients with T2DM. METHODS: In this cross-sectional study, 1,042 participants were sampled using a multistage stratified probability-proportionate-to-size method. On-site interviews were conducted using a structured questionnaire administered by 122 family doctors from 13 community health service centres in 8 administrative districts...
February 27, 2024: Family Practice
Takuya Aoki, Sota Zukeran, Masato Matsushima
BACKGROUND: The existence of a stable usual source of care (USC) is fundamental to the provision of quality health care. However, no longitudinal studies have examined whether core primary care attributes influence the stability of USC status. OBJECTIVES: We aimed to examine the association between primary care attributes (first contact, longitudinality, coordination, comprehensiveness, and community orientation) and the loss or change of USC. METHODS: This nationwide cohort study was conducted during the coronavirus disease 2019 pandemic using a representative sample of the Japanese adult population aged 40-75 years...
February 21, 2024: Family Practice
Mylène Arsenault, Stephanie Long, Vinita D'Souza, Alexandru Ilie, Keith J Todd
BACKGROUND: With the onset of the COVID-19 pandemic, telemedicine was rapidly implemented in care settings globally. To understand what factors affect the successful completion of telemedicine visits in our urban, academic family medicine clinic setting, we analysed telemedicine visits carried out during the pandemic. METHODS: We conducted a retrospective chart review of telemedicine visits from 2 clinical units within a family medicine centre. To investigate the association between incomplete visits and various factors (age, gender, presenting complaints, physician level of training [resident or staff] and patient-physician relational continuity), we performed a multivariable logistic regression on data from August 2020, February 2021, and May 2021...
February 21, 2024: Family Practice
Rosalia Olaya Zuñiga, Irene Parra-García, Luis Alejandro Gómez-Barrera
BACKGROUND: According to some health programmes, implementing primary health care through community health workers (CHWs) facilitates the connection between community and health services in Latin America. However, these are isolated processes that face different obstacles and would benefit from an overview of the corresponding health policies and programmes. OBJECTIVE: To provide an overview of CHW participation in 6 Latin American countries. METHODS: This exploratory qualitative study was based on 3 sources of information: a literature review, a review of public health policy documents, and interviews with experts who have led CHW programmes in 6 Latin American countries...
February 1, 2024: Family Practice
Leon Jonker, Stacey Jayne Fisher
BACKGROUND: The National Institute for Health and Care Research (NIHR) was set up to enhance clinical and health research activity in a variety of National Health Service (NHS) healthcare settings, including primary care. OBJECTIVE: To appraise how overall General Practitioner (GP) practice performance, location, and staffing levels may interact with NIHR Portfolio activity in primary care in England. METHODS: Cross-sectional summary of GP practice research activity and practice descriptors; complete data from 6,171 GP practices was collated from NIHR (using data for 2013-2023 for Portfolio studies), Public Health England, Care Quality Commission, and NHS Digital sources, respectively...
February 1, 2024: Family Practice
Margarida Gil Conde, Vera L Rodrigues, Raquel C Ramos, Ana Rente, Paula Broeiro-Gonçalves, Cristina Ribeiro, Paulo J Nicola
BACKGROUND: There is a need for a deeper understanding of the barriers to research in family medicine (FM) and to consider the perceptions and perspectives of professionals. Our study aims to provide a strategic view for research capacity building in FM. We included the perspective of family physician researchers (FPR) on the existing barriers to investigation in this context. OBJECTIVES: To understand and characterize the barriers to research in FM (personal and structural), from the perspective of Portuguese family physicians who are researchers...
February 1, 2024: Family Practice
Sarah McErlean, John Broughan, Geoff McCombe, Ronan Fawsitt, Mark Ledwidge, Walter Cullen, Joe Gallagher
BACKGROUND: Worldwide, atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults and poses a significant burden to patients, physicians, and healthcare systems. We developed a quality of care score based on the Atrial Fibrillation Better Care pathway recommended by the European Society of Cardiology and the European Heart Rhythm Association guidelines. This is a 14-point score that we have termed the MAGIC score(Management of Atrial Fibrillation in Integrated Care and General Practice)...
January 30, 2024: Family Practice
Rebecca S Etz, Craig A Solid, Martha M Gonzalez, Sarah R Reves, Erin Britton, Larry A Green, Asaf Bitton, Christine Bechtel, Kurt C Stange
INTRODUCTION: The lingering burden of the COVID-19 pandemic on primary care clinicians and practices poses a public health emergency for the United States. This study uses clinician-reported data to examine changes in primary care demand and capacity. METHODS: From March 2020 to March 2022, 36 electronic surveys were fielded among primary care clinicians responding to survey invitations as posted on listservs and identified through social media and crowd sourcing...
January 29, 2024: Family Practice
Yoann Gaboreau, Paul Frappé, Céline Vermorel, Alison Foote, Jean-Luc Bosson, Gilles Pernod
BACKGROUND: To assess bleeding risk of patients treated by oral anticoagulants, several scores have been constructed to assist physicians in the evaluation of the benefit risk. Most of these scores lack a strong enough level of evidence for use in family practice. OBJECTIVE: To assess the predictive prognostic accuracy of 13 scores designed to assess the risk of major or clinically relevant non-major (CRNM) bleeding events in a French ambulatory cohort receiving Vitamin-K antagonists (VKA) or direct oral anticoagulants (DOACs) in a family practice setting...
January 28, 2024: Family Practice
Yiyang Liow, Monica Lazarus, Victor Loh, Shefaly Shorey, Cornelia Chee, Doris Young, Jose M Valderas
BACKGROUND: Postnatal mental health problems (PMHPs) are prevalent and negatively affect mothers, children, and society. International and local guidelines recommend that Singapore primary care physicians (PCP) screen, assess, and manage mothers with PMHPs. However, little is known about their experiences and views. METHODS: We conducted semi-structured interviews with 14 PCPs in Singapore. Interview questions elicited perspectives on the identification and management of mothers with PMHPs...
January 27, 2024: Family Practice
Natasja D Vijfschagt, Michiel R de Boer, Marjolein Y Berger, Huibert Burger, Gea A Holtman
BACKGROUND: Recognition of acute diverticulitis is important to determine an adequate management strategy. Differentiating it from other gastrointestinal disorders is challenging as symptoms overlap. Clinical tests might assist the clinician with this diagnostic challenge. Previous reviews have focussed on prognostic questions and imaging examinations in secondary care. OBJECTIVE: To evaluate the diagnostic accuracy of clinical tests feasible in primary care for acute diverticulitis in suspected patients...
January 25, 2024: Family Practice
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