Helen J Curtis, Seb Bacon, Richard Croker, Alex J Walker, Rafael Perera, Michael Hallsworth, Hugo Harper, Kamal R Mahtani, Carl Heneghan, Ben Goldacre
BACKGROUND: Unsolicited feedback can solicit changes in prescribing. OBJECTIVES: Determine whether a low-cost intervention increases clinicians' engagement with data, and changes prescribing; with or without behavioural science techniques. METHODS: Randomized trial (ISRCTN86418238). The highest prescribing practices in England for broad-spectrum antibiotics were allocated to: feedback with behavioural impact optimization; plain feedback; or no intervention...
March 30, 2021: Family Practice
Hanifah Davis, Rachel Heilmann, Jessica Milchak, Thomas Delate
BACKGROUND: While use of glucagon-like peptide-1 (GLP-1) agonists and sodium-glucose cotransporter-2 (SGLT-2) inhibitors reduces the risk of atherosclerotic cardiovascular disease outcomes and lowers glycosylated haemoglobin (A1C), evidence on patient characteristics associated with clinically relevant A1C reduction is lacking. OBJECTIVE: The objective of this retrospective cohort study was to identify patient characteristics associated with A1C reduction with initial GLP-1 or SGLT-2 use...
March 23, 2021: Family Practice
Merijn C F Mulders, Feike J Loots, Joey van Nieuwenhoven, Jan C Ter Maaten, Hjalmar R Bouma
BACKGROUND: Use of sepsis-criteria in hospital settings is effective in realizing early recognition, adequate treatment and reduction of sepsis-associated morbidity and mortality. Whether general practitioners (GPs) use these diagnostic criteria is unknown. OBJECTIVE: To gauge the knowledge and use of various diagnostic criteria. To determine which parameters GPs associate with an increased likelihood of sepsis. METHODS: Two thousand five hundred and sixty GPs were invited and 229 agreed to participate in a survey, reached out to through e-mail and WhatsApp groups...
March 23, 2021: Family Practice
Nicole D Gehring, Maryam Kebbe, Sarah Rathwell, Arnaldo Perez, Chenhui Peng, Emily Zendher, Josephine Ho, Geoff D C Ball
BACKGROUND: It is recommended that primary care-based physicians refer children with overweight and obesity to multidisciplinary paediatric obesity management, which can help to improve weight and health. OBJECTIVE: To determine predictors of referral to multidisciplinary paediatric obesity management. METHODS: This retrospective, population-level study included physicians who could refer 2-17 years old with a body mass index ≥85th percentile to one of three multidisciplinary paediatric obesity management clinics in Alberta, Canada...
March 23, 2021: Family Practice
Oktawia A DeYoung, Kaci Boehmer, Denise Hung, Carrie McAdam-Marx
BACKGROUND: Substance use disorder (SUD) is a known barrier to patient-self-management, which can hinder efforts to achieve treatment goals in type 2 diabetes (T2D) when the conditions coexist. OBJECTIVE: Identify the association between SUD and glycemic control in patients with T2D treated in a primary care setting. METHODS: This retrospective cohort study included patients with T2D treated by providers at family medicine clinics at an academic medical center and its affiliated regional sites from January 2014 to October 2019...
March 19, 2021: Family Practice
Caoimhe Madden, Sinéad Lydon, Andrew W Murphy, Paul O'Connor
BACKGROUND: Patients remain an under-utilized source of information on patient safety, as reflected by the dearth of patient-report measures of safety climate, particularly for use in general practice settings. Extant measures are marked by poor coverage of safety climate domains, inadequate psychometric properties and/or lack of consideration of usability. OBJECTIVE: To develop a novel patient-report measure of safety climate specifically for completion by general practice patients, and to establish the validity, reliability and usability of this measure...
March 19, 2021: Family Practice
José Augusto Simões, Filipe Prazeres, Tiago Maricoto, Pedro Augusto Simões, Joana Lourenço, João Pedro Romano, Luiz Miguel Santiago
BACKGROUND: Empathy is the capacity to understand and resonate with the experiences of other people. Patient enablement is the degree to which a patient feels strengthened in terms of being able to deal with, understand and manage their disease. METHODS: Secondary cross-sectional analysis of existing data from 2 independent datasets (456 primary health care patients), with the application of two validated questionnaires, Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and Patient Enablement Instrument (PEI)...
March 19, 2021: Family Practice
Patricia Norwood, Isabel Correia, Sebastian Heidenreich, Paula Veiga, Verity Watson
BACKGROUND: In 2005, the Portuguese government launched a Primary Care reform that aimed to reinforce continuity of care. After a promising start, the reform is still incomplete and continuity has been compromised by the lack of General Practice doctors. OBJECTIVE: This study evaluates public preferences for relational continuity of care alongside other attributes of Primary Care services in Portugal. METHODS: We use a discrete choice experiment (DCE) to evaluate preferences and estimate the population's willingness to pay (WTP) for Primary Care attributes...
March 19, 2021: Family Practice
Ingrid Looijmans-van den Akker, Anouk Werkhoven, Theo Verheij
BACKGROUND: Despite a clear guideline for asthma medication, excessive use of short-acting β2-agonists (SABAs) is common in clinical practice. Previous research has shown that excessive use of SABAs is associated with poor asthma control. OBJECTIVE: This study examines current use of asthma medication in primary care and whether excessive use of SABAs is associated with exacerbations. METHODS: The study design was a retrospective analysis using information from electronical medical records from patients aged 18 and older of five Julius Health Centers located in Utrecht, the Netherlands, in the period of 1 July 2018 through 1 July 2019...
March 19, 2021: Family Practice
Yusuf Karayurek, Hakan Demirci
AIM: The aim of this study was to determine the reasons for the relocation of contracted family physicians and the relationship of this situation with burnout and job satisfaction status. METHODS: This study was conducted with contracted family physicians in Bursa province between May 2019 and December 2019. The physicians were visited in the family health centres where they worked. The participants were asked to fill out a socio-demographic data form, Maslach Burnout Inventory Scale and Minnesota Job Satisfaction Questionnaire...
March 18, 2021: Family Practice
Osman Sanyer, Jorie M Butler, Katherine Fortenberry, Tatiana Webb-Allen, Dominik Ose
PURPOSE: Team-based care offers potential improvements in communication, care coordination, efficiency, value and satisfaction levels of both patients and providers. However, the question of how to balance the need for information in team-based care without disregarding patient preferences remains unanswered. This study aims to determine patients' perceptions of information sharing via electronic health records (EHRs) in team-based care. METHODS: This qualitative study used a focus group approach...
March 4, 2021: Family Practice
Tanzeela Y Khalid, Lorna J Duncan, Hannah V Thornton, Gemma Lasseter, Peter Muir, Zara Abigail Toney, Alastair D Hay
BACKGROUND AND OBJECTIVES: Rapid multi-viral respiratory microbiological point-of-care tests (POCTs) have not been evaluated in UK primary care. The aim of this study was to evaluate the use of a multi-viral microbiological POCT for suspected respiratory tract infections (RTIs). METHODS: In this observational, mixed-methods feasibility study practices were provided with a POCT machine for any patient aged ≥3 months with suspected RTI. Dual throat/nose swabs tested for 17 respiratory viruses and three atypical bacteria, 65 minutes per sample...
March 4, 2021: Family Practice
L Miriam Dickinson, Patrick Hosokawa, Jeanette A Waxmonsky, Bethany M Kwan
No abstract text is available yet for this article.
March 3, 2021: Family Practice
Derek E Hersch, Marc James A Uy, Samantha M Ngaw, Katie A Loth
BACKGROUND: Primary care physicians (PCPs) are in a critical position for identifying, preventing and treating childhood obesity. However, a one-size-fits-all approach does not exist for having conversations about weight with families. A better understanding of how PCPs can address paediatric patients' weight concerns is needed in order to develop effective guidelines and trainings. OBJECTIVE: To describe PCPs preferences and behaviours regarding weight-related conversations with paediatric patients' and their families...
March 2, 2021: Family Practice
Qi Zhang, Ke Zhang, Miao Li, Jiaxin Gu, Xintong Li, Mingzi Li, Yi Jin
OBJECTIVES: To examine the validity and reliability of the Mandarin version of the Treatment Burden Questionnaire (TBQ) among stroke patients. BACKGROUND: Stroke patients need long-term management of symptoms and life situation, and treatment burden has recently emerged as a new concept that can influence the health outcomes during the rehabilitation process. METHODS: The convenience sampling method was used to recruit 187 cases of stroke patients in a tertiary grade hospital in Tianjin for a formal investigation...
February 22, 2021: Family Practice
Eileen E Burns, Holly M Mathias, Courtney Heisler, Yunsong Cui, Olga Kits, Sander Veldhuyzen van Zanten, Jennifer L Jones
BACKGROUND: There is little literature related to access to inflammatory bowel disease (IBD) care that incorporates the perspective of key system stakeholders, such as primary healthcare providers (PHCP), despite their clear and integral role in facilitating access. OBJECTIVE: This study aimed to identify barriers to referring patients to speciality IBD care as perceived by referring PHCP. In particular, we sought to understand PHCP satisfaction with the current IBD specialist referral system, as well as indicators of geographic variance to access...
February 22, 2021: Family Practice
William R Phillips, Diana Nelson Louden, Elizabeth Sturgiss
BACKGROUND: Despite broad efforts to improve the reporting of biomedical research, no reporting guideline exists for primary care (PC) research. Little is known about current reporting practices or how well reports meet the needs of varied users in PC. OBJECTIVE: To map the published literature on PC research reporting: quality, strengths and weaknesses, recommendations and efforts to improve reporting. METHODS: Scoping review of literature across seven major databases and search engines to identify all articles on PC research reporting published in English, 2000-20...
February 18, 2021: Family Practice
Jane Desborough, Sally Hall Dykgraaf, Christine Phillips, Michael Wright, Raglan Maddox, Stephanie Davis, Michael Kidd
BACKGROUND: COVID-19 is the fifth and most significant infectious disease epidemic this century. Primary health care providers, which include those working in primary care and public health roles, have critical responsibilities in the management of health emergencies. OBJECTIVE: To synthesize accounts of primary care lessons learnt from past epidemics and their relevance to COVID-19. METHODS: We conducted a review of lessons learnt from previous infectious disease epidemics for primary care, and their relevance to COVID-19...
February 15, 2021: Family Practice
Vivian A Christensen, Shannon M Nugent, Chelsea K Ayers, Benjamin J Morasco, Devan Kansagara
BACKGROUND: The legalization of cannabis is expanding across the USA, and its use has increased significantly, including among Veterans. Although the Veterans Health Administration (VHA) abides by the classification of cannabis as a Schedule I substance, it recently recommended that clinicians discuss cannabis with their patients. Little is known about VHA clinicians' perspectives on and knowledge of cannabis. OBJECTIVE: We sought to better understand clinicians' attitudes, beliefs, knowledge and communication with patients regarding cannabis...
February 9, 2021: Family Practice
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