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BMC Family Practice

Jo-Anne Manski-Nankervis, Sharmala Thuraisingam, Janet K Sluggett, Gary Kilov, John Furler, David O'Neal, Alicia Jenkins
BACKGROUND: Previous studies in general practice and hospital settings have identified that prescribing of non-insulin diabetes medications may be sub-optimal in people with type 2 diabetes (T2D) and renal impairment. Since these publications, a number of new medications have become available for the management of T2D. Study aims were to, in a cohort of Australians with T2D and renal impairment attending general practice, (1) investigate whether the prescribing of non-insulin diabetes medications is consistent with dosing adjustments recommended within current Australian Diabetes Society (ADS) guidelines; and (2) identify patient socio-demographic and clinical factors associated with at least one prescription of a non-insulin diabetes medication inconsistent with current ADS guidelines for medication doses...
February 18, 2019: BMC Family Practice
Christopher Harrison, Joan Henderson, Graeme Miller, Helena Britt
BACKGROUND: The ageing population and increasing prevalence of multimorbidity place greater resource demands on the health systems internationally. Accurate prediction of general practice (GP) services is important for health workforce planning. The aim of this research was to develop a parsimonious model that predicts patient visit rates to general practice. METHODS: Between 2012 and 2016, 1449 randomly selected Australian GPs recorded GP-patient encounter details for 43,501 patients in sub-studies of the Bettering the Evaluation and Care of Health (BEACH) program...
February 14, 2019: BMC Family Practice
Jane O'Doherty, Leonard F W Leader, Andrew O'Regan, Colum Dunne, Soorej Jose Puthoopparambil, Raymond O'Connor
BACKGROUND: Anti-microbial resistance (AMR) is a global threat to public health and antibiotics are often unnecessarily prescribed for acute respiratory tract infections (ARTIs) in general practice. We aimed to investigate why general practitioners (GPs) continue to prescribe antibiotics for ARTIs despite increasing knowledge of their poor efficacy and worsening antimicrobial resistance. METHODS: We used an explorative qualitative study design. Thirteen GPs were recruited through purposive sampling to represent urban and rural settings and years of experience...
February 14, 2019: BMC Family Practice
Ali M K Hindi, Ellen I Schafheutle, Sally Jacobs
BACKGROUND: This study aimed to use marketing theory to examine the views of patients, pharmacists and general practitioners (GPs) on how community pharmacies are currently used and to identify how community pharmacy services may be better integrated within the primary care pathway for people with long-term conditions (LTCs). METHODS: A qualitative research design was used. Two focus groups were conducted with respiratory patients (n = 6, 5) and two with type 2 diabetes patients (both n = 5)...
February 8, 2019: BMC Family Practice
Àngels Molló, Anna Berenguera, Esther Rubinat, Bogdan Vlacho, Manel Mata, Josep Franch, Bonaventura Bolíbar, Dídac Mauricio
BACKGROUND: The management of hyperglycaemia and associated cardiovascular risk factors in patients with type 2 diabetes mellitus (T2DM) may reduce diabetes-related complications. The strategy to broaden the knowledge base of primary care professionals to improve health care has mainly been prompted by the current reality of limited resources and access to specialized care. The main objective of this study is to assess the effectiveness of comprehensive interventions focused on treatment intensification, decrease clinical inertia and reduce possible barriers to treatment adherence in patients with poorly controlled diabetes in a primary care setting...
February 7, 2019: BMC Family Practice
Luis-Angel Pérula-de Torres, Juan Carlos Verdes-Montenegro Atalaya, Javier García-Campayo, Ana Roldán-Villalobos, Rosa Magallón-Botaya, Cruz Bartolomé-Moreno, Herminia Moreno-Martos, Elena Melús-Palazón, Norberto Liétor-Villajos, Francisco Javier Valverde-Bolívar, Nur Hachem-Salas, Luis-Alberto Rodríguez, Mayte Navarro-Gil, Ronald Epstein, Antonio Cabezón-Crespo, Carmen Morillo-Velarde Moreno
BACKGROUND: Health personnel are susceptible to high levels of work stress and burnout due to the psychological and emotional demands of their work, as well as to other aspects related to the organisation of that work. This paper describes the rationale and design of the MINDUUDD study, the aim of which is to evaluate the effectiveness of a mindfulness and self-compassion 4-session programme versus the standard 8-session programme to reduce work stress and burnout in Family and Community Medicine and Nursing tutors and residents...
February 6, 2019: BMC Family Practice
Tina Drud Due, Thorkil Thorsen, Marius Brostrøm Kousgaard
BACKGROUND: Accreditation is a widely adopted tool for quality control and quality improvement in health care, which has increasingly been employed for general practice. However, there is lack of knowledge of how accreditation is received and experienced by health professionals in general practice. This study explores how general practitioners (GPs) and their staff experienced the comprehensibility of accreditation standards and how they worked to increase their understanding of the standards...
January 31, 2019: BMC Family Practice
Caoimhe Madden, Sinéad Lydon, Margaret E Cupples, Nigel D Hart, Ciara Curran, Andrew W Murphy, Paul O'Connor
BACKGROUND: Patient safety research is conducted predominantly in hospital settings, with a dearth of insight from primary care, despite suggestions that 2.2% of primary care consultations result in a patient safety incident. This study aimed to assess the feasibility of an intervention intended to improve patient safety in general practice. METHODS: A randomised controlled feasibility study was conducted with general practices in the Republic of Ireland (N = 9) and Northern Ireland (N = 2), randomly assigned to the intervention (N = 5) or control (N = 6) group...
January 30, 2019: BMC Family Practice
Lotte Firet, Chrissy de Bree, Carmen M Verhoeks, Doreth A M Teunissen, Antoine L M Lagro-Janssen
BACKGROUND: Stress urinary incontinence (SUI) is the most prevalent subtype of urinary incontinence and is a bothering condition in women. Only a minority of those with SUI consult a general practitioner (GP). EHealth with pelvic floor muscle training (PFMT) is effective in reducing incontinence symptoms and might increase access to care. The role of the GP regarding such an eHealth intervention is unknown. The aim of the study is to gain insight into the attitudes towards a PFMT internet-based, eHealth, intervention for SUI...
January 26, 2019: BMC Family Practice
Abeer J Khalaf, Aysha I Aljowder, Meead J Buhamaid, Mona F Alansari, Ghufran A Jassim
BACKGROUND: Research in primary care is essential for disease diagnosis, management and prevention in relation to the individuals, families and the community. This research aims to study the attitude of primary care physicians towards conducting research in Bahrain and to identify the main barriers encountered during research. METHODS: A cross-sectional study was conducted amongst 200 randomly selected primary care physicians registered in Ministry of Health affiliated primary healthcare centers in Bahrain...
January 26, 2019: BMC Family Practice
Marie Droz, Nicolas Senn, Christine Cohidon
BACKGROUND: Representing 60% of medical consultations in Switzerland, primary care holds an important place in our medical system. Patients' values in family medicine (FM) are nowadays recognized as important factors to take into account in order to provide good quality of care. The aim of this study is to describe patients' most important values regarding FM and to assess their associations with socio-demographics factors in a fee-for-services health system. METHODS: We analyzed the Swiss 2012 study on Quality and Costs of Primary Care (QUALICOPC)...
January 25, 2019: BMC Family Practice
Rick T van Uum, Roderick P Venekamp, Anne G M Schilder, Roger A M J Damoiseaux, Sibyl Anthierens
BACKGROUND: For unclarified reasons, parents tend to be cautious about administering analgesics to their children, potentially leading to suboptimal management of AOM symptoms. We aim to understand parents' views and expectations of pain management in acute otitis media (AOM) in children. METHODS: Qualitative study alongside a cluster-randomised controlled trial (PIM-POM study) aimed at optimising pain management in childhood AOM. We purposefully sampled 14 parents of children diagnosed with AOM by their GP, who were recruited to the trial between November 2017 and May 2018...
January 23, 2019: BMC Family Practice
Lindsey M Philpot, Jon O Ebbert, Ryan T Hurt
BACKGROUND: Healthcare providers play a critical role in facilitating patient access to medical cannabis. However, previous surveys suggest only a minority of providers believe that medical cannabis confers benefits to patients. Significant new knowledge about the potential benefits and harms of medical cannabis has recently emerged. Understanding current attitudes and beliefs of providers may provide insight into the ongoing challenges they face as states expand access to medical cannabis...
January 22, 2019: BMC Family Practice
Tom Kingstone, Bernadette Bartlam, Heather Burroughs, Peter Bullock, Karina Lovell, Mo Ray, Peter Bower, Waquas Waheed, Simon Gilbody, Elaine Nicholls, Carolyn A Chew-Graham
BACKGROUND: Anxiety and depression often co-exist. These disorders are under-diagnosed and under-treated, specifically among older people, and lead to increased use of health and social care services and raised mortality. Older people report a reluctance to present to their GP with depression or anxiety symptoms due to perceived stigma about mental health problems, lack of acceptable treatments and the prioritising of physical health problems. Third sector organisations, who work closely with older people in the community, are well-placed to provide additional support...
January 19, 2019: BMC Family Practice
Clara González-Formoso, Ana Clavería, M J Fernández-Domínguez, F L Lago-Deibe, Luis Hermida-Rial, Antonio Rial, Francisco Gude-Sampedro, Salvador Pita-Fernández, Victoria Martín-Miguel
BACKGROUND: Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. METHODS: Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138)...
January 18, 2019: BMC Family Practice
Géraldine Tournu, Laurent Abramowitz, Camille Couffignal, Frédéric Juguet, Agnès Sénéjoux, Stéphane Berger, Anne-Laure Wiart, Marc Bernard, Françoise Provost, Hélène Pillant-Le Moult, Dominique Bouchard, Jean-Pierre Aubert
Following publication of the original article [1], the authors reported an error to one of the 'study groups' in the authorship section.
January 17, 2019: BMC Family Practice
Nicole Anastasides, Carmelen Chiusano, Christina Gonzalez, Fiona Graff, David R Litke, Erica McDonald, Jennifer Presnall-Shvorin, Nicole Sullivan, Karen S Quigley, Wilfred R Pigeon, Drew A Helmer, Susan L Santos, Lisa M McAndrew
BACKGROUND: Communication between patients and providers about persistent "medically unexplained" physical symptoms (MUS) is characterized by discordance. While the difficulties are well documented, few studies have examined effective communication. We sought to determine what veterans with Gulf War Illness (GWI) perceive as the most helpful communication from their providers. Veterans with GWI, a type of MUS, have historically had complex relationships with medical providers...
January 16, 2019: BMC Family Practice
Roos van Amerongen, Roel P Gazendam, Jan E A M van Bergen
BACKGROUND: Sexually transmitted infections (STI) caused by multidrug resistant Neisseria gonorrhoea are an emerging threat to global health. In the Netherlands, the general practitioner (GP) provides the major part of STI care. In 2013 an update of the Dutch guideline was published, recommending a single dose of intramuscular ceftriaxone as treatment for gonorrhoea infections. Data from a Dutch General Practitioner research database was used to investigate the guideline implementation for the treatment of gonorrhoea...
January 15, 2019: BMC Family Practice
Christopher J Gidlow, Naomi J Ellis, Lisa Cowap, Victoria Riley, Diane Crone, Elizabeth Cottrell, Sarah Grogan, Ruth Chambers, David Clark-Carter
BACKGROUND: NHS Health Check is a national cardiovascular disease (CVD) risk assessment programme for 40-74 year olds in England, in which practitioners should assess and communicate CVD risk, supported by appropriate risk-management advice and goal-setting. This requires effective communication, to equip patients with knowledge and intention to act. Currently, the QRISK®2 10-year CVD risk score is most common way in which CVD risk is estimated. Newer tools, such as JBS3, allow manipulation of risk factors and can demonstrate the impact of positive actions...
January 14, 2019: BMC Family Practice
Diana Jurić, Ivančica Pavličević, Ana Marušić, Mario Malički, Ivan Buljan, Velen Šarotić, Nataša Mrduljaš-Đujić, Ante Komparak, Miona Vujević, Danijela De Micheli-Vitturi, Pjera Šušnjar, Tina Puljiz, Minka Jerčić, Dario Leskur, Matko Marušić
BACKGROUND: Uncontrolled blood pressure remains an urgent issue in clinical practice worldwide. This study aimed to compare the characteristics and effectiveness of hypertension control in family medicine pratice in the first treatment year, in relation to the geographical position, socio-economic standard, and access to medical services and public pharmacies in urban, rural and island environments (city of Split vs. Dalmatian Hinterland vs. islands in Southern Croatia). METHODS: A historical cohort study included 213 patients diagnosed from 2008 to 2014 with essential arterial hypertension (AH) and without related complications or diabetes mellitus...
January 14, 2019: BMC Family Practice
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