MedWorm: Family Practices

Patient enablement requires physician empathy: a cross-sectional study of general practice consultations in areas of high and low socioeconomic deprivation in Scotland

BMC Family Practice — Wed, 08 Feb 2012 05:00:00 +0100

Conclusions: Although other factors influence patient enablement, the patients' perceptions of the doctors' empathy is of key importance in patient enablement in general practice consultations in both high and low deprivation settings. (Source: BMC Family Practice)

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Predictors of warfarin use in atrial fibrillation in the United States: a systematic review and meta-analysis

BMC Family Practice — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: Warfarin use has increased somewhat over time. The decision to prescribe warfarin for stroke prevention in atrial fibrillation is based upon multiple prescriber and patient characteristics. These findings can be used by family practice prescribers and other healthcare decision-makers to target interventions or methods to improve utilization of warfarin when it is indicated for stroke prevention. (Source: BMC Family Practice)

Functional knee brace use effect on peak vertical ground reaction forces during drop jump landing

Knee Surgery, Sports Traumatology, Arthroscopy — Tue, 31 Jan 2012 16:46:55 +0100

Conclusions The significantly lower group mean PVGRF while using a FKB could keep traumatic forces from reaching the ACL until the active neuromuscular restraints are activated to provide protection to the knee joint ligaments. Also, accommodation to FKB is possible after approximately 14.0 h of brace use. The results of this paper will assist clinicians in providing information to their patients regarding a FKB ability to offer protection to an ACL-deficient knee or to address concerns about early muscle fatigue, energy expenditure, heart rate, and decrease in performance level. Level of evidence Prospective study, Level I. Content Type Journal ArticleCategory KneePages 1-8DOI 10.1007/s00167-012-1911-zAuthors Neetu Rishiraj, ACTIN Health an...

The roles of self‐efficacy and pretest counseling in type 2 herpes simplex virus screening in asymptomatic adults

Journal of the American Academy of Nurse Practitioners — Mon, 30 Jan 2012 05:00:00 +0100

Conclusions: The overwhelming majority of participants were (a) willing to undergo screening; (b) take suppressive antiviral medication if necessary; (c) share their results with sexual partners; and (d) consider safer sexual practices as a consequence of screening. Older patients were less willing to consider daily antiviral medication. Men who have sex with men (MSM) had lower perceived susceptibility to HSV‐2 but were more likely to undergo and report screening.Implications for practice: Future research should include predictive models for determining the most appropriate patients to screen for HSV‐2 and best practices for those who test positive. Shared decision making between patients and advanced practice nurses regarding the risks and benefits of screening for HSV‐2 should be ...

[Bibliometric analysis of International Scientific production on Primary Care.]

Atencion Primaria — Mon, 30 Jan 2012 05:00:00 +0100

CONCLUSIONS: The production of Primary care is about 1% of the total scientific output, with a noticeable and higher than average growth over 20 years. The proportion of clinical trials is similar to other disciplines. Although Anglo-Saxon countries and journals are the highest producers, Spain and the journal Aten Primaria is among those highlighted. PMID: 22296794 [PubMed - as supplied by publisher] (Source: Atencion Primaria)

Improving accuracy of medication identification in an older population using a medication bottle color symbol label system

NeLM - Care of Older People — Tue, 24 Jan 2012 05:00:00 +0100

This study was conducted in two phases, consisting of three focus groups of patients from a family medicine clinic in North Texas, USA, (n = 25) and a pre-post medication identification test in a second group of patient participants (n = 100). Results of focus group discussions were used to refine the medication label ... (Source: NeLM - Care of Older People)

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Purpose and procedure

Evidence-Based Medicine — Mon, 23 Jan 2012 05:00:00 +0100

The general purpose of Evidence-Based Medicine is to select from the health-related literature* those articles reporting important advances in internal medicine, general and family practice, surgery, psychiatry, paediatrics, and obstetrics and gynaecology, and whose results are most likely to be both true and useful. These articles are described, critiqued and commented on by clinical experts. The specific purposes of Evidence-Based Medicine are: to identify, using predefined criteria, the best original and review articles on the cause, course, diagnosis, prevention, treatment, quality of care, or economics of disorders in the foregoing fields to provide a description and expert commentary on the context of each article, its methods, and the clinical applications that its findings warrant...

Recognition of distress and depression in primary care: how far should we go?

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

(Source: Family Practice)

Care for common mental health problems: applying evidence beyond RCTs

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

(Source: Family Practice)

Routinely recorded patient safety events in primary care: a literature review

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. There is limited use of routinely collected data to measure adverse events in primary care despite large volumes of data generated. The potential for using readily available data recorded in primary care for active patient safety surveillance needs further exploration. (Source: Family Practice)

Does recognition of depression in primary care affect outcome? The PREDICT-NL study

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. A minority of patients with MDD is recognized in primary care. Those who were unrecognized had comparable outcome after 12 and 39 months as participants with recognized depression. (Source: Family Practice)

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Mental health of young adult patients who do not attend appointments in primary care: a retrospective cohort study

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. Non-attendance of a young adult for a doctor’s appointment in primary care may signal a mental health problem. This applies whether or not the patient is known to have presented mental health problems in the past. (Source: Family Practice)

Impact of subjective sleep quality on glycemic control in type 2 diabetes mellitus

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. This study demonstrated that both poor sleep quality and less-efficient sleep are significantly correlated with worse glycaemic control in patients with type 2 diabetes. These findings are expected to contribute to the prevention and risk reduction of microvascular complications in type 2 diabetes. (Source: Family Practice)

Primary care patients with heart failure in the last year of their life

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. A minority of patients with advanced HF have a terminal phase and died of progressive HF. In the last year of life, the GP is the main provider of care. (Source: Family Practice)

Acceptability of a guided self-help mental health intervention in general practice

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion. The intervention appeared to improve the psychological well-being of the patients and was regarded positively by both clinicians and patient participants. Further testing of the efficacy of the intervention on a larger sample with a randomized controlled trial study design is warranted. (Source: Family Practice)

Targeted treatment in primary care for low back pain: the treatment system and clinical training programmes used in the IMPaCT Back study (ISRCTN 55174281)

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Discussion. This paper describes in detail the IMPaCT Back study’s subgrouping for targeted treatment system and the training and mentoring packages aimed at equipping clinicians to deliver it, within the IMPaCT Back study. Study registration. ISRCTN55174281. (Source: Family Practice)

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Treatment of acute otitis media in general practice: quality variations across countries

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion. The majority of patients with AOM were treated with antibiotics in all six countries, but considerable variations in both prescribing rate and choice of antibiotics were identified. (Source: Family Practice)

Comparing diagnostic delay in cancer: a cross-sectional study in three European countries with primary care-led health care systems

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. A large-scale study comparing cancer delays in European countries and based on primary care-held records is feasible but would require supplementary sources of data in order to maximize information on demographic variables, the cancer stage at diagnosis and treatment details. Such a large-scale study is timely and desirable since our findings suggest systematic differences in the way cancer is managed in the three countries. (Source: Family Practice)

Widespread use of pure and impure placebo interventions by GPs in Germany

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. Placebo interventions are a widely accepted part of medical treatment in German general practices and are used primarily for their psychological effects. Impure placebos are used much more frequently than pure placebos. (Source: Family Practice)

The significance of health anxiety and somatization in care-seeking for back and upper extremity pain

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion. The study implies that prevention of back pain and upper extremity pain requires different strategies and that gender and health anxieties should be taken into account. (Source: Family Practice)

Personal maternal care reflections of general practice physicians

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion. This research supports the growing body of evidence that there are unique problems facing doctor–patients and clinicians treating them. However, contrary to expectations derived from anecdotal evidence, GPs indicated that care was enhanced due to their occupation. This study raises awareness of areas for consideration when female GPs approach pregnancy and health care professionals deliver maternal health care. (Source: Family Practice)

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A qualitative study on patients' and physicians' visions for the future management of overweight or obesity

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusion. Options should be developed for closer cooperation between GPs and support facilities inside and outside practices. (Source: Family Practice)

Factors predicting recruitment to a UK wide primary care smoking cessation study (the ESCAPE trial)

Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions. Proactive recruitment methods can increase participation in smoking cessation trials and weighting the target sample in favour of more deprived areas will recruit a more representative sample. The number and timing of mailings to potential participants can also increase recruitment. (Source: Family Practice)

Dying at home in Belgium: a descriptive GP interview study

BMC Family Practice — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions: Many people dying at home under the care of their GPs in Belgium function relatively well until the last week of life and cognitive status seems to be preserved until the end in many cases. However, symptoms which GPs find difficult to control still manifest in many patients in the final week of life. (Source: BMC Family Practice)

COPD exacerbations in general practice: variability in oral prednisolone courses

BMC Family Practice — Thu, 12 Jan 2012 05:00:00 +0100

Conclusion: Under normal conditions GPs prescribe prednisolone quite uniformly, within the range of the current Dutch guidelines. There is insufficient guidance regarding how to adjust corticosteroid treatment to exacerbation severity, disease severity and the presence of diabetic co-morbidity. Under these circumstances, there is a substantial variation in treatment duration. (Source: BMC Family Practice)

Coding of procedures documented by general practitioners in Swedish primary care - an explorative study using two procedure coding systems

BMC Family Practice — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions: Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED-CT. Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care. (Source: BMC Family Practice)

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General practitioners' and practice nurses' views and experience of managing depression in coronary heart disease: a qualitative interview study.

BMC Family Practice — Thu, 05 Jan 2012 05:00:00 +0100

Conclusions: GPs and PNs view depression in CHD similarly to depression uncomplicated by physical illness. However, uncertainty exists as to how best to manage depression associated psychosocial issues. Personalised interventions are needed which account for individual need and which enable and encourage clinicians and patients to make use of existing resources to address the psychosocial factors which contribute to depression. (Source: BMC Family Practice)

Knee OA: Which patients are unlikely to benefit from manual PT and exercise?

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Deyle GD, Gill NW, Allison SC, Hando BR, Rochino DA Abstract A preliminary clinical prediction rule uses 3 patient attributes to predict who will fare better with alternative treatments. PMID: 22220299 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: Does cervical membrane stripping in women with group B Streptococcus put the fetus at risk?

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Crago MS, Gauer R, Frazier J Abstract No direct evidence points to fetal harm from cervical membrane stripping (CMS) to induce labor in term pregnancies complicated by group B Streptococcus (GBS) colonization. PMID: 22220298 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: Does ultrasound screening for abdominal aortic aneurysm reduce mortality?

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Miranda-Usua Y, Whitworth JD, Tillett J Abstract Yes, screening reduces mortality in men, although it's unclear whether it has the same effect in women. PMID: 22220297 [PubMed - in process] (Source: The Journal of Family Practice)

Asymptomatic crusted lesions on the palms.

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Liaw FY, Huang CF, Fang WH, Wang WM Abstract Was there a link between where the patient lived (a nursing home) and the lesions on her hands? PMID: 22220296 [PubMed - in process] (Source: The Journal of Family Practice)

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PURLs: Combatting lice in a single treatment.

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Brown D, Rowland K Abstract Spinosad (Natroba), a topical pediculicide approved by the FDA in 2011, effectively eradicates lice-- with no nit-picking. PMID: 22220295 [PubMed - in process] (Source: The Journal of Family Practice)

HPV vaccine is now routinely indicated for males.

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Campos-Outcalt D Abstract ACIP recommends vaccinating all males ages 11 to 21 years and men ages 22 to 26 years who have sex with men or are HIV positive. PMID: 22220294 [PubMed - in process] (Source: The Journal of Family Practice)

Genetic blood disorders: Questions you need to ask.

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Paul Starr S Abstract No one is better positioned than you to look for evidence of inherited diseases--especially when you consider that many FPs care for 2, or even 3, generations of a single family. PMID: 22220293 [PubMed - in process] (Source: The Journal of Family Practice)

Exercise-induced proteinuria?

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Saeed F, Naga Pavan Kumar Devaki P, Mahendrakar L, Holley JL Abstract Urinalysis reveals an excessive level of protein, but your patient is a runner. How concerned should you be? PMID: 22220292 [PubMed - in process] (Source: The Journal of Family Practice)

Shoulder pain: 3 cases to test your diagnostic skills.

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Shah N, Bartsokas T, Wagner R Abstract Before you conclude that rotator cuff tendinitis is the cause of your patient's pain or order a range of imaging studies, take a look at these cases--and the take-away message each provides. PMID: 22220291 [PubMed - in process] (Source: The Journal of Family Practice)

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A 2012 health care wish list.

The Journal of Family Practice — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Susman J PMID: 22220290 [PubMed - in process] (Source: The Journal of Family Practice)

Effectiveness of an implementation strategy for a breastfeeding guideline in Primary Care: cluster randomised trial.

BMC Family Practice — Fri, 30 Dec 2011 05:00:00 +0100

This study involves a community based cluster randomized trial in primary healthcare centres in Leganes (Madrid, Spain). The project aims to determine whether the use of an implementation strategy (including training session, information distribution, opinion leader) of a breastfeeding guideline in primary care is more effective than usual diffusion.The number of patients required will be 240 (120 in each arm). It will be included all the mothers of infants born during the study period (6 months) who come to the health centre on the first visit of the child care programme and who give their consent to participate. The main outcome variable is the exclusive o predominant breastfeeding at 6 moths of age..Main effectiveness will be analyzed by comparing the percentage of infants with exclusiv...

The Influence of Self-Owned Home Blood Pressure Monitoring (HBPM) on Primary Care Patients With Hypertension: a Qualitative Study

BMC Family Practice — Fri, 30 Dec 2011 05:00:00 +0100

Conclusions: HBPM is becoming an integral part of hypertension management. Primary care patients who self-initiated HBPM reported being more self-efficacious, but lack of participation and guidance from their doctors created confusion, and hindered the true benefit of HBPM. (Source: BMC Family Practice)

Improving accuracy of medication identification in an older population using a medication bottle color symbol label system

BMC Family Practice — Thu, 29 Dec 2011 05:00:00 +0100

This study was conducted in two phases, consisting of three focus groups of patients from a family medicine clinic (n=25) and a pre-post medication identification test in a second group of patient participants (n=100). Results of focus group discussions were used to refine the medication label symbols according to themes and messages identified through qualitative triangulation mechanisms and data analysis techniques. A pre-post medication identification test was conducted in the second phase of the study to assess differences between standard labeling alone and the addition of the refined color-specific symbols. The pre-post test examined the impact of the added labels on participants' ability to accurately match their medication to the indication for which it was prescribed when placed i...

What factors affect patients' recall of general practitioners' advice?

BMC Family Practice — Wed, 28 Dec 2011 05:00:00 +0100

Background: In order for patients to adhere to advice, provided by family doctors, they must be able to recall it afterwards. However, several studies have shown that most patients do not fully understand or memorize it. The aim of this study was to determine the influence of demographic characteristics, education, amount of given advice and the time between consultations on recalled advice. Methods: A prospective survey, lasting 30 months, was conducted in an urban family practice in Slovenia. Logistic regression analysis was used to identify the risk factors for poorer recall. Results: 250 patients (87.7% response rate) received at least one and up to four pieces of advice (2.4+/-0.8). A follow-up consultation took place at 47.4+/-35.2 days. The determinants of better recall were high sc...

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Obesity management and continuing medical education in primary care: results of a Swiss survey

BMC Family Practice — Thu, 22 Dec 2011 05:00:00 +0100

Conclusions: The majority of GPs followed guideline recommendations promoting physical activity and dietary counselling. We observed a gap between the increasing evidence for waist circumference assessment as an important measure in obesity management and actual clinical practice. Our data indicated that specific obesity-related CME might help to reduce this gap. (Source: BMC Family Practice)

Beliefs About Who Should Be Tested for HIV Among African American Individuals Attending a Family Practice Clinic

AIDS Patient Care and STDs — Tue, 20 Dec 2011 21:51:27 +0100

AIDS Patient Care and STDs Jan 2012, Vol. 26, No. 1: 1-4. (Source: AIDS Patient Care and STDs)

Does Clinical Exam Aid in the Diagnosis of UTIs in Women?Does Clinical Exam Aid in the Diagnosis of UTIs in Women?

Medscape Today Headlines — Tue, 20 Dec 2011 04:00:00 +0100

Urinary tract infection is one of the most common bacterial infections seen in primary care. But clinical findings on their own may not be enough to provide a reliable diagnosis. BMC Family Practice (Source: Medscape Today Headlines)

[Stigmatisation of psychiatric patients by general practitioners and medical students: a review of the literature].

Tijdschrift voor Psychiatrie — Sun, 18 Dec 2011 09:30:02 +0100

Authors: Adriaensen K, Pieters G, De Lepeleire J Abstract summary background In clinical practice general practitioners (gps) and society tend to stigmatise patients with psychiatric problems. aim To attempt to describe this stigmatisation by gps and medical students on the basis of information given in the literature. method We searched the literature via PubMed using mesh terms: ‘family practice’,‘physicians’, ‘family’, ‘mental disorder’, &ls...

Using your electronic medical record for research: a primer for avoiding pitfalls

ICMCC: The International Council on Medical and Care Compunetics — Fri, 16 Dec 2011 19:30:33 +0100

Source: Terry AL et al, Family Practice, 27(1) Content: In Canada, use of electronic medical records (EMRs) among primary health care (PHC) providers is relatively low. However, it appears that EMRs will eventually become more ubiquitous in PHC. This represents an important development in the use of health care information technology as well as a [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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Potential application of item-response theory to interpretation of medical codes in electronic patient records

BMC Medical Research Methodology - Latest articles — Fri, 16 Dec 2011 05:00:00 +0100

Conclusion: The application of item response theory models to coded electronic patient records might potentially contribute to identifying medical codes that offer poor discrimination or low calibration. This might indicate the need for improved coding sets or a requirement for improved clinical coding practice. However, in this study estimates were only obtained for a small proportion of participants and there was some evidence of poor model fit. There was also evidence of variation in the utilisation of codes between family practices raising the possibility that, in practice, properties of codes may vary for different coders. (Source: BMC Medical Research Methodology - Latest articles)

Disease management for co-morbid depression and anxiety in diabetes mellitus: design of a randomised controlled trial in primary care

BMC Family Practice — Thu, 15 Dec 2011 05:00:00 +0100

DiscussionThe disease management model for co-morbid depression and anxiety in primary care patients with diabetes is expected to result in reduced symptoms of depression and anxiety, improved quality of life, reduced diabetes specific distress and improved glyceamic control, compared to care as usual.Trial registration: Dutch Trial Register NTR2626 (Source: BMC Family Practice)

Family Doctor Responses to Changes in Incentives for Influenza Immunization under the U.K. Quality and Outcomes Framework Pay‐for‐Performance Scheme

Health Services Research — Thu, 15 Dec 2011 05:00:00 +0100

ConclusionsMaking quality targets more demanding can not only lead to improvement in quality of care but can also have other consequences. (Source: Health Services Research)

Predictors of the quality of cardiovascular prevention - a multilevel cross-sectional study.

Croatian Medical Journal — Thu, 15 Dec 2011 05:00:00 +0100

Conclusion. This study shows that the quality of cardiovascular prevention could be measured as a composite outcome and future studies should further develop this approach and test the impact of several practice/patient characteristics on the quality of CVD prevention with the international data. PMID: 22180271 [PubMed - in process] (Source: Croatian Medical Journal)

Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice

BMC Family Practice — Tue, 13 Dec 2011 05:00:00 +0100

Conclusions: Several context factors seem to influence doctor-patient communication, requiring the GP to apply communication skills differently from recommendations on communication. From this study we conclude that there is a need to explicitly account for context factors in the assessment of GP (and GP registrar) communication performance. The next step is to validate our findings. (Source: BMC Family Practice)

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Workload of Rural vs Urban Primary Care Physicians in GermanyWorkload of Rural vs Urban Primary Care Physicians in Germany

Medscape Today Headlines — Tue, 13 Dec 2011 04:00:00 +0100

Many countries are facing a shortage of primary care physicians, especially in rural areas--perhaps due to the perception that rural physicians have a higher workload. Is it true? BMC Family Practice (Source: Medscape Today Headlines)

Evaluation of job satisfaction of practice staff and general practitioners: an exploratory study

BMC Family Practice — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions: Non-physician staff evaluate their job satisfaction higher than GPs except recognition for work. Job satisfaction of members of primary care teams is important because poor satisfaction is associated with suboptimal healthcare delivery, poor clinical outcomes and higher turnover of staff. (Source: BMC Family Practice)

Letters: Readers comment on Medical Economics stories

Modern Medicine — Sat, 10 Dec 2011 05:00:00 +0100

Letters discuss guidelines, electronic health records, and the difference between family practice specialists and general practitioners. (Source: Modern Medicine)

New Research Aims To Help Transient Ischaemic Attack (TIA) Patients By Assessing Their Risk Of Stroke

Health News from Medical News Today — Tue, 06 Dec 2011 08:00:00 +0100

Research carried out by the HRB Centre for Primary Care Research, based in the Royal College of Surgeons in Ireland (RCSI), recently published in the journal Family Practice aims to help patients that have suffered a transient ischaemic attack (TIA), otherwise known as a "mini-stroke" by assessing their risk of subsequent stroke. Clinical Prediction Rule's (CPR's) are used regularly by doctors to help identify the best combination of medical signs and symptoms in order to predict the likelihood of a patient experiencing a specific disorder... (Source: Health News from Medical News Today)

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

BMC Family Practice — Tue, 06 Dec 2011 05:00:00 +0100

Conclusions: The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete. (Source: BMC Family Practice)

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Primary Care Models for Prevention of Cardiovascular DiseasePrimary Care Models for Prevention of Cardiovascular Disease

Medscape Today Headlines — Tue, 06 Dec 2011 04:00:00 +0100

This study compared the quality of preventive cardiovascular care among different primary care delivery models. Are there significant differences? BMC Family Practice (Source: Medscape Today Headlines)

Utilization characteristics of spinal interventions

The Spine Journal — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions: These findings demonstrate that relatively few providers are responsible for a disproportionately high percentage of interventional spine procedures. This pattern of marked overutilization by a minority of providers is the dominant characteristic of utilization within all specialties. (Source: The Spine Journal)

Knowledge, attitudes, practices, and barriers reported by patients receiving diabetes and hypertension primary health care in Barbados: a focus group study

BMC Family Practice — Fri, 02 Dec 2011 05:00:00 +0100

Conclusions: Primary care providers should take a more patient centred approach to the care of those with diabetes and hypertension. The care system should provide better service by reducing waiting times. Patient self-management could be encouraged by a patient version of care guidelines and greater educational efforts. (Source: BMC Family Practice)

Guidelines on acute gastroenteritis in children: a critical appraisal of their quality and applicability in primary care.

BMC Family Practice — Fri, 02 Dec 2011 05:00:00 +0100

Conclusions: The present study shows considerable variation in the quality of guidelines on AGE in children, as well as inconsistencies between the recommendations. It remains unclear how to asses the extent of dehydration and determine the preferred treatment or referral of a young child with AGE presenting in general practice. (Source: BMC Family Practice)

Prenatal Care: Touching the Future

Primary Care: Clinics in Office Practice — Fri, 02 Dec 2011 05:00:00 +0100

The provision of preconception and prenatal care is a critical and time-honored role for family physicians. It could even be termed the first preventive care a human being receives. It has been suggested by some studies that, because of the continuity of care that is considered a cornerstone of family practice, family physicians provide prenatal care that may improve birth outcome. Although prenatal care is acknowledged as important for a healthy pregnancy and delivery, there is debate regarding the true efficacy of prenatal care. (Source: Primary Care: Clinics in Office Practice)

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Child and adolescent mental health care in Dutch general practice: Time trend analyses

BMC Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

This study aims to investigate the identification and treatment of child and adolescent mental health problems in general practice over a five-year period (2004-2008). Methods: Data of patients aged 0-18 years (N ranging from 37716 to 73432) were derived from electronic medical records of 42-82 Dutch general practices. Time trends in the prevalence of recorded mental health problems, prescriptions for psychotropic medication, and referrals to primary and secondary mental health care were analysed. Results: In 2008, 6.6% of children and 7.5% of adolescents were recorded as having mental health problems; 15.2% of these children and 29.4% of these adolescents were prescribed psychotropic medication; 18.9% of these children and 22.9% of these adolescents were referred, mainly to secondary ment...

Diabetes and alcohol use: Detecting at-risk drinking.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Engler PA, Ramsey SE Abstract Asking a simple question helps uncover at-risk drinking in patients with diabetes, and brief office interventions have proven effective in modifying behavior. PMID: 22163365 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: Ferning in amniotic fluid: Is it a useful indicator of ruptured membranes?

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Gaddey H, Bailey J, Smith RF Abstract Yes. The presence of arborized crystals (ferning) in amniotic fluid is both sensitive (74% -100%) and specific (77% -100%) for diagnosing rupture of membranes in laboring women who report loss of fluid. However, it is much less sensitive and specific for women with fluid loss who aren't in labor. PMID: 22163364 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: Should you test for H pylori in patients with nonulcer dyspepsia?

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Lanier JB, Wilder L Abstract Possibly. Helicobacter pylori increases the risk of developing peptic ulcer disease, but there is no evidence that treating H pylori reduces that risk. PMID: 22163363 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: What should you tell pregnant women about exposure to parvovirus?

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Snyder M, Wallace R Abstract Tell patients that parvovirus infections before 20 weeks' gestation confer a risk of fetal morbidity and mortality as high as 16%, but don't significantly increase long-term developmental sequelae. PMID: 22163362 [PubMed - in process] (Source: The Journal of Family Practice)

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Clinical Inquiry: How can we minimize recurrent ankle sprains?

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Hemphill B, Whitworth JD, Smith RF Abstract Using external ankle supports during physical activity significantly reduces the likelihood of primary and secondary sprains. PMID: 22163361 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: What treatment is best for hypertrophic scars and keloids?

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Williams CC, De Groote S Abstract No one treatment is best; no good evidence exists comparing treatments with each other. PMID: 22163360 [PubMed - in process] (Source: The Journal of Family Practice)

Acute abdominal pain in an elderly patient.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Poulin MF, Yegneswaran B Abstract A possible large bowel obstruction and severe dehydration prompted us to admit this patient. But a day later, the clinical picture became even more worrisome. PMID: 22163359 [PubMed - in process] (Source: The Journal of Family Practice)

PURLs: Offer this contraceptive to breastfeeding new moms.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Jones K, Egan M, Stevermer JJ Abstract Early insertion of the etonogestrel implant does not affect lactogenesis, and fosters contraceptive compliance. PMID: 22163358 [PubMed - in process] (Source: The Journal of Family Practice)

PURLs: Postprostatectomy incontinence? Here's help.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Sharma U Abstract Behavioral therapy is an effective treatment for incontinence related to prostatectomy. PMID: 22163357 [PubMed - in process] (Source: The Journal of Family Practice)

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CDC update on gonorrhea: Expand treatment to limit resistance.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Campos-Outcalt D Abstract In all cases, add azithromycin to ceftriaxone or an acceptable alternative agent, and screen asymptomatic individuals at high risk of infection. PMID: 22163356 [PubMed - in process] (Source: The Journal of Family Practice)

Detecting and treating delirium--key interventions you may be missing.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Ghandour A, Saab R, Mehr DR Abstract Early identification of risk factors for delirium and routine use of screening are often overlooked--with dire effects. Here's what to look for and how to respond. PMID: 22163355 [PubMed - in process] (Source: The Journal of Family Practice)

How best to address these common movement disorders.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Yaman A, Akdeniz M, Yaman H Abstract This review describes how to manage everything from Parkinson's disease and tic disorders to restless legs syndrome and ataxia. PMID: 22163354 [PubMed - in process] (Source: The Journal of Family Practice)

Inhalation therapy: Help patients avoid these mistakes.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Self TH, Wallace JL, George CM, Howard-Thompson A, Schrock SD Abstract Faulty technique can sabotage the best of treatment plans for asthma and COPD. Here are some common errors and how you can help patients avoid them. PMID: 22163353 [PubMed - in process] (Source: The Journal of Family Practice)

There's no substitute for a family physician.

The Journal of Family Practice — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Susman J PMID: 22163352 [PubMed - in process] (Source: The Journal of Family Practice)

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GPs Hesitate to Refer Diabetics to a Self-Management ProgramGPs Hesitate to Refer Diabetics to a Self-Management Program

Medscape Today Headlines — Tue, 29 Nov 2011 11:50:23 +0100

This paper reports on a study exploring why a substantial number of GPs were reluctant to refer patients to a self-management education program. What lessons can be learned? BMC Family Practice (Source: Medscape Today Headlines)

Incident somatic comorbidity after psychosis: results from a retrospective cohort study based on Flemish general practice data

BMC Family Practice — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion: Significantly higher morbidity rates for some somatic conditions in patients with psychosis are apparent. People with a diagnosis of psychosis benefit from regular assessments for the emergence of somatic disorders and risk factors, including diabetes in case of atypical antipsychotic medication. (Source: BMC Family Practice)

A Mobile Phone Application for the Assessment and Management of Youth Mental Health Problems in Primary Care: A Randomised Controlled Trial

BMC Family Practice — Tue, 29 Nov 2011 05:00:00 +0100

Conclusions: Monitoring mental health symptoms appears to increase ESA and implementing a mental health program in primary care and providing frequent reminders, clinical resources and support to GPs substantially improved mental health outcomes for the sample as a whole.Trial Registration: ClinicalTrials.gov NCT00794222. (Source: BMC Family Practice)

A cluster randomised pragmatic trial applying Self-determination theory to type 2 diabetes care in general practice

BMC Family Practice — Thu, 24 Nov 2011 05:00:00 +0100

DiscussionChallenges and advantages of the pragmatic design are discussed. In a real-world setting, this study will determine the impact on motivation, HbA1c, cholesterol, and well-being for people with diabetes by offering a training course in autonomy support to practice-nurses from general practices with nurse-led consultations.Trial registration: Clinical Trials Gov. Identifier NCT01187069 (Source: BMC Family Practice)

The epidemiology and natural history of depressive disorders in Hong Kong's primary care

BMC Family Practice — Thu, 24 Nov 2011 05:00:00 +0100

DiscussionThe study will provide information regarding cross-sectional prevalence, 12 month incidence, remission rate, outcomes and factors affecting outcomes of patients with depressive disorders in primary care. The epidemiology, outcomes, pathways of care, predictors for prognosis and service needs for primary care patients with depressive disorders will be described and recommendations made for policy and service planning. (Source: BMC Family Practice)

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Safety incidents in family medicine

Quality and Safety in Health Care — Wed, 23 Nov 2011 05:00:00 +0100

Conclusion MSCP has developed and implemented the first safety learning system in Canada for family practice. All clinic members were encouraged to submit reports, but most of the incidents were reported by physicians. The vast majority of incidents reported were preventable with limited severity. The most frequently reported types of incidents fell into the categories of documentation and medication. The low reporting rates suggest that for family practices incident reporting may not be the most effective method to determine the types and frequency of incidents in family medicine. (Source: Quality and Safety in Health Care)

Identifying unintended consequences of quality indicators: a qualitative study

Quality and Safety in Health Care — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions It is important to identify concerns and experiences about unintended consequences of indicators at an early stage when there is time to remove or adapt problem indicators. Since the UK government currently spends over £1 billion each year on QOF, the £150 000 spent on each piloting cohort (0.0005% of the total QOF budget) appears to be good value for money. (Source: Quality and Safety in Health Care)

Effect of Lifestyle Intervention for People With DiabetesEffect of Lifestyle Intervention for People With Diabetes

Medscape Today Headlines — Tue, 22 Nov 2011 11:50:24 +0100

The integration of healthy lifestyle interventions into primary care is challenging--and the prevalence of T2DM is increasing. Can an effective program be developed? BMC Family Practice (Source: Medscape Today Headlines)

Do guidelines on first impression make sense? Implementation of a chest pain guideline in primary care: a systematic evaluation of acceptance and feasibility

BMC Family Practice — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions: Overall, the participating GPs perceived the guideline recommendations as useful to increase awareness and to reflect on diagnostic issues. Although behaviour change in consequence of the guideline was not reported on a general level, guidelines on history taking and the clinical examination may serve an important conservative and practical function in a technology driven environment. Further research to increase the implementation success of the guideline should be undertaken. (Source: BMC Family Practice)

Differences Between Family Practices in the Associations of Patient Characteristics With Health Care Experiences

Medical Care Research and Review — Mon, 21 Nov 2011 05:00:00 +0100

When comparing health care providers, patient experience data are usually adjusted for case-mix associations to ensure fair comparisons. Previous studies in the United States showed that case-mix associations sometimes vary across health care providers. Such variation could indicate differential provider behavior for patient subgroups, in which case current adjustment techniques might be inappropriate. To see whether this variation is also apparent in a health care system different from the U.S. system, the authors analyzed Dutch patients’ experiences with family practice care. Using multilevel random slope models, the associations between age, general health status, mental health status, education, sex, and ethnicity on one hand and reported experiences on the other hand were assess...

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Research Calls For More Personalized Approach To Smear Tests

Health News from Medical News Today — Sun, 20 Nov 2011 08:00:00 +0100

Women's personal testimonies of cervical smear testing in the UK show that their experiences are often far from positive, says a new study from the University of Leicester published in the international journal Family Practice. The study reveals the stress, anxieties, as well as pain that women can suffer when they undergo the test, which involves taking cells from the cervix using special instruments. Women say that they are not always treated with the kindness and sensitivity that they would like... (Source: Health News from Medical News Today)

Purpose and procedure

Evidence-Based Medicine — Sun, 20 Nov 2011 05:00:00 +0100

Cervical Smears - The Stress And Humiliation

Health News from Medical News Today — Fri, 18 Nov 2011 15:00:00 +0100

According to a new investigation from the University of Leicester published yesterday in the international journal Family Practice, testimonies from women's personal experience of cervical smear testing in the UK are frequently negative. The investigation highlights the anxieties, stress and pain that some women suffer during the test. Cervical smear tests involve removing cells from the cervix using special instruments... (Source: Health News from Medical News Today)

Treatment of depressive disorders in primary care - protocol of a multiple treatment systematic review of randomized controlled trials

BMC Family Practice — Tue, 15 Nov 2011 05:00:00 +0100

DiscussionPractitioners do not only want to know whether there is evidence that a specific treatment is more effective than placebo, but also how the treatment options compare to each other. Therefore, we believe that a multiple treatment systematic review of primary-care based randomized controlled trials on the most important therapies against depression is timely. (Source: BMC Family Practice)

Early detection of colorectal cancer: barriers to screening in the primary care setting

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

(Source: Family Practice)

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Gynaecological symptoms reported by young women: examining the potential for earlier diagnosis of cervical cancer

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Gynaecological complaints are frequent in primary care, though the symptoms of possible cervical cancer only represent a small minority of the total. Although the chance of cancer in young women with abnormal vaginal bleeding is very small, visualization of the cervix is appropriate. (Source: Family Practice)

Treatment of 5413 hypertensive patients: a cross-sectional study

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusion. In general practice, the proportion of hypertensive patients achieving optimal BP control is inadequate. The majority of hypertensive patients are treated with only one or two antihypertensive drugs. (Source: Family Practice)

Presentation, antibiotic management and associated outcome in Polish adults presenting with acute cough/LRTI

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Antibiotics continue to be frequently prescribed for acute cough/LRTI in Poland, and the decision to prescribe was strongly associated with clinicians’ findings of abnormalities on auscultation and diagnosis of LRTI. Delayed prescribing was infrequent. Mucolytics were commonly prescribed despite evidence of no effect. (Source: Family Practice)

GenetiKit: a randomized controlled trial to enhance delivery of genetics services by family physicians

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. This study demonstrated that a complex educational intervention was able to significantly improve practice intent for clinical genetics scenarios found in primary care, as well as confidence in genetics skills. (Source: Family Practice)

Variation in formulary adherence in general practice over time (2003-2007)

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. General practice information networks are useful for monitoring general patterns of formulary on a year-to-year basis. Formulary adherence is stable over time but varies across diagnoses, patients and general practices. In the past decade, efforts have been made to increase the level of formulary adherent prescribing. These general efforts managed to stabilize (variation in) adherence in a field where many other initiatives (e.g. by pharmaceutical companies) are undertaken to influence prescribing behaviour. (Source: Family Practice)

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Family physicians beliefs and attitudes regarding adult pneumococcal and influenza immunization in Lebanon

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Education and intervention efforts are needed to overcome barriers faced by practitioners and to define the most effective strategies to overcoming these barriers. (Source: Family Practice)

Disparities in testing for renal function in UK primary care: cross-sectional study

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Quality improvement initiatives and equity audits, which include CKD should take account of disparities in renal function testing. (Source: Family Practice)

Views of health professionals on the role of primary care in the follow-up of men with prostate cancer

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. If primary care is to play a significant role in providing high-quality follow-up care for men with prostate cancer, then steps need to be taken to address the barriers to increased primary care involvement identified by this study. (Source: Family Practice)

What's in a name: integrative medicine or simply good medical practice?

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. The concept and practice of integrative medicine among the doctors interviewed were diverse. This has implications for the Royal Australian College of General Practitioners inclusion criteria for the membership of their integrative medicine chapter. More broadly, the findings have implications for all medical practice and the education of medical students, as much of what integrative medicine doctors do may be considered simply as ‘good medical practice’. (Source: Family Practice)

A multi-country qualitative study of clinicians' and patients' views on point of care tests for lower respiratory tract infection

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Acceptability of POCTs to clinicians is likely to be improved if tests perform well on accuracy, time to result, simplicity and cost. Including POCTs in the routine management of acute cough/LRTI is likely to be acceptable to most patients. (Source: Family Practice)

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Obstacles to colorectal screening in general practice: a qualitative study of GPs and patients

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Numerous obstacles to colorectal screening, from both the physicians’ and the patients’ perspectives, were found. The major goal to improve mass screening may be to increase awareness and understanding of both physicians and patients regarding this process. (Source: Family Practice)

Management of out-of-hours calls by a general practice cooperative: a geographical analysis of telephone access and consultation

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Patients experience differences in how their call to out-of-hours services is managed depending on where they live. Telephone access and consultation can be used to overcome geographical barriers but do not necessarily make access geographically equitable. Those who live furthest away are more likely to receive telephone advice rather than being seen face-to-face, but paradoxically, those who do get a home visit are more likely to live at a greater distance from the PCC. These findings present important challenges to proposals to integrate urgent care services and increase telephone-based provision and suggest that attention should be given to configuring services to ensure geographical equity of access, regardless of how far away people live from health services. (Source: Fam...

Validity of self-reported colorectal cancer test use in different racial/ethnic groups

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Self-report prevalence data are overestimating CRC test use in all groups; current measures are less sensitive in Hispanics. (Source: Family Practice)

Recruiting end-of-life cancer patients in the Netherlands for a study on suffering and euthanasia requests

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Recruitment of slightly more than the minimal target number of end-of-life cancer patients in this study in general practice was realized. Monitoring of all eligible patients permitted to evaluate the selection which occurred. Recruitment through GPs who were direct professional colleagues of one of the researchers was a positive recruitment factor. (Source: Family Practice)

Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montreal

BMC Family Practice — Thu, 10 Nov 2011 05:00:00 +0100

DiscussionOur study will identify contextual factors associated with the effectiveness, successful implementation and sustainability of such a program. The contextual information will enable us to extrapolate our results to other contexts with similar conditions.Trial registration: ClinicalTrials.gov NCT01326130 (Source: BMC Family Practice)

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GP Characteristics and Delay in Cancer DiagnosisGP Characteristics and Delay in Cancer Diagnosis

Medscape Today Headlines — Tue, 08 Nov 2011 11:20:19 +0100

Delay in cancer diagnosis may have serious prognostic consequences. Are certain practitioner characteristics more likely to be associated with delayed diagnosis? BMC Family Practice (Source: Medscape Today Headlines)

Patients' evaluations of European general practice--revisited after 11 years

International Journal for Quality in Health Care — Mon, 07 Nov 2011 05:00:00 +0100

Conclusion Overall, the patients' evaluations of general practice were very positive in family practice care in the years 1998 and 2009. The trends over the years need to be carefully interpreted over time. (Source: International Journal for Quality in Health Care)

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol

BMC Family Practice — Sat, 05 Nov 2011 04:00:00 +0100

This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity.Trials Registration: ClinicalTrials.gov (NCT01282190) (Source: BMC Family Practice)

Doctor Is Indicted in Medicare Case

WSJ.com: Health — Fri, 04 Nov 2011 23:31:20 +0100

A New York-area family-practice doctor who was featured in a WSJ article about Medicare abuses last year was indicted by a federal grand jury this week for allegedly submitting more than $13 million of false claims to the program. (Source: WSJ.com: Health)

Beliefs About Who Should Be Tested for HIV Among African American Individuals Attending a Family Practice Clinic

AIDS Patient Care and STDs — Fri, 04 Nov 2011 20:43:06 +0100

AIDS Patient Care and STDs , Vol. 0, No. 0. (Source: AIDS Patient Care and STDs)

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"Opportunities for primary and secondary prevention of excess gestational weight gain: General Practitioners' perspectives"

BMC Family Practice — Fri, 04 Nov 2011 03:42:43 +0100

Conclusions: GPs were aware of the importance of healthy GWG yet routine weighing was not standard practice for diverse reasons. Management of GWG and perspectives of the issue varied widely. Time efficient and cost effective interventions may assist GPs in ensuring women are supported in achieving healthy GWG to provide optimal maternal and infant health outcomes. (Source: BMC Family Practice)

Early identification of and proactive palliative care for patients in general practice, incentive and methods of a randomized controlled trial

BMC Family Practice — Thu, 03 Nov 2011 04:00:00 +0100

DiscussionWe expect that this study will increase the number of identified palliative care patients and improve different aspects of quality of palliative care. This is of importance to improve palliative care for patients with COPD, CHF and cancer and their informal caregivers, and to empower the GP. The study protocol is described and possible strengths and weaknesses and possible consequences have been outlined. The Netherlands National Trial Register: NTR2815 (Source: BMC Family Practice)

The prevalence of undiagnosed chronic obstructive pulmonary disease in a primary care population with respiratory tract infections - a case finding study

BMC Family Practice — Thu, 03 Nov 2011 04:00:00 +0100

Background: Chronic obstructive pulmonary disease (COPD) is an underdiagnosed cause of morbidity and mortality worldwide. Prevalence of COPD has been shown to be highly associated with positive smoking history and increasing age. Spirometry is the method used for diagnosing COPD. However, identifying patients at risk of COPD to undergo spirometry tests has been challenging. Therefore, there is a need for new cost-effective and feasible diagnostic screening procedures for use in primary care centers. Our aim was to describe the prevalence and severity of undiagnosed COPD in a group of patients with respiratory infections attending urgent primary care, and to identify those variables in patients' history that could be used to detect the disease. Methods: Patients of 40-75 years (n=138) atten...

Management of asthma in pregnant women by general practitioners: A cross sectional survey

BMC Family Practice — Thu, 03 Nov 2011 04:00:00 +0100

Conclusion: A lack of confidence and/or knowledge among general practitioners in managing deteriorating asthma in pregnancy was observed despite a good understanding of the safety of asthma medications during pregnancy, compliance with evidence-based guidelines in the selection of preventive medications, and self reported good asthma knowledge. (Source: BMC Family Practice)

Psychosocial stressors and depression at a Swedish primary health care centre: a gender perspective study

BMC Family Practice — Wed, 02 Nov 2011 04:00:00 +0100

Background: Psychosocial stress may account for the higher prevalence of depression in women and in individuals with a low educational background. The aim of this study was to analyse the association between depression and socio-demographic data, psychosocial stressors and lifestyle circumstances from a gender perspective in a relatively affluent primary care setting. Methods: Patients, aged 18- 75 years, visiting a drop-in clinic at a primary care health centre were screened with Beck's Depression Inventory (BDI). The physicians used also targeted screening with BDI. A questionnaire on socio-demographic data, psychosocial stressors and use of alcohol and tobacco was distributed. Among patients, who scored BDI [greater than or equal to]10, DSM-IV-criteria were used to diagnose depression. ...

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General practitioners' views and experiences of counselling for physical activity through the New Zealand Green Prescription program

BMC Family Practice — Wed, 02 Nov 2011 04:00:00 +0100

Conclusions: The results of this study suggest that New Zealand GPs view the Green Prescription program as beneficial for their patients with pre-existing conditions and/or weight problems. While this is encouraging, the Green Prescription may also be used to promote physical activity in currently healthy but low-active and sedentary individuals. Such individuals are currently disease free, but are at risk for future health-related problems because of their inactive lifestyle. It is recommended that time constraints of the consultation in regard to administering Green Prescriptions could be dealt with by delegating the more time consuming tasks to the patient support counsellors that support the Green Prescription program, and having practice nurses assist in the administration of Green Pr...

Incidence of Kidney Diseases After a Albuminuria Self-TestIncidence of Kidney Diseases After a Albuminuria Self-Test

Medscape Today Headlines — Tue, 01 Nov 2011 10:20:20 +0100

This study looked at the impact of a nationwide albuminuria self-test program on the number of newly diagnosed patients with kidney disease. What group showed the highest risk? BMC Family Practice (Source: Medscape Today Headlines)

Understanding adolescent and young adult use of family physician services: a cross-sectional analysis of the Canadian Community Health Survey

BMC Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: We highlight key messages not known previously for adolescent and young adult use of family physician services. There is inequity concerning regional variation and for those who do not have a regular medical doctor. There is variation in factors associated with family physician services across the three age groups of adolescence. Health care and health care policies aimed at younger adolescents must consider that parents are still the primary decision-maker while older adolescents are more autonomous. There is variation in the factors associated with the two outcomes of utilization and intensity of services. Factors associated with utilization must be understood when considering the equitability of access to primary health care while factors associated with intensity must be u...

Patient safety culture measurement in general practice. Clinimetric properties of SCOPE

BMC Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time. (Source: BMC Family Practice)

Bromocriptine: Its place in type 2 diabetes Tx.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Sando KR, Taylor J Abstract Patients intolerant of other diabetes medications or requiring minimal A1c reduction may benefit from bromocriptine. PMID: 22049355 [PubMed - in process] (Source: The Journal of Family Practice)

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Clinical Inquiry: Which combination drug therapies are most effective for hypertension?

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Crawford P, Dy D, Carney M Abstract Insufficient evidence exists to determine which specific combinations most effectively decrease cardiovascular morbidity and mortality, although combinations of hypertension medications at lower doses generally reduce cardiovascular outcomes (stroke, coronary heart disease) more than monotherapy. PMID: 22049354 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: Which regimen treats vitamin D deficiency most effectively?

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Osborn J, Germann A, St Anna L Abstract Several vitamin D replacement regimens are effective. Cumulative dosing may be more important than frequency of dosing. PMID: 22049353 [PubMed - in process] (Source: The Journal of Family Practice)

Clinical Inquiry: What's best for croup?

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Pitluk JD, Uman H, Safranek S Abstract A single dose of Corticosteroids is the first-line treatment for croup, resulting in fewer return visits and hospital admissions, shorter lengths of stay in the emergency department or hospital, and less need for supplemental medication. PMID: 22049352 [PubMed - in process] (Source: The Journal of Family Practice)

Breast swelling and erythema in a teen.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Lester JL, Buccolo LS, McAdams CA Abstract An ED doctor suspected a cat scratch was to blame and prescribed antibiotics. A week later, though, the patient developed dyspnea. PMID: 22049351 [PubMed - in process] (Source: The Journal of Family Practice)

PURLs: Ear wax removal: Help patients help themselves.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Rogers N, Stevermer JJ Abstract Do-it-yourself ear wax removal is safe and simple--and a timesaver for patients as well as physicians. PMID: 22049350 [PubMed - in process] (Source: The Journal of Family Practice)

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PURLs: Zinc for the common cold-not if, but when.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Rao G, Rowland K Abstract A new meta-analysis shows that zinc supplementation can reduce the duration and severity of a cold, if it's started early on. PMID: 22049349 [PubMed - in process] (Source: The Journal of Family Practice)

Managing eczema in children--a treatment update.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Dempster J, Jani B, Daly T Abstract What's the best way to manage pediatric atopic dermatitis? Do alternative remedies work? This evidence-based review--and easy-to-use treatment formula--answers these questions. PMID: 22049348 [PubMed - in process] (Source: The Journal of Family Practice)

Identifying cognitive impairment during the Annual Wellness Visit: Who can you trust?

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

This study found that patients, family members, and even physicians have trouble detecting cognitive impairment. A better bet: Routinely administer an objective cognition test. PMID: 22049347 [PubMed - in process] (Source: The Journal of Family Practice)

Getting injured runners back on track.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Butts JF, Gebke KB Abstract With more people running--and incurring lower extremity injuries--than ever before, you'll have many occasions to use this handy diagnostic and treatment guide. PMID: 22049346 [PubMed - in process] (Source: The Journal of Family Practice)

Introducing industry direct.

The Journal of Family Practice — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Susman J PMID: 22049345 [PubMed - in process] (Source: The Journal of Family Practice)

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Complaints against family physicians submitted to disciplinary tribunals in the Netherlands: lessons for patient safety.

Annals of Family Medicine — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS The disciplinary law system in the Netherlands differs fundamentally from a legal malpractice system. It can be used to learn from patients' complaints with a view on improving patient safety. PMID: 22084263 [PubMed - in process] (Source: Annals of Family Medicine)

A day in my practice in 2020.