Family practice
-
Multicenter Study Comparative Study Clinical Trial
Do GPs prescribe antidepressants differently for South Asian patients?
In spite of evidence from controlled trials and published guidelines, general practitioners prescribe antidepressants in lower doses and for shorter courses than are recommended [2]. However, these studies have not examined the effect of ethnicity on antidepressant prescribing by general practitioners. ⋯ The results suggest that successful drug treatment of depressed South Asian patients may be less likely than in White patients.
-
Comparative Study
A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations.
We aimed to compare a new primary care outcome measure-the Patient Enablement Instrument (PEI)-against two established satisfaction measures [the Medical Interview Satisfaction Scale (MISS) and the Consultation Satisfaction Questionnaire (CSQ)]. Specifically, we sought (i) to test whether enablement and satisfaction are related or separate concepts; and (ii) to assess whether the internal consistency of the PEI might be enhanced by the inclusion of items from the satisfaction instruments. ⋯ The study shows that 'enablement' is a primary care outcome measure which is related to but is different from general satisfaction.
-
We aimed to analyse factors influencing referral of patients by primary care physicians to specialist consultants at the beginning of the era of direct access to specialists in Israel. ⋯ The results of this study can be used as an aid for decision makers in the health services for determining policy. Direct access to some specialties might be appropriate, but not to all. Adoption of a policy based on these findings could lead to reduced health care costs by reducing the burden on hospital emergency rooms. It might also increase patient satisfaction in that the patients will have greater freedom of choice. On the other hand, more appropriate training of family physicians and more extensive self- and peer-quality assurance will increase the primary physician's knowledge and ability to diagnose and treat a broad range of problems and improve the level of care.
-
The London Academic Training Scheme (LATS) provides a 1-year training programme in research methods and teaching for GPs who have recently finished vocational training. This paper describes an adult educational approach to learning about research methods through teaching as part of the LATS trainees' weekly academic programme. ⋯ The active involvement of learners as teachers is a practical and rewarding means of using adult educational principles in providing an academic programme.
-
Randomized Controlled Trial Clinical Trial
Changing attitudes to infection management in primary care: a controlled trial of active versus passive guideline implementation strategies.
When attempting to implement evidence-based medicine, such as through clinical guidelines, we often rely on passive educational tactics, for example didactic lectures and bulletins. These methods involve the recipient in relatively superficial processing of information, and any consequent attitude changes can be expected to be short-lived. However, active methods, such as practice-based discussion, should involve recipients in deep processing, with more enduring attitude changes. In this experiment, the aim was to assess the efficacy of an active strategy at promoting deep processing and its effectiveness, relative to a typical passive method, at changing attitudes between groups of GPs over 12 months across an English Health District. ⋯ An active educational strategy attracted more participation and was more effective at generating deep cognitive processing than a passive strategy. A large improvement, lasting for at least 12 months, in attitude-compliance with guidelines on the optimal treatment of infections was imparted by the active processing method. A typical passive method was much less popular and had an insignificant impact on attitudes. The findings suggest that initiatives aiming to implement evidence-based guidelines must employ active educational strategies if enduring changes in attitude are to result.