Family practice
-
Prescribing of proton-pump inhibitors has substantially increased. Information from clinical settings is warranted to gain insight into reasons for prescribing. ⋯ Most patients treated with proton-pump inhibitors are treated daily, on a long-term basis, and due to symptoms. Few consultations led to alterations in treatment, and only 25% of patients had a consultation regarding proton-pump inhibitor treatment with their general practitioner within the last year. Substantial variability between general practitioners with regard to management was detected.
-
Provoked Vulvodynia (PVD) is the most common cause of vulvar pain. General practitioners (GPs) are insufficiently familiar with it, causing a delay in many women receiving correct diagnosis and treatment. Besides patients factors, this delay can partly be explained by the reluctance of GPs to explore the sexual context of PVD and by their negative emotional reactions such as helplessness and frustration when consulted by patients with medically unexplained symptoms like PVD. ⋯ Women with PVD prefer a patient-centred approach and want GPs to acknowledge their autonomy and to address sexuality proactively.
-
Health inequalities are an emerging issue in ageing societies, but inequalities in pre-frailty, which is suffered by almost half of older people, are mostly unknown. ⋯ Older individuals with a lower SES were less likely to recover from a pre-frailty status.
-
The culture at a medical school and the positive experiences in primary care clerkships influence student specialty choice. This choice is significant if the demand for primary care physicians is to be met. The aim of this study was to examine family medicine clerkship directors' perceptions of the medical school environment. ⋯ Family medicine clerkship directors often perceived negativity towards family medicine, a finding that may limit the effectiveness of academic health centres in their mission to better serve their community and profession.
-
In Germany, almost 50% of prescriptions for benzodiazepines and drugs as Zolpidem and Zopiclone are as out-of-pocket (OOP) prescriptions-requiring patients to buy the drug at their own expense-although almost 90% of the population has statutory health insurance covering medication costs. ⋯ Current regulations do not provide guidance to GPs regarding hypnotics and sedatives. A clear regulatory framework and guidelines could possibly reduce physicians' defensive attitudes about these drugs and their use of OOP prescriptions. The approach to use OOP prescriptions as a barrier to reduce patients' medication use lacks evidence regarding effectiveness.