Family practice
-
Euthanasia and assisted suicide laws in the Netherlands require physicians meet clinical guidelines when performing the practice to ensure death is peaceful and painless. Despite oversight by the regional review committees over each case, little research exists into the frequency of guideline deviation and the reasons for nonadherence. ⋯ Deviations from the guidelines and violations of due medical care are rare, but should nonetheless be monitored and prevented. A few areas for improvement include skills training for physicians, consistency between review committee rulings, and further clarity on dosage recommendations.
-
Practice population socioeconomic status is associated with practice postgraduate training accreditation. General Practitioner recruitment to socioeconomically deprived areas is challenging, exposure during training may encourage recruitment. ⋯ General practices in affluent areas remain more likely to train, although this association appears to be related to larger practice list sizes rather than socioeconomic factors. To ensure a variety of training environments training bodies should target, and support, smaller practices working in more socioeconomically deprived areas.
-
Observational Study
Differences in US antibiotic prescription use by facility and patient characteristics: evidence from the National Ambulatory Medical Care Survey.
Antibiotic resistance is increasing, largely due to the overuse of antibiotics. Patient demographic characteristics can influence rates of antibiotic prescription, but less research has assessed the role of facility-level characteristics. ⋯ The care setting that patients visit may influence their odds of receiving antibiotics. Initiatives addressing overuse of antibiotics should be mindful of facility- and patient-based characteristics when designing interventions.
-
General Practitioners' (GPs') workload has been suggested to increase in many countries; how does this impact patient follow-up? ⋯ Increased use of GP consultations, mainly among the healthiest participants, encourage further research into whether these patients displace patients with heavier and more complex needs.
-
Randomized Controlled Trial
Self-efficacy and doctor support as mediators of depression outcomes following counselling by family doctors for intimate partner violence.
Previous research shows counselling delivered by trained family doctors reduces depression for women experiencing intimate partner violence (IPV). However, the potential for self-efficacy, doctor support and safety enquiry to mediate these effects has not been examined. ⋯ Counselling by trained family doctors can help increase support and self-efficacy of women who have experienced IPV, mediating reduced depression.