Family practice
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Randomized Controlled Trial
Case control study of access to medications during COVID-19 and longitudinal impact on health outcomes for primary care patients managing multiple chronic conditions.
During coronavirus disease 2019 (COVID-19), people managing multiple chronic conditions (MCCs) experienced barriers to obtaining needed medications. The purposes of this paper are to (i) determine risk factors for difficulty obtaining medications during COVID-19, (ii) document reasons for the difficulty, and (iii) evaluate the impact on later physical and mental health outcomes. ⋯ People with socioeconomic disadvantages experienced a disproportionate impact of difficulty obtaining medications and poorer health outcomes due to COVID-19. They may be at greater risk in the event of future pandemics and other societal disruptions.
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Observational Study
Recent life events and adverse childhood experiences in predicting antenatal depression and anxiety: cross-sectional study.
Antenatal depression and anxiety are associated with preterm labour, low birth weight, and postpartum depression, and can impact the emotional and mental development of the child. Both adverse childhood experiences and recent stressful events are linked to negative health outcomes. However, certain events may be more impactful than others. ⋯ Recent stressful life events have a stronger association with postnatal mental health than adverse childhood events, implying that it might be useful for clinicians providing routine antenatal care to gather information on recent stressors.
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Despite the increasing presence of women in US medical schools over the past 25 years, gender equity in medical leadership remains elusive. This qualitative study delves deeper into definitions of institutional leadership roles, who they are designed for, and how women currently contribute in unrecognized and uncompensated leadership positions. ⋯ Increasing the number of women in leadership positions can be achieved through innovative leadership models that prioritize collaboration, flexibility, and work-life balance. Organizations must revise definitions of leadership to expand it to include the valuable, unrewarded work women undertake that advance their goals and overall patient health.
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Randomized Controlled Trial
The relationship between self-care preparedness and quality of life in a 3-year-follow-up: a study in primary health care.
Measuring self-care preparedness may enable better support for patients in general practice. ⋯ Those patients who managed to increase their SCPI over the study period experienced an improvement in HRQoL.
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Shifting tasks from General practitioners (GPs) to practice nurses (PNs) could help address the shortage of GPs in Europe. Internationally, PN-led care (PNLC) is feasible and offers similar health outcomes to usual care. However, PN-led consultations (PN-cons) or as PN-led dosage changes for permanent medication (PN-DCPM) are uncommon in German general practice offices (GPO). ⋯ Participants showed openness towards PN-cons and were more reserved towards PN-DCPM in German GPO. Further quantitative studies should assess how acceptance and rejection of PN-led care are distributed among patients, GPs, and PNs.