Family practice
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Registration studies have shown great variations in prescribing volume and prescribing patterns of benzodiazepines (BZDs) and minor opiates among GPs. ⋯ It was a striking feature that many of the attitudes towards the drugs were common both within and between the three groups of prescribers. All doctors regarded the task of prescribing as difficult, and the great majority strongly advocated restriction in prescribing. In order to cope with daily practice and to live with high prescribing volumes, doctors make use of effective working strategies. These strategies, of ascribing responsibility to the previous doctor, to patient autonomy and responsibility, to the patient's age and to concomitant diseases, are described in this study. An allocation of responsibility to other persons or circumstances delimits the doctors' professional discretion in this matter. Striking differences between prescriber groups were not found in the analysis, but when all small tendencies in all steps of the decision-making process were added, a clear trend was revealed.
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This study aimed to review published papers which use qualitative interviewing in general practice as their methodology. To look specifically at the detail of how the methodology is presented to the reader, with particular emphasis on the clarity of detail about recruitment, the relationship of the interviewer to the respondents, the setting and how the research was presented to the respondents. ⋯ Published papers using qualitative interviewing in general practice often lack explicit methodological detail about the relationship between the interviewer and the respondents, the setting, who did the recruiting and how the research was explained to the respondents. This methodological detail is important for the critical appraisal of qualitative research, where the context of the research can influence the data.
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Statistical power is a measure of the extent to which a study is capable of discerning differences or associations which exist within the population under investigation, and is of critical importance whenever a hypothesis is tested by statistics. Conventionally, studies should reach a power level of 0.8, such that four times out of five a false null hypothesis will be rejected by a study. Statistical power may most easily be increased by increasing sample size. ⋯ While achieving higher power than studies in similar surveys of other disciplines, the power of general practice research falls short of the 0.8 convention. Adequate power is essential so that effects which exist are not missed. Recommendations are made concerning power calculations prior to the start of research and reporting of results in journal articles.
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Information about use and attitudes of GPs towards complementary medicine is required in order to inform the debate about its place within mainstream medicine. There is evidence that public use of complementary medicine is particularly high in the South-West of England. ⋯ Over two-thirds of the GPs in Devon and Cornwall who responded to the survey had been involved with complementary medicine in some way during the previous week. This figure is higher than the national average. The majority of respondents believed that acupuncture, chiropractic and osteopathy were effective and should be funded by the NHS.
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The international Classification of Primary Care (ICPC) has now been available to the family medicine community for a decade as the main ordering principle of its domain. Research data and practical experiences with ICPC, as well as the development of new concepts in family medicine, have resulted in new applications. ⋯ ICPC as the ordering principle of patient data is now available in 19 languages. Its conversion structure with the International Classification of Diseases (ICD-10) allows the highest possible level of specificity in a patient's problem list necessary in patient care, while the compatibility of the ICPC drug codes with the Anatomic Therapeutic Chemical Classification Index allows the systematic inclusion of data on prescription.