Scandinavian journal of primary health care
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Scand J Prim Health Care · Feb 2025
A shared approach to managing urinary tract infections in nursing homes improved perceived care quality, workload, and collaboration - a qualitative study.
In 2019, around 4.95 million global deaths were linked to bacterial antimicrobial resistance (AMR). Managing urinary tract infections (UTIs) in nursing homes involves prevention, diagnosis, and treatment. This is often complex and cause excessive antibiotic use, increasing AMR. Infection prevention and antimicrobial stewardship (AMS) are complementary strategies for reducing AMR. Studies show that nursing home staff can safely reduce antibiotic prescriptions for UTIs using these strategies and that cross-sectoral collaboration with general practice is important in UTI management. However, the impact of combining infection prevention with AMS and general practice is unknown. ⋯ Our findings suggest that the intervention had a positive impact on experienced care quality, workload, and cross-sector collaboration. However, physical attendance at the seminar limits the large-scale implementation of the intervention.
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Scand J Prim Health Care · Feb 2025
Differences in use of telemedicine integrated into traditional primary health care - a comparative observational study.
Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend on who will use the new technology. ⋯ Our findings suggest that users are more likely to be women and below the age of 60. Likewise, users also tend to have a greater need for health care services compared to non-users, and they seek health care more often compared to non-users. No differences regarding SES were found.
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Scand J Prim Health Care · Jan 2025
B-phosphatidylethanol testing to identify hazardous alcohol use in primary health care-a game changer and a challenge for general practitioners: a qualitative study.
Alcohol use disorder (AUD) and hazardous alcohol use are common but underdiagnosed in primary health care (PHC). This study aimed to explore general practitioners' (GPs') experiences and perceptions of using B-Phosphatidylethanol (PEth), a specific quantitative biomarker for alcohol use, in their clinical work with patient consultations and treatment follow-up in Swedish PHC. ⋯ PEth is an important tool in the identification of hazardous alcohol use. Emerging ethical dilemmas regarding patient information on PEth testing and management of medical and medico-legal obligations when test results indicate high alcohol use need to be addressed in future guidelines for clinical management of PEth.
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Scand J Prim Health Care · Jan 2025
Cognitive dysfunction in diabetes - the 'forgotten' diabetes complication: a narrative review.
In addition to peripheral neuropathy of various kinds, diabetes can also cause central neuropathy, which among other things can manifest itself as premature cognitive dysfunction, often linked to vascular dysfunction. Although the link between diabetes and cognitive dysfunction was discovered more than 100 years ago and has important clinical implications, this diabetes complication remains relatively unknown. Recent years have seen research that has clarified cerebral insulin resistance and defective insulin signaling as examples of pathogenic factors behind this cognitive impairment in diabetes. ⋯ Optimization of lifestyle factors (e.g. physical activity), as well as several pharmaceutical agents already in clinical use against diabetes, have shown promising results in improving cognitive function in diabetic patients. An important task for primary health care, where most patients with type 2 diabetes are diagnosed, treated, and followed, is to increase awareness and early detection of cognitive dysfunction in these patients for optimizing risk factor control.