The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Multicenter Study Comparative Study
Continuity in different care modes and its relationship to quality of life: a randomised controlled trial in patients with COPD.
New care modes in primary care may affect patients' experienced continuity of care. ⋯ Although personal continuity decreases when new care modes are introduced, no evidence that this affects patients' experienced team continuity or patients' quality of life was found. Patients still experienced smooth, ongoing care, and considered care to be connected. Overall, no evidence was found indicating that the introduction of new care modes in primary care for patients with COPD should be discouraged.
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Randomized Controlled Trial Multicenter Study
A primary care specialist genetics service: a cluster-randomised factorial trial.
GPs do not have the confidence to identify patients at increased genetic risk. A specialist primary care clinical genetics service could support GPs with referral and provide local clinics for their patients. ⋯ An integrated primary care genetics service both supports GPs in appropriate cancer referral and provides care in the right place by the right person.
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Multicenter Study Clinical Trial
Difficulties in differential diagnosis of COPD and asthma in primary care.
Chronic obstructive pulmonary disease (COPD) and asthma treatment must be based on appropriate diagnosis. However, patients receiving inhaled therapy in primary care may not be accurately diagnosed according to current guidelines. ⋯ Most patients can be classified as having COPD or asthma by primary care physicians. The use of the two questionnaires did not provide a better differential diagnostic compared with symptoms and spirometry with a BDT. Misdiagnosis may lead to inadequate treatment.
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Randomized Controlled Trial Multicenter Study
Patients' experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study.
Self-management of hypertension, comprising self-monitoring of blood pressure with self-titration of medication, improves blood pressure control, but little is known regarding the views of patients undertaking it. ⋯ Participants valued the additional information and many felt confident in both self-monitoring blood pressure and self-titrating medication. The reluctance to change medication for borderline readings suggests behaviour similar to the clinical inertia seen for physicians in analogous circumstances. Additional support for those lacking in confidence to implement prearranged medication changes may allow more patients to undertake self-management.
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Multicenter Study
Identifying patients with suspected gastro-oesophageal cancer in primary care: derivation and validation of an algorithm.
Gastro-oesphageal is one of the most common cancers worldwide. Evidence suggested that increased awareness of symptoms and earlier diagnosis could help improve treatment options and improve survival. ⋯ The algorithm has good performance and could potentially be used to help identify those at highest risk of gastro-oesophageal cancer, to facilitate early referral and investigation.