The British journal of general practice : the journal of the Royal College of General Practitioners
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A study of practice nurse workload in 1989 by the East Anglian reporting system revealed that nurses were undertaking a wide range of activities, with 12% of nursing time being spent on administration. The 1990 contract for general practitioners emphasized the role of general practice in health promotion. ⋯ Changes have taken place in the volume and range of work undertaken by practice nurses. There is potential for practice nurses to use the results both for negotiation and for education.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Controlled evaluation of brief intervention by general practitioners to reduce chronic use of benzodiazepines.
It is recommended that long-term users of benzodiazepines in general practice be withdrawn from their medication where possible. ⋯ The study indicates that some chronic users can successfully reduce their intake of benzodiazepines with simple advice from the general practitioner and a self-help booklet. This type of intervention does not lead to psychological distress or increased consultation.
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Review
Review of 39 years of randomized controlled trials in the British Journal of General Practice.
Randomized controlled trials are being used increasingly to evaluate the effectiveness of health care interventions, including those in primary care. ⋯ Some imaginative solutions to the logistic difficulties of conducting randomized trials in general practice were noted. These may serve as an incentive to those undertaking such studies in the future.
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It is generally assumed that people committing suicide see their doctor shortly before their death, and consequently that enhancing doctors' psychiatric knowledge and interview skills might help prevent some suicides. ⋯ These data suggest that medical practitioners, particularly those working in primary care, are not failing to detect and intervene in significant numbers of preventable suicides. Consequently, the likelihood of implementing successful suicide prevention strategies based within primary care is open to question. Greater awareness of the risk of eventual suicide in those with a previous history of psychiatric disorder may contribute to any future reduction in suicide rates.
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Against a background of concern over the costs of the cervical screening programme in the United Kingdom, increased precision in targeting groups at high risk of having an abnormal cervical smear offers a means of increasing efficiency. Previous papers have described the development of a risk scoring system and its feasibility and reliability in primary care. ⋯ Given the ease with which risk status can be ascertained (a risk score could not be calculated for only 23 of 3661 women) and the magnitude of difference in risk, the risk scoring system appears to have potential for assisting the targeting of screening resources. Studies of risk perception and behaviour, and ultimately a randomized controlled trial, are required to assess the effectiveness and cost effectiveness of risk targeting.