The European journal of general practice
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Primary care is challenged to provide high quality, accessible and affordable care for an increasingly ageing, complex, and multimorbid population. To counter these challenges, primary care professionals need to take up new and innovative practices, including eHealth. eHealth applications hold the promise to overcome some difficulties encountered in the care of people with complex medical and social needs in primary care. However, many unanswered questions regarding (cost) effectiveness, integration with healthcare, and acceptability to patients, caregivers, and professionals remain to be elucidated. ⋯ Blended care, i.e. combining face-to-face care with remote options, personalized to the individual patient should be considered. Stakeholders need to be involved in the development and implementation of eHealth via co-creation processes, and design should be mindful of vulnerable groups and eHealth illiteracy. Furthermore, a global perspective on eHealth should be adopted, and eHealth ethics, patients' safety and privacy considered.
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Background: For effective prevention and intervention, and reduction of dependency, it is essential to determine the presence of frailty in the community. Objectives: To describe the prevalence of frailty among elderly persons living independently, in two primary healthcare areas in Spain; to identify factors correlated with its presence. Methods: This descriptive cross-sectional study was conducted between May 2015 and July 2016 among non-institutionalized individuals aged ≥70 years living in the primary healthcare areas of Gipuzkoa and Costa del Sol (Spain). ⋯ In the multivariable model, 'geographical area' differences persisted, with an OR of 3.51 (95%CI: 2.29-5.36) for the Costa del Sol area, using Gipuzkoa as reference. Conclusion: In this population of community-dwelling persons aged 70 years and over, the prevalence of frailty was 26%. Factors correlated with frailty were female sex, comorbidity, poorer self-perceived lifestyle and health status, and dissatisfaction with the domestic environment.
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Background: Pertussis testing is most important when transmission to vulnerable groups is likely. Patients with signs and symptoms suggestive of pertussis are prevalent in primary care, yet general practitioners' (GPs) reasons (not) to test for pertussis are largely unknown. Objectives: To evaluate GP-reported diagnostic practices for pertussis, reasons for (not) testing and intentions towards testing among GPs. ⋯ The most reported reason for testing was to confirm the clinical pertussis diagnosis (70%); the most reported reason for not testing was that the diagnostic test result does not influence treatment (70%). Overall, judging from the clinical vignettes, GPs reported being more likely to perform diagnostic testing based on symptoms than based on vulnerable groups at risk. Conclusion: In contrast to national guidelines, our results suggest that GPs report to test for pertussis mainly based on clinical symptoms rather than based on protecting vulnerable groups at risk.
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Background: Common cold and influenza result in an increased number of primary care consultations, significant work/school absences and cause a socio-economic burden. Laypeople's perceptions and knowledge regarding common cold and influenza prevention is poorly understood and under-researched. Objectives: Our study explores laypeople's knowledge of prevention of common cold and influenza across three European countries. ⋯ There were very few cross-country differences in results. Conclusion: The perception of health risk of contracting influenza and a primary healthcare physicians' recommendation played an important role in shaping participants' decisions towards vaccination. Primary healthcare physicians are invited to assess and if necessary adjust inappropriate prevention behaviour through their everyday patient consultations as well as add to the knowledge about influenza severity and influenza vaccination benefits to their patients.