The European journal of general practice
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Multicenter Study
Cancer screening and follow-up in general practice: A French nationwide cross-sectional study.
The overall activity of general practitioners (GPs) related to cancer screening and follow-up is poorly documented. ⋯ Around 5% of French general practice consultations include cancer screening or follow-up. Socio-economical inequalities demand further research.
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To deliver optimal palliative care, a Care Pathway for Primary Palliative Care (CPPPC) was developed. This CPPPC was implemented by general practitioners (GPs) in territories of five Belgian palliative care networks (2014-2016). Belgian doctors have much therapeutic freedom, and do not commonly follow guidelines. ⋯ Palliative care frameworks which help GPs to deliver 'tailor-made' care have more chance to be adopted than strict protocols. GPs should be given education for bad news breaking. Palliative care and advance care planning practices differ locally: guideline dissemination plans should respect these local differences.
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The World Health Organisation Alma-Ata Declaration on Primary Healthcare, and the more recent Astana Declaration from the Global Conference on Primary Healthcare, emphasise the involvement of individuals and communities in health decision-making about their individual health care, service delivery and policy development. Increasingly, health funding agencies and academic publishers like the BMJ require Public and Patient Involvement in health research. These imperatives cover health decision-making about different issues in different settings. ⋯ I use the social science concept of participatory spaces, to describe three overlapping forms of involvement - shared decision-making (SDM) in clinical care, community participation to develop services and Public and Patient Involvement in research. I refer to evidence of implementation challenges for these forms of involvement and provide insights about how to routinise them with reference to the need for these practices to make more sense to general practitioners, for general practitioners to have more time and resources to incorporate them into their daily work and for more research to understand the power dynamics involved. We need leadership in our discipline, and partnership working with policymakers, patient and community organisations, to progress these issues and enable us to optimise benefits for general practitioners, patients and the broader practice population.
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Targeted Therapies (TT) are among the therapeutic innovations for cancer treatment in outpatient settings. TT-related Adverse Events (AEs) are a source of loss of opportunity for patients if their management is inappropriate. ⋯ Patients experienced an average of 4 AEs. AE severity rating was significantly different between patients and nurses. Patients do not always communicate AEs to health care professionals.
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Background: Undetected dementia in primary care is a global problem. Since general practitioners (GPs) act as the first step in the identification process, examining their routines could help us to enhance the currently low recognition rates. Objectives: The study aimed to explore, for the first time in Hungary, the dementia identification practices and views of GPs. ⋯ Longer consultation time was chosen as the most important facet of improvement needed for better identification of dementia in primary care (81%). Half of the GPs (49%) estimated dementia recognition rate to be lower than 30% in their practice. Conclusions: Hungarian GPs were aware of the benefits of early recognition, but the shortage of consultation time in primary care was found to be a major constraint on efficient case-finding.