The European journal of general practice
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Most patients presenting chest complaints in primary care are referred to secondary care facilities, whereas only a few are diagnosed with acute coronary syndrome (ACS). ⋯ In patients presenting chest pain, plasma H-FABP reaches the highest diagnostic value when a cut-off value of 4 ng/ml is used. Diagnostic values of an algorithm combining point-of-care H-FABP measurement and a score of signs and symptoms should be studied in primary care, to learn if such an algorithm could safely reduce referral rate by GPs.
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Research in family medicine is a well-established entity nationally and internationally, covering all aspects of primary care including remote and isolated practices. However, due to limited capacity and resources in rural family medicine, its potential is not fully exploited yet. An idea to foster European rural primary care research by establishing a practice-based research network has been recently put forward by several members of the European Rural and Isolated Practitioners Association (EURIPA) and the European General Practice Research Network (EGPRN). ⋯ A SWOT analysis was used as the main tool to analyse the current situation in Europe regarding the research in rural family practice at both meetings. The key messages gained from these meetings may be employed by the Wonca Working Party on research, the International Federation of Primary Care Research Network and the EGPRN that seek to introduce a practice-based research approach. The cooperation and collaboration between EURIPA and EGPRN creates a fertile ground to discuss further the prospect of a European practice-based rural family medicine research network, and to draw on the joint experience.
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Methadone maintenance treatment in primary care is cost-effective and improves outcomes for opiate-dependent patients. A more developed understanding of the evolving needs of this important cohort will facilitate further improvements in their integrated care within the community. ⋯ Correcting for routine methadone care and drug-related illnesses, MMPs had a higher burden of chronic disease and used both primary and secondary health services more intensively than matched controls.
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Multicenter Study
Treatment targets in patients with type 2 diabetes set by primary care physicians from Central and Eastern Europe.
Primary care physicians have an important role in the care of patients with Type 2 diabetes but little is known about this issue in Central and Eastern European countries. ⋯ For patients with diabetes approximately half of physicians set treatment goals at levels that were recommended within the international guidelines. Most of them set treatment goals for HbA1c and BP at very low levels. Educational efforts to raise awareness about new treatment goals are needed.
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Many developed industrialized countries perceive considerable value in developing practice based research networks. In this paper, the development of the Scottish Primary Care Research Network (SPCRN) from 1924-2013 is described. After a false start in the early twentieth century and some local developments 10-15 years ago, the Scottish Primary Care Research Network was finally built upon existing networks of teaching and training practices centred on research active departments of general practice and primary care. ⋯ Long-term funding commitment to the network by the National Health Service meant that the infrastructure could be developed in the knowledge that it would be likely to become incorporated into wider Scottish and UK systems. Two-thirds of Scottish practices regularly participate in research at a rate of 50-60 studies each year, which result in a range of publications that influence clinical decisions and health policy. As the success of the network grows, greater demands are placed upon it, and the capacity of practices to continue to engage in research may be tested.