Bmc Fam Pract
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Randomized Controlled Trial Multicenter Study
The Heart Health Study - increasing cardiovascular risk assessment in family practice for first degree relatives of patients with premature ischaemic heart disease: a randomised controlled trial.
This study aimed to increase cardiovascular disease (CVD) risk assessment in adult first degree relatives of patients with premature ischaemic heart disease (PIHD) using written and verbal advice. ⋯ This low cost intervention demonstrates that individuals who have a family history of PIHD and are at moderate or high risk of CVD can be targeted for early intervention of modifiable risk factors. Further research is required to improve the uptake of the intervention in relatives.
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Self-management support to facilitate people with type 2 diabetes to effectively manage their condition is complex to implement. Organisational and system elements operating in relation to providing optimal self-management support in primary care are poorly understood. We have applied operational research techniques to model pathways in primary care to explore and illuminate the processes and points where people struggle to find self-management support. ⋯ The model provides a clear visual picture of the complexities implicated in achieving optimal self-management support. Self-management is quickly hidden from view in a system orientated to treatment delivery rather than to enhancing patient self-management. The model created highlights the limited self-management support currently provided and illuminates points where service change might impact on providing support for self-management. Ensuring professionals are aware of locally available support and people's existing network support has potential to provide appropriate and timely direction to community facilities and the mobilisation of resources.
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GPPAQ (General Practice Physical Activity Questionnaire) is a self-assessment physical activity questionnaire widely used in primary care. Reliability and validity data in older people are lacking. The study aims were: to assess GPPAQ's reliability and validity in 60-74 year olds from the PACE-Lift (Pedometer Accelerometer Consultation Evaluation-Lift) physical activity trial; and to assess whether adding brisk walking to the GPPAQ score improves its validity when assessing if physical activity guidelines are being met. ⋯ GPPAQ has reasonable reliability but results from this study measuring validity in older adults indicates poor agreement with objective accelerometry for accurately identifying physical activity levels. Including brisk walking in GPPAQ increased sensitivity, but reduced specificity and did not improve overall screening performance. GPPAQ's use in National Health Service health checks in primary care in this age group cannot therefore be supported by this validity study comparing to accelerometry.