Primary health care research & development
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Prim Health Care Res Dev · Oct 2013
General Practitioners' coronary risk estimates, decisions to start lipid-lowering treatment, gender and length of clinical experience: their interactions in primary prevention.
We investigated whether the risk estimates of General Practitioners (GPs) and their treatment decisions mutually influence each other and whether factors not related to the patient's risk, such as the gender and length in clinical practice, interact. ⋯ The task of making CHD risk estimates and the task of making decisions whether to start lipid-lowering treatment do not seem to influence each other. The gender of physicians and the length of clinical experience seem to affect treatment decisions. Female GPs and less experienced GPs are more likely to make correct decisions. However, the relatively low response rate to the questionnaires may limit the generalizability of these results.
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Prim Health Care Res Dev · Jul 2013
Evaluation of welfare advice in primary care: effect on practice workload and prescribing for mental health.
To determine Citizen's Advice Bureaux (CAB) and general practice staff perceptions on the impact of a CAB Health Outreach (CABHO) service on staff workload. To quantify the frequency of mental health issues among patients referred to the CABHO service. To measure any impact of the CABHO service on appointments, referrals and prescribing for mental health. ⋯ Most GPs and CAB staff perceived the service reduced practice staff workload, although practice managers were less certain. CAB staff believed that many patients referred to them had mental health issues. Data were obtained for 148/250 referrals of whom 46% may have had a mental health issue. There were statistically significant reductions in the number of GP appointments and prescriptions for hypnotics/anxiolytics during the six months after referral to CABHO compared with six months before. There were also non-significant reductions in nurse appointments and prescriptions for antidepressants, but no change in appointments or referrals for mental health problems. The quantitative findings therefore confirmed perceptions among both CAB and practice staff of reduced workload and in addition suggest that prescribing may be reduced, although further larger-scale studies are required to confirm this.
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Prim Health Care Res Dev · Apr 2013
A questionnaire survey of patients and carers of patients prescribed Sativex as an unlicensed medicine.
To identify the areas of daily function most affected by the introduction of Sativex, a cannabis-based medicine, and the impact on caregivers and people with multiple sclerosis (MS). ⋯ The response rate was 57%, with 124 questionnaires returned. The majority of respondents and their caregivers reported improvements across a range of daily functional activities, alongside a reduction in the use of concomitant anti-spasticity medication and in the use of other healthcare resources.
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Prim Health Care Res Dev · Apr 2013
Feasibility and acceptability of routine human immunodeficiency virus testing in general practice: your views.
Early diagnosis of human immunodeficiency virus (HIV) leads to a decreased morbidity and mortality. General practice offers an important window for earlier diagnosis. The British HIV Association produced guidelines in 2008 advocating an increase in HIV testing, with specific references to primary care. ⋯ Almost half the respondents were not aware of the guidelines; having read them, the majority felt that implementation is feasible. This demonstrates the necessity for better dissemination of these guidelines. This study found that the main barrier to performing an HIV test was felt to be patient acceptance, a contradiction to findings from recent pilot studies.
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Prim Health Care Res Dev · Apr 2013
Conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease.
To describe conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease (COPD) in different stages of the disease. ⋯ Two main descriptive categories were found: (1) unchanged life situation where no support was needed; (2) changed life situation related to severity of COPD, where support was needed. The categories were described from the perspective 'ME and my spouse'. Even in their caregiving situation, the men continued with their own life and activities and did not put themselves in second place. No support was needed from healthcare or municipality when the women had mild COPD, but this changed when the COPD progressed. The men felt that daily life was burdened, restricted and the partner relationship was affected, even if the disease had not reached the final stage. The COPD forced them gradually into a caregiving role, and their daily life changed. They become more of a caregiver than a spouse. The men experienced lack of knowledge and support, and they felt that health professionals and municipality did not care about them.