Family practice
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Multicenter Study Comparative Study
Testing a European set of indicators for the evaluation of the management of primary care practices.
Effective practice management is an important prerequisite for offering good clinical care. Internationally valid, reliable and feasible indicators and instruments are needed to describe and compare the management of primary care practices in Europe. ⋯ The EPA instrument provides feedback to practices that facilitates quality improvement and can compare primary care practices on a national and an international level.
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Randomized Controlled Trial Comparative Study
Long-term prognosis of acute otitis media in infancy: determinants of recurrent acute otitis media and persistent middle ear effusion.
Children under 2 years of age with acute otitis media are known to have a relatively poor prognosis. The objective of this study was to assess whether known determinants for recurrent acute otitis media and persistent middle ear effusion after an episode of acute otitis media during childhood also apply to children under 2 years. ⋯ Prediction of recurrent acute otitis media or persistent middle ear effusion in individual young children remains poor.
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Comparative Study
Meeting and treating cultural difference in primary care: a qualitative interview study.
Primary care doctors see patients from diverse cultural backgrounds and communication plays an important role in diagnosis and treatment. Communication problems can arise when patient and doctor do not share the same cultural background. ⋯ This study indicates that cultural difference is not treated in GPs consultation with immigrant patients. Learning about cultural difference's effect on mutual understanding between doctor and patient could improve GPs cross-cultural communication. Increased awareness of the culture the doctor brings to the consultation could facilitate management of cross-cultural consultations.
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Comparative Study
What do stroke patients and their carers want from community services?
Previous research has focused on the longer term needs of 'new' stroke patients at fixed time intervals after the event, but neglected those of stroke patients who may have had the event many years earlier. ⋯ Better methods of providing information for long-term survivors of stroke, and for addressing their emotional and psychological needs are required. Primary care could be a key setting for helping to provide more inclusive services for both patient and carer.
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Comparative Study
The use of medication for chronic pain in primary care, and the potential for intervention by a practice-based pharmacist.
The majority of people with chronic pain use analgesics regularly. Ensuring their safe and appropriate use is important. This study aimed to describe patterns of analgesic prescribing in one general practice, devise a method of identifying chronic pain patients from prescribing records, and assess prescribing recommendations made after a pharmacist-led review of analgesic prescribing and identify the proportion of these acted on by GPs. ⋯ We have demonstrated a method of identifying patients with chronic pain in primary care, and the feasibility and acceptability of a pharmacist-led intervention. This is of potential value in primary care, as relevant prescribing recommendations were made for most patients although further research is required to assess these.