Family practice
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Clinical Trial
Logistic support service improves processes and outcomes of diabetes care in general practice.
Guidelines for type 2 diabetes care in general practice are well known and accepted, but the implementation falls short. ⋯ Simple logistic support by the DSS proved to have the capacity to implement type 2 diabetes guidelines in general practice.
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Randomized Controlled Trial Multicenter Study
Prevalence and predictors of polypharmacy among older primary care patients in Germany.
Older people consume an increasing amount of medication. Polypharmacy is associated with an elevated risk of adverse health outcomes resulting in hospitalizations and sometimes death. ⋯ This older general practice population in Germany is among the top pharmaceutical user group of European study samples. Apart from disease-specific determinants, GPs should be aware that low subjective health and medication disagreement are independent predictors of polypharmacy.
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Despite asthma being primarily managed in general practice and primary care, there is little research into the issues and tools which may impact on managing poorly controlled asthma in this setting. ⋯ Our findings indicate that guidelines are seen as providing the 'why' of helping asthma patients' self-manage but not the 'what to...' or 'how to...' communicate. Poor professional-patient communication seems largely to explain the poor uptake of SMPs and guideline use in general practice and primary care. This limitation is more obvious to professionals when they are working with patients with poorly controlled asthma. There is a need to identify key communication skills for effective professional-patient partnership in adult asthma management, and to develop robust strategies for effectively training GPs and PNs in enhancing these skills.
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To understand why a complex breastfeeding coaching intervention, which offered health professional-facilitated breastfeeding groups for pregnant and breastfeeding mothers and personal peer coaches, was more effective at improving breastfeeding rates in some areas than others. ⋯ We hypothesise that involving several local health professionals in implementing an intervention may be more effective than a breastfeeding expert approach. Inter- and intra-health professional relationships may be an important determinant of outcome in interventions that aim to influence population behaviours like breastfeeding.
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Multicenter Study Comparative Study
Physical health care of patients with schizophrenia in primary care: a comparative study.
Excess morbidity and mortality associated with schizophrenia is well established. Despite this, no previous multi-centre study has investigated whether patients with schizophrenia receive equitable physical healthcare within primary care. ⋯ Patients with a diagnosis of schizophrenia are less likely to receive some important general health checks than patients without schizophrenia.