Family 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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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.
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Health organisations continually seek good output indicators of family medicine health care provision because they are accountable to society, they need to compare services, and need to evaluate the impact of organisational reforms. ⋯ Using sources of information that are routinely employed in primary health care services management, the model enables the measurement of the output of family medicine by considering the dimensions such as inter-personnel relationships, internal coordination of the team and the scientific-technical quality of the service. Despite its simplicity, this measure of the output incorporates the views not only of the users but of the health care professionals, as well.
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People of South Asian origin have higher mortality and morbidity from coronary heart disease (CHD) and diabetes than those of European origin. However, physical activity, of established value in primary and secondary prevention, appears lower among South Asians. ⋯ Better health professional guidance on appropriate physical activity, its health benefits and its safety is needed for this highly at-risk group. Promoting informal moderate-intensity physical activity may help. Strategies should avoid any tendency to overemphasize cultural barriers noting greater similarities than differences between cultural groups.
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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.