Family practice
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Randomized Controlled Trial Multicenter Study
Lower inhaled steroid requirement with a fluticasone/salmeterol combination in family practice patients with asthma or COPD.
Previous studies on inhaled steroid and long-acting beta2-agonist combination products may not be representative for the asthma and chronic obstructive pulmonary disease (COPD) patients in family practice. ⋯ In family practice patients diagnosed with asthma, several treatment goals were better achieved with a lower dose of fluticasone and salmeterol in a combination product than with a higher dose of fluticasone. We found no differences between the two approaches for patients with COPD.
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Continuity of care is widely regarded as a core value of primary care. Type 2 diabetes is a common chronic disease with major health, social and economic impacts. Primary health care professionals in many countries are involved in the management of patients with type 2 diabetes, but their perspectives on continuity remain neglected in research. ⋯ GPs and practice nurses dealing with patients with type 2 diabetes identified three types of continuities, each influenced by several factors. Relational continuity deals better with psychosocial care while team continuity promotes better physical care; therefore, imposing one type of continuity may inhibit good diabetic care. Cross-boundary continuity between primary and secondary care is fundamental to contemporary diabetic services and ways should be found to achieve more effective communication.
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To develop and evaluate an evidence-based tool for predicting the likelihood of emergency admission to hospital of older people aged 75 years and over in the UK. ⋯ In this study, we have developed and validated a simple-to-apply tool for identifying older people in the UK who are at risk of having an emergency admission within the following 12 months. EARLI can be used as a simple triage-screening tool to help identify the most vulnerable older people, either to target interventions and support to reduce demand on hospital services or for inclusion in testing the effectiveness of different preventive interventions.