Family practice
-
It is unclear how patient preferences for autonomy vary given different severity of a single condition. ⋯ No combination of predicted risk, demographics or attitudes strongly predicted the preference of an individual patient. Clinicians should therefore seek to understand and confirm each patient's preferences.
-
Review Meta Analysis
Pre-arrest predictors of failure to survive after in-hospital cardiopulmonary resuscitation: a meta-analysis.
Our objective was to perform a systematic review of pre-arrest predictors of the outcome of in-hospital cardiopulmonary resuscitation (CPR) in adults. ⋯ We identified several pre-arrest variables associated with failure to survive to discharge. This information should be shared with patients as part of a shared decision-making process regarding the use of do not resuscitate orders.
-
Primary care professionals often manage patients with multiple long-term health conditions, but managing multimorbidity is challenging given time and resource constraints and interactions between conditions. ⋯ Primary care professionals identify a number of challenges in care for multimorbidity and adopt a particular model of decision making to deliver care for multiple individual conditions. However, they did not describe specific decision making around managing multimorbidity per se.
-
The prevalence of multimorbidity in primary care and its effect on health care utilization and cost.
Multimorbidity is common among the heterogeneous primary care population, but little data exist on its association with health care utilization or cost. ⋯ Multimorbidity is very common in primary care and in a system with strong gatekeeping is associated with high health care utilization and cost across the health care system. Interventions to address quality and cost associated with multimorbidity must focus on primary as well as secondary care.
-
The rarity of childhood cancers makes providing palliative care in the community an unusual event for primary care practitioners. Providing this care requires effective inter-professional collaboration with the team that forms to provide the care often working together for the first and only time. ⋯ Engaging primary care practitioners needs to be more actively anticipated and negotiated at the transition to palliation. Variation in out of hours care is another cause for concern. Enhancing inter-professional collaboration and planning during both active and palliative care phases may help.