Family practice
-
Observational Study
Depressive symptom severity is a major risk factor for frailty in community-dwelling older adults with depression. A prospective study.
Depression and frailty are closely related, but the mechanisms by which depressed older adults are at an increased risk of becoming frail are still not well understood. ⋯ Both clinical and social characteristics are risk factors for frailty, but severity of depressive symptoms had the highest independent effect on frailty in depressed aged subjects. Frailty requires a multidisciplinary approach that pays special attention to pain and depressed mood.
-
Observational Study
Feasibility of the cardiac output response to stress test in suspected heart failure patients.
Diagnostic tools available to support general practitioners diagnose heart failure (HF) are limited. ⋯ The CORS is feasible and patients with HF responded differently to non-HF, and HFrEF from HFpEF. These findings provide further evidence for the potential use of the CORS to improve HF diagnostic and referral accuracy in primary care.
-
Randomized Controlled Trial
Cost-effectiveness of an occupational therapy-led self-management support programme for multimorbidity in primary care.
Multimorbidity is a major public health concern. Complex interventions, incorporating individualized care plans, may be appropriate for patients with multimorbidity given their individualized and variable needs. There is a dearth of evidence on the cost-effectiveness of complex multimorbidity interventions. ⋯ This study adds to the limited evidence base on the cost-effectiveness of complex interventions for multimorbidity, and highlights the potential for the OPTIMAL programme to be cost-effective. Further studies are warranted to explore the clinical and cost-effectiveness of complex interventions for the multimorbidity patient population, and for subgroups within it.
-
Studies on the impact of coronavirus disease 2019 (COVID-19) on people's routine medical care are limited, and understanding the factors associated with medical care avoidance can inform us about the ongoing pandemic. ⋯ The rates of hospital visit avoidance and exacerbation varied among patients with different diseases under the COVID-19 stay-at-home policy in April and May 2020, and disease-specific preparedness may be necessary for the pandemic.
-
Quality of care remains a priority issue and is correlated with patient experience. Measuring multidimensional patient primary care experiences in multiprofessional clinics requires a robust instrument. Although many exist, little is known about their quality. ⋯ Numerous patient self-assessment instruments were identified capturing a wide range of patient experiences, but their measurement properties were weak. Research is required to develop and validate a generic instrument for assessing quality of multiprofessional primary care.