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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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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Randomized Controlled Trial Multicenter Study
The use of text messaging to improve attendance in primary care: a randomized controlled trial.
Non-attendance is common in primary care and previous studies have reported that reminders were useful in reducing broken appointments. ⋯ Text messaging reminder system was effective in improving attendance rate in primary care. It was more cost-effective compared with the mobile phone reminder.
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Randomized Controlled Trial Multicenter Study
Cluster randomized trial of a multifaceted primary care decision-support intervention for inherited breast cancer risk.
GPs are increasingly expected to meet the needs of patients concerned about their risk of inherited breast cancer, but may lack skills or confidence to use complex management guidelines. We developed an evidence-based, multifaceted intervention intended to promote confidence and skills in this area. ⋯ No convincing evidence of the effectiveness of the intervention was found, probably reflecting barriers to its use in routine practice.
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Randomized Controlled Trial Comparative Study
Long-term prognosis of acute otitis media in infancy: determinants of recurrent acute otitis media and persistent middle ear effusion.
Children under 2 years of age with acute otitis media are known to have a relatively poor prognosis. The objective of this study was to assess whether known determinants for recurrent acute otitis media and persistent middle ear effusion after an episode of acute otitis media during childhood also apply to children under 2 years. ⋯ Prediction of recurrent acute otitis media or persistent middle ear effusion in individual young children remains poor.