Family practice
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Randomized Controlled Trial Clinical Trial
How does a change in the administration method affect the reliability of the COOP/WONCA Charts? World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians.
An interviewer is often needed to administer the COOP/WONCA Charts to Chinese patients, and this may affect the reliability of results. ⋯ The Chinese COOP/WONCA Charts were reliable in detecting real differences when administered by an interviewer. A change in the method of administration significantly decreased the reliability of the results. The use of more than one method of data collection in the same survey should be discouraged.
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial of an intervention designed to improve the care given in general practice to Type II diabetic patients: patient outcomes and professional ability to change behaviour.
Our objective was to evaluate the effect of training in a patient-centred intervention for GPs and practice nurses on outcomes for patients with Type II diabetes. ⋯ The efficacy of this behavioural intervention remains unproved, despite its acceptability to professional staff. Detailed and prolonged development and testing of behavioural interventions is an essential first step before embarking on randomized controlled trials which involve complex behavioural changes in professionals or patients.
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Randomized Controlled Trial Clinical Trial
Changing attitudes to infection management in primary care: a controlled trial of active versus passive guideline implementation strategies.
When attempting to implement evidence-based medicine, such as through clinical guidelines, we often rely on passive educational tactics, for example didactic lectures and bulletins. These methods involve the recipient in relatively superficial processing of information, and any consequent attitude changes can be expected to be short-lived. However, active methods, such as practice-based discussion, should involve recipients in deep processing, with more enduring attitude changes. In this experiment, the aim was to assess the efficacy of an active strategy at promoting deep processing and its effectiveness, relative to a typical passive method, at changing attitudes between groups of GPs over 12 months across an English Health District. ⋯ An active educational strategy attracted more participation and was more effective at generating deep cognitive processing than a passive strategy. A large improvement, lasting for at least 12 months, in attitude-compliance with guidelines on the optimal treatment of infections was imparted by the active processing method. A typical passive method was much less popular and had an insignificant impact on attitudes. The findings suggest that initiatives aiming to implement evidence-based guidelines must employ active educational strategies if enduring changes in attitude are to result.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of instruction by practice assistants on inhaler technique and respiratory symptoms of patients. A controlled randomized videotaped intervention study.
Many patients with asthma or chronic obstructive pulmonary disease use their medication inhalers incorrectly. General practitioners, pharmacists and other health care providers do not always have the opportunity to instruct patients in correct inhaler technique. ⋯ The inhaler technique of patients can be improved significantly by the instruction of patients by trained practice assistants, possibly resulting in less dyspnoea.