Family practice
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Integrated cancer care requires cooperation between specialists and general practitioners (GPs). Mutual understanding of each other's tasks and responsibilities is essential if cooperation is to be successful. While GPs' opinions about oncologists have been addressed in previous studies, less is known about oncologists' views on the role of GPs' in cancer care, especially with regard to GPs' patient-centred, communication-based tasks. ⋯ Our analysis found that oncologists clearly distinguish between their own sphere of evidence-based treatment decision-making and GPs' sphere of psychosocial caring. The question remains how these roles get interconnected in real life situations in order to meet patients' needs adequately. So far it seems that it is often the patient who is travelling between both spheres and needs to initiate interconnection to get comprehensive cancer care.
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The benefits of watchful waiting (WW) over antidepressants (ADs) for the treatment of depression in primary care (PC) are unclear. ⋯ Superiority was not demonstrated by either treatment option. More robust evidence is needed to inform recommendations for the management of depressive symptoms in PC.
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Inappropriately high levels of antibiotics are still prescribed in primary health care for respiratory tract infections (RTIs). Access to diagnostic point-of-care tests (POCTs) for RTIs might reduce this over-prescription. ⋯ Our study shows that diagnostic POCTs for respiratory viruses might contribute to a precise and evidence-based diagnosis of RTIs and could positively influence prescription of antibiotics by GPs. However, before implementation in primary healthcare, diagnostic accuracy of the POCT needs improvement and it is impact on clinical decision making should be further assessed.
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Several new medications for type 2 diabetes (T2DM) have been introduced, including dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 receptor (GLP-1) agonists. Variation in the prescribing of these agents has implications for quality, safety and costs. We aimed to investigate geographical variation in the prescribing of anti-diabetic medications in Ireland. ⋯ There is substantial geographical variation in the prescribing of new T2DM medicines, particularly GLP-1 agonists. The prescribing variation which was identified may not only represent differences in the application of clinical guidelines, but also variation in professional opinion or patient preference.
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We must study alternatives to structure an effective diabetic retinopathy screening program for Brazilian public health system. ⋯ Trained family physician reached a good performance for evaluation of retinography for diabetic retinopathy. There was improvement in readability with pupil dilation in older patients.