Family practice
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Shared decision-making (SDM) is an important component of patient-centred care. However, there is limited information on its implementation in Malaysia, particularly in chronic diseases such as hypertension. ⋯ Preferences for involvement in decision-making among patients with hypertension are varied, and influenced by age and educational level. Physicians have a key role in encouraging patients to participate in SDM.
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An important aim of integrated care for frail elderly is to generate more cost-effective health care. However, empirical research on the cost-effectiveness of integrated care for community-dwelling frail elderly is limited. ⋯ The WICM is not cost-effective, and the costs per quality-adjusted life year are high. The costs of the integrated care intervention do not outweigh the limited effects on health-related quality of life after 12 months. More analyses of the cost-effectiveness of integrated care for community-dwelling frail elderly are recommended as well as consideration of the specific costs and effects.
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Randomized Controlled Trial
Feasibility and acceptability of TRANSFoRm to improve clinical trial recruitment in primary care.
Recruitment of study participants is a challenging process for health professionals and patients. The Translational Medicine and Patient Safety in Europe (TRANSFoRm) clinical trial tools enable automated identification, recruitment and follow-up in clinical trials, potentially saving time, effort and costs for all parties involved. ⋯ This study provides new evidence on the acceptability and feasibility of TRANSFoRm to enable automated identification, recruitment and follow-up of study participants in primary care trials. It also helps to better understand and address users' requirements in eHealth-supported clinical research.
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Comparative Study
Comparing importance and performance from a patient perspective in English general practice: a cross-sectional survey.
Patient experience and satisfaction are important indicators of quality in health care. Little is known about where to prioritize efforts to improve patient satisfaction. ⋯ Attributes needing most improvement concerned access to primary care and patient empowerment. More research is needed to identify how to improve access without generating unnecessary additional demand or compromising continuity of care.
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Young adulthood provides an enormous opportunity to alter trajectories of smoking behaviour for a large public health impact. ⋯ These findings highlight barriers to cessation and the reasons that young smokers give for quitting. This information may be helpful to physicians as they counsel their young adult patients to quit smoking.