Family practice
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Family physicians in Taiwan have expressed low willingness to provide palliative home care. ⋯ Through palliative home care with the participation of family physicians, patients' preference could be a significant determinant of home death. Our finding can be helpful to the establishment of an ethical care model for terminal cancer patients.
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According to current guidelines, spirometry should be performed in patients suspected of chronic obstructive pulmonary disease (COPD) by the results of history taking and physical examination. However, little is known about the diagnostic value of patient history and physical examination for COPD. ⋯ There is insufficient evidence to assess the value of history taking and physical examination for diagnosing COPD.
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Randomized Controlled Trial Multicenter Study Comparative Study
Economic evaluation of early administration of prednisolone and/or aciclovir for the treatment of Bell's palsy.
Bell's palsy (BP), which causes facial paralysis, affects 11-40 people per 100 000 per annum in the UK. Its cause is unknown but as many as 30% of patients have continuing facial disfigurement, psychological difficulties and occasionally facial pain. We present an randomised controlled trial (RCT)-based economic evaluation of the early administration of steroids (prednisolone) and/or antivirals (acyclovir) compared to placebo, for treatment of BP. ⋯ Treatment of BP with prednisolone is likely to be considered CE while treatment with acyclovir is highly unlikely to be considered CE. Further data on costs and utilities would be useful to confirm findings.
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Randomized Controlled Trial Multicenter Study
Does a system of instalment dispensing for newly prescribed medicines save NHS costs? Results from a feasibility study.
In view of the increasing cost of general practice of drug prescribing, it is important to look at ways of reducing drug wastage and thereby improve the cost-effectiveness of prescribing. ⋯ Introduction of a system of instalment dispensing produced savings in the general practice of drugs bill, but these were not large enough to offset additional costs for pharmacists.
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Comparative Study
Evaluation of the management of heart failure in primary care.
The extent to which guidelines for the treatment of heart failure are currently followed in primary care in the UK is unclear. ⋯ These data suggest that while most patients with heart failure receive an ACE inhibitor/ARB in primary care, few are titrated to target dose and many do not receive a beta-blocker. Optimum treatment appears to be most likely for young men. New strategies are required to ensure equitable and optimal treatment for all.