Family practice
-
Asthma is one of the most frequent reasons children visit a general practitioner (GP). The diagnosis of childhood asthma is challenging, and a variety of diagnostic tests for asthma exist. GPs may refer to clinical practice guidelines when deciding which tests, if any, are appropriate, but the quality of these guidelines is unknown. ⋯ The variable quality of guidelines, lack of good quality evidence, and inconsistent recommendations for diagnostic tests may contribute to poor clinician adherence to guidelines and variation in testing for diagnosing childhood asthma.
-
Physicians are likely to be asked to provide medical care to relatives or friends. Evidence suggests that most physicians treat loved ones during their active years. However, in the academic literature, critical approaches to the matter are dominating. Ethical guidelines often discourage physicians from treating family members and friends outside of exceptional circumstances. ⋯ This systematic review shows that the discourse of physicians treating loved ones is held predominantly in the context of personal experiences. The majority of authors seem to have a rather pragmatic interest in the topic, and systematic or analytic approaches are rare. While most authors mention various codes of ethics, several publications criticize these or consider them insufficient.
-
In France, general practitioners (GPs) prescribe benzodiazepines and Z-drugs (BZD/ZDs) widely, and especially to older adults. Several characteristics of patients and/or GPs linked to BZD/ZD overprescription have been described in the general population but not among older patients in primary care. ⋯ BZD/ZD overprescription was associated with a greater chronic disease burden and the number of drugs prescribed per consultation but not with any sociodemographic or practice-related GP characteristics. Targeted actions are needed to help GPs limit their prescription of BZD/ZDs to older patients with multiple comorbidities and polypharmacy.
-
Headache disorders are globally prevalent and insufficient treatment contribute to low quality of life, increased disability, and socioeconomic costs. However, headache can to a large extent be treated appropriately by general practitioners. ⋯ This study provides insights to how GPs manage patients with long-lasting headache. Focus should be on reducing opioids, increasing preventive treatment, and keeping more patients in primary care.