Family practice
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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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Randomized Controlled Trial Comparative Study
A multifactorial strategy of pain management is associated with less pain in scheduled vaccination of children. A study realized by family practitioners in 239 children aged 4-12 years old.
The multiplicity of vaccine injections during childhood leads to iterative painful and stressful experiences which may lead in turn to anticipated pain and then possibly to a true needle phobia. We aimed at evaluating a multifactorial strategy of pain management combining pharmacological and non-pharmacological approaches during vaccination, as compared to usual care, in 4- to 12-year-old children. ⋯ This multifactorial method significantly decreases vaccination pain in 4- to 12-year-old children. This strategy could make vaccines more acceptable to children and may improve child-doctor relationships and contribute to a decrease in child fear about health care.
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Randomized Controlled Trial Multicenter Study
Interactive workshops increase chlamydia testing in primary care--a controlled study.
Primary care clinicians suggest that staff education is needed to increase chlamydia testing appropriately. ⋯ Interactive workshops for general practices can be used to successfully increase chlamydia-testing rates. Chlamydia detection rates will need to be monitored as this type of educational programme may not increase absolute numbers of chlamydia infections detected, if patients at lower risk of infection are inappropriately tested. Other interventions may need to be combined with the workshops, to reach sufficiently high chlamydia screening rates to significantly reduce prevalence of chlamydial infection.
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Randomized Controlled Trial
The use of mixed methodology in evaluating complex interventions: identifying patient factors that moderate the effects of a decision aid.
Mixed method research, the combined use of qualitative and quantitative methods, is increasingly popular in health services research, especially as a way to examine 'complex interventions'. This paper seeks to provide a case example of the use of mixed methods in the analysis of a complex intervention (a computerized interactive decision aid) to test whether their use affords insights into potential moderators of the intervention (i.e. patient factors that were associated with the impact of the intervention). ⋯ Mixed methods can illuminate different aspects of an intervention or provide greater insight into particular issues. Health service researchers need to be aware that the qualitative and quantitative results may be discrepant, and methods need to be developed to deal with such discrepancies. However, exploring seemingly discrepant results can lead to greater insight and the development of new hypotheses and avenues of research.
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Randomized Controlled Trial
'DNA' may not mean 'did not participate': a qualitative study of reasons for non-adherence at home- and centre-based cardiac rehabilitation.
Cardiac rehabilitation (CR) has been shown to improve prognosis and function following an acute myocardial infarction or revascularization. However, participation in CR programmes is low and adherence is poor. ⋯ Reasons for non-participation/non-adherence were generally multifactorial and individualistic. Many patients who had not attended or not adhered to their CR programme had participated in rehabilitative activities in other ways. Social characteristics, individual patient needs and preferences and the location of CR programmes need to be taken into account in programme design to maximize participation.