Scandinavian journal of primary health care
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Scand J Prim Health Care · Jun 2020
Randomized Controlled Trial Multicenter Study Comparative StudyTwo-year weight, risk and health factor outcomes of a weight-reduction intervention programme: Primary prevention for overweight in a multicentre primary healthcare setting.
Objective: To study the long-term effects of weight reduction, quality of life and sense of coherence in a primary health care (PHC)-based programme with two different intensities. Design: Prospective two-armed randomised intervention. Setting: Three PHC centres in south west of Sweden. ⋯ High intensity did not lead to a significant difference in weight reduction between the groups. The high-intensity group reported more health effects, such as better quality of life, reduced anxiety, and increased greenery intake. It is unknown how much support patients in a weight- reduction programme in PHC require to succeed with weight loss and a healthy lifestyle.
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Scand J Prim Health Care · Jun 2020
Comparative Study Observational StudyCharacteristics of patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare.
Objective: The aim of this study was to describe patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare and to examine factors associated with depression. Design: This was an observational study. Setting: Fourteen outpatient clinics and 33 general practitioners and municipality memory teams across Norway. ⋯ Depression was associated with female gender, older age, more severe decline in cognitive functioning (IQCODE, OR 1.65), higher caregiver burden (RSS, OR 1.10) and with being assessed in primary healthcare (OR 1.53). Conclusion: Post-diagnostic support tailored to patients diagnosed with dementia in primary healthcare should consider their poor cognitive function and limitations in ADL and that these people often live alone, have BPSD and depression. Key pointsPeople diagnosed in Norwegian primary healthcare had more needs than people diagnosed in specialist healthcare. • They were older, less educated, had poorer cognitive functioning and activity limitations, more often lived alone, and had more BPSD and depression. • Depression was associated with being female, older, having cognitive decline, being assessed in primary care and the caregiver experiencing burden • Post diagnostic support for people with dementia should be tailored to the individual's symptoms and needs.
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Scand J Prim Health Care · Jun 2020
Insomnia in the elderly: reported reasons and their associations with medication in general practice in Denmark.
Objective: The aim of this study was to investigate reasons for insomnia symptoms and their associations with sleep medication prescription in elderly patients in general practice. Design: Over a period of 20 weekdays, general practitioners (GPs) recorded reasons and treatment for insomnia symptoms. Patient characteristics and outcomes were analysed using descriptive statistics. ⋯ Regardless of reason, a majority of the consultations resulted in prescription of sleep medication with potential serious adverse effects. This indicates that there is still room for improving the management of insomnia among older adults. Key PointsAlthough insomnia is common in the elderly, little is known about its reasons and their associations with prescription patterns. The most commonly reported reasons for insomnia symptoms in the elderly are psychiatric diagnosis and somatic illness. According to guidelines, sleep medication with potential serious adverse effects is prescribed too frequently to elderly patients. An effort should be made to identify and optimally treat comorbid insomnia, which appears to be prevalent in older adults.
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Scand J Prim Health Care · Jun 2020
Associations between lifestyle, erectile dysfunction and healthcare seeking: a population-based study.
Objective: To investigate associations between age, lifestyle and erectile dysfunction (ED) in the general population and to explore associations between age, lifestyle and contact with a general practitioner (GP) regarding ED. Design: Cross-sectional web-based questionnaire study. Setting: The general Danish population. ⋯ Furthermore, lifestyle was significantly associated with reporting ED, but largely not associated with healthcare seeking. These findings are important for future interventions aiming to improve diagnosis and treatment of ED. Key pointsExperiencing erectile dysfunction is frequent in the general population, especially among older men. • In this large-scale national survey, age and lifestyle were significantly associated with reporting erectile dysfunction. • Healthcare seeking with erectile dysfunction was significantly associated with age, but not with lifestyle. • Diagnosis and treatment of erectile dysfunction might be challenged when erectile dysfunction does not lead to healthcare seeking.
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Objective: To assess the use of point-of-care ultrasound (POCUS) in Norwegian general practice. Design: Retrospective register study based on general practitioners' (GPs') reimbursement claims. Setting: Norwegian general practice excluding out-of-hours clinics in 2009, 2012 and 2016. ⋯ The use of POCUS increased six-fold from 2009 to 2016. Three out of four scanning GPs performed less than 10 scans annually. Male GPs performed 80% of the claimed scans.