Scandinavian journal of primary health care
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Scand J Prim Health Care · Jun 2022
Construction and validation of a morbidity index based on the International Classification of Primary Care.
In epidemiological studies it is often necessary to describe morbidity. The aim of the present study is to construct and validate a morbidity index based on the International Classification of Primary Care (ICPC-2). ⋯ The ICPC morbidity index performs equal to the Charlson index and can be recommended for use in data materials collected in primary health care.Key pointsThis is the first morbidity index based on the International Classification of Primary Care, 2nd edition (ICPC-2)It predicted mortality equal to the Charlson index and validated acceptably in a different populationThe ICPC morbidity index can be used as an adjustment variable in epidemiological research in primary care databases.
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Scand J Prim Health Care · Jun 2022
Exploration of the feasibility to combine patients with chronic obstructive pulmonary disease and chronic heart failure in self-management groups with focus on exercise self-efficacy.
To compare the level of exercise self-efficacy, symptoms, functional capacity and health status and investigate the association between these variables in patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Additionally, to investigate how diagnosis, symptoms and patient characteristics are associated with exercise self-efficacy in these patient groups. ⋯ Patients with COPD or CHF have similar levels of exercise self-efficacy, symptoms, functional capacity and health status. More severe symptoms are associated with lower levels of exercise self-efficacy regardless of diagnosis, sex and age. When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider level of symptoms than the specific diagnosis of COPD or CHF.Key pointsExercise training is an important part of self-management in patients with COPD and chronic heart failure (CHF). High exercise self-efficacy is required for optimal exercise training.Patients with COPD and CHF have similar symptoms and similar levels of exercise self-efficacy, functional capacity and health status.Not the diagnosis, but symptoms of dyspnea, fatigue, pain, depression and anxiety are important factors influencing exercise self-efficacy and need to be addressed.When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider the level of symptoms than the specific diagnosis of COPD or CHF.
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Scand J Prim Health Care · Jun 2022
Variation of GP antibiotic prescribing tendency for contacts with out-of-hours primary care in Denmark - a cross-sectional register-based study.
To study variation in antibiotic prescribing rates among general practitioners (GP) in out-of-hours (OOH) primary care and to explore GP characteristics associated with these rates. ⋯ Some variation in the GPs' tendency to prescribe antibiotics was found for OOH primary care contacts. Available GP characteristics, such as GPs' activity level and familiarity with OOH care, explained only small parts of this variation. Future research should focus on identifying factors that can explain this variation, as this knowledge could be used for designing interventions.KEY POINTSCurrent awareness:Antibiotic prescribing rates seem to be higher in out-of-hours than in daytime primary care.Most important results:Antibiotic prescribing rates varied significantly among general practitioners after adjustment for contact- and patient-characteristics.This variation remained even after accounting for variation attributable to chance.General practitioners' activity level and familiarity with out-of-hours care were positively associated with their tendency to prescribe antibiotics.
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Scand J Prim Health Care · Jun 2022
Factors related to self-rated health: a survey among patients and their general practitioners.
To explore associations between general practice patients' SRH and symptoms, diagnoses, chronic conditions, unexplained conditions, and life stressors. ⋯ The likelihood of reporting poor SRH increased with an increasing number of symptoms, partly independent of the diagnosis given by GPs. This result coincides with our previous findings of a strong association between the number of symptoms, function, and health. The symptom burden thus appears to be an important factor for SRH among patients in general practice.KEY POINTSThere is a high prevalence of poor SRH in general practice patients.The likelihood of reporting poor SRH is partly independent of the diagnosis given.The number of symptoms was the factor strongest associated with poor SRH.
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Scand J Prim Health Care · Jun 2022
Migrant GPs and patients: a cross-sectional study of practice characteristics, patient experiences and migration concordance.
To investigate practice type and location of native and immigrant general practitioners (GPs); effects of migration status concordance between GPs and patients on experiences of patients in key areas of primary care quality and discrimination. ⋯ Patient experiences did not vary with GPs' migration status. Although experience of discrimination was uncommon, first-generation migrant patients experienced more discrimination. Primary care should provide non-discriminatory care, through GP awareness of unconscious bias and training to address this. Key messagesThere were large differences in percentage of migrant GPs between countries.Migrant GPs' practices had an above average proportion of people from ethnic minorities.In general, patients' experienced discrimination from GPs and practice staff was low, but first-generation migrant patients more often experienced discrimination.First-generation migrant patients more often experienced discrimination when they visited a native GP.