Scandinavian journal of primary health care
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Scand J Prim Health Care · Mar 2024
Randomized Controlled TrialEffects of an interactive web-based support system via mobile phone on preference-based patient participation in patients living with hypertension - a randomized controlled trial in primary care.
To estimate the effects of an interactive web-based support system via mobile phone on preference-based patient participation in patients with hypertension treated in primary care (compared with standard hypertensive care only). ⋯ The interactive web-based support system via mobile phone had a wavering effect on preference-based patient participation. There is a prevailing need to better understand how person-centered patient participation can be facilitated in primary care.
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Scand J Prim Health Care · Mar 2024
Observational StudyInsulin initiation in patients with type 2 diabetes is often delayed, but access to a diabetes nurse may help-insights from Norwegian general practice.
Objective: We opted to study how support staff operational capacity and diabetes competences may impact the timeliness of basal insulin-initiation in general practice patients with type 2 diabetes (T2D). Design/Setting/Outcomes: This was an observational and retrospective study on Norwegian primary care patients with T2D included from the ROSA4-dataset. Exposures were (1) support staff size, (2) staff size relative to number of GPs, (3) clinic access to a diabetes nurse and (4) share of staff with diabetes course (1 and 2 both relate to staff operational capacity, whereas 3 and 4 are both indicatory of staff diabetes competences). ⋯ Adjusted risk of 'timely basal insulin-initiation' was more than twofold higher if access to a diabetes nurse (OR = 2.40, [95%CI, 1.68, 3.43]), but related only vaguely to staff size (OR = 1.01, [95%CI, 1.00, 1.03]). No other staff factors related significantly to neither the primary nor the secondary outcome. Conclusion: In Norwegian general practice, insulin initiation in people with T2D may be affected by therapeutic inertia but access to a diabetes nurse may help facilitating more timely insulin start-up.
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Scand J Prim Health Care · Mar 2024
Heart failure patients without echocardiography are more commonly diagnosed in hospital care and are associated with higher mortality compared to primary care.
This Swedish study aimed to assess the prevalence, associated clinical factors, and mortality rates of heart failure patients diagnosed without echocardiograms in both hospital and primary care settings. ⋯ In a Swedish region, heart failure diagnoses without echocardiograms were more common in hospitals, and these patients initially faced worse prognoses. After the first month, however, the prognosis of hospital-diagnosed patients mirrored that of those diagnosed in primary care. These findings emphasize the need for improved diagnostic and treatment approaches in both care settings to enhance outcomes.
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Scand J Prim Health Care · Mar 2024
Importance of continuity of care from a patient perspective - a cross-sectional study in Swedish health care.
The primary objective of this study was to evaluate the patients' view on continuity of care (CoC), including preference for a certain general practitioner (GP) and importance and access to a regular general practitioner (RGP). ⋯ In conclusion, this study showed that the majority of patients value CoC in terms of importance of having an RGP. Older patients were more likely to have a preference for a certain GP. Two-third of the patients succeeded in seeing their RGP always or a lot of the time. The results in this study provide evidence that CoC is important for most patients, regardless of age and gender.Key pointsPrevious studies have showed that continuity of care (CoC) is important regarding mortality and morbidity. In primary care, there is a current debate regarding CoC, accessibility and the strive for CoC. This study showed that the majority of patients, regardless of age and gender, value CoC and consider it being important. However, there was a statistically significant difference regarding age, where patients above 65 years old thought it was more important to have a regular general practitioner and more often had a preference for a certain GP.
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Scand J Prim Health Care · Mar 2024
Experiences of hospital rotation from family medicine residents' points of view an empirical holistic study.
Trainees or medical residents' experiences of hospital rotations and training have not been sufficiently studied. More empirical holistic studies of experiences of General Practice/Family Medicine (GP/FM) residents in Sweden are needed. The purpose of this study was to describe experiences of hospital rotation during residency. ⋯ The study suggests that family medicine residents required a structured and planned schedule during hospital rotations. This study may contribute to increased quality of hospital rotations during residency as a family physician.