BMJ : British medical journal
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Randomised trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: outcomes and patients' preference.
Firstly, to compare the effectiveness of a brief physiotherapy intervention with "usual" physiotherapy for patients with neck pain. Secondly, to evaluate the effect of patients' preferences on outcome. ⋯ Usual physiotherapy may be only marginally better than a brief physiotherapy intervention for neck pain. Patients with a preference for the brief intervention may do at least as well with this approach. Additional training for the physiotherapists in cognitive behaviour techniques might improve this approach further.
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Randomized Controlled Trial Multicenter Study Clinical Trial
United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: effectiveness of physical treatments for back pain in primary care.
To estimate the effect of adding exercise classes, spinal manipulation delivered in NHS or private premises, or manipulation followed by exercise to "best care" in general practice for patients consulting with back pain. [See figure]. ⋯ Relative to "best care" in general practice, manipulation followed by exercise achieved a moderate benefit at three months and a small benefit at 12 months; spinal manipulation achieved a small to moderate benefit at three months and a small benefit at 12 months; and exercise achieved a small benefit at three months but not 12 months.
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Multicenter Study
UK legislation on analgesic packs: before and after study of long term effect on poisonings.
To evaluate the long term effect of legislation limiting the size of packs of analgesics sold over the counter. ⋯ Legislation restricting pack sizes of analgesics in the United Kingdom has been beneficial. A further reduction in pack sizes could prevent more deaths.
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Multicenter Study
Evidence based guidelines or collectively constructed "mindlines?" Ethnographic study of knowledge management in primary care.
To explore in depth how primary care clinicians (general practitioners and practice nurses) derive their individual and collective healthcare decisions. ⋯ These findings highlight the potential advantage of exploiting existing formal and informal networking as a key to conveying evidence to clinicians.
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Randomized Controlled Trial Multicenter Study Clinical Trial
NHS Direct versus general practice based triage for same day appointments in primary care: cluster randomised controlled trial.
To assess the relative effects on consultation workload and costs of off-site triage by NHS Direct for patients requesting same day appointments compared with usual on-site nurse telephone triage in general practice. ⋯ External management of requests for same day appointments by nurse telephone triage through NHS Direct is possible but comes at a higher cost than practice nurse delivered triage in primary care. If NHS Direct could achieve the same proportions of consultation types as practice based triage, costs would be comparable.