The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Does Advanced Access improve access to primary health care? Questionnaire survey of patients.
General practices in England have been encouraged to introduce Advanced Access, but there is no robust evidence that this is associated with improved access in ways that matter to patients. ⋯ Patients are seen more quickly in Advanced Access practices, but speed of access is less important to patients than choice of appointment; this may be because most consultations are about long-standing problems. Appointment systems need to be flexible to accommodate the different needs of different patient groups.
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Randomized Controlled Trial Multicenter Study
Health risk appraisal in older people 3: prevalence, impact, and context of pain and their implications for GPs.
Pain is a common experience in later life. There is conflicting evidence of the prevalence, impact, and context of pain in older people. GPs are criticised for underestimating and under-treating pain. ⋯ A multidimensional approach to assessing pain is appropriate. Primary care practitioners should also assess the impact of pain on activities of daily living.
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Randomized Controlled Trial Multicenter Study
Influence of magnetic resonance of the knee on GPs' decisions: a randomised trial.
Magnetic resonance imaging (MRI) of the knee for meniscus and ligament injuries is an accurate diagnostic test. Early and accurate diagnosis of patients with knee problems may prevent the onset of chronic problems such as osteoarthritis, a common cause of disability in older people consulting their GP. ⋯ Access to MRI did not significantly alter GPs' diagnoses or treatment plans compared with direct referral to an orthopaedic specialist, but access to MRI significantly increased their confidence in these decisions.
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Multicenter Study
A case-control study of presentations in general practice before diagnosis of coeliac disease.
Delay in the diagnosis of coeliac disease prolongs morbidity and may increase mortality. Little is known about presentations in general practice that may predict a subsequent diagnosis of coeliac disease. ⋯ [corrected] GPs should consider testing for coeliac disease when patients present often, especially with diarrhoea and/or who are discovered to be anaemic. Further research is required to clarify the role of depression and/or anxiety in the diagnosis of coeliac disease.