The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Patients' ideas, concerns, and expectations (ICE) in general practice: impact on prescribing.
Although studies are available on patients' ideas, concerns, and expectations in primary care, there is a scarcity of studies that explore the triad of ideas, concerns, and expectations (ICE) in general practice consultations and the impact on medication prescribing. ⋯ An association was found between the presence of concerns and/or expectations, and less medication prescribing. The data suggest that exploring ICE components may lead to fewer new medication prescriptions.
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Multicenter Study
Economic influences on GPs' decisions to provide out-of-hours care.
Introduction of the new general medical services contract offered UK general practices the option to discontinue providing out-of-hours (OOH) care. This aimed to improve GP recruitment and retention by offering a better work-life balance, but put primary care organisations under pressure to ensure sustainable delivery of these services. Many organisations arranged this by re-purchasing provision from individual GPs. ⋯ The opportunity to opt out of OOH care has provided flexibility for GPs to raise additional income, although primary care organisations vary in the extent to which they offer these opportunities. Examining intrinsic motivation is an area for future study.
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Multicenter Study
Users' reports and evaluations of out-of-hours health care and the UK national quality requirements: a cross sectional study.
National standards for delivery of out-of-hours services have been refined. Health service users' preferences, reports, and evaluations of care are of importance in a service that aims to be responsive to their needs. ⋯ Users have high expectations of UK out-of-hours healthcare services. Service provision that meets nationally designated targets is currently judged as being of 'good' quality by service users. Attaining 'excellent' levels of service provision would prove challenging, and potentially costly. Delivering services that result in high levels of user satisfaction with care needs to take account of users' expectations as well as their experience of care.
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Randomized Controlled Trial Multicenter Study
Randomised controlled trial of intensive multifactorial treatment for cardiovascular risk in patients with screen-detected type 2 diabetes: 1-year data from the ADDITION Netherlands study.
A growing body of evidence suggests that earlier diagnosis and treatment of diabetes may be beneficial; however, definitive evidence is lacking. ⋯ Intensified multifactorial treatment of patients with screen-detected diabetes in general practice reduces cardiovascular risk factor levels significantly without worsening HRQoL.