The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Variations in anxiolytic and hypnotic prescribing by GPs: a cross-sectional analysis using data from the UK Quality and Outcomes Framework.
Wide variations in anxiolytic and hypnotic prescribing by GPs in England have been described, but are largely unexplained. ⋯ Demographic factors were more powerful determinants of prescribing than characteristics of the practice itself. Nevertheless, the findings provide some support for the notion that high prescribing practices were less well developed, in that their QOF scores were lower and they were less likely to be training practices.
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Randomized Controlled Trial Multicenter Study
REDIRECT: cluster randomised controlled trial of GP training in first-episode psychosis.
Delays in accessing care for young people with a first episode of psychosis are significantly associated with poorer treatment response and higher relapse rates. ⋯ GP training on first-episode psychosis is insufficient to alter referral rates to early-intervention services or reduce the duration of untreated psychosis; however, there is a suggestion that training facilitates access to the new specialist teams for early psychosis.
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Multicenter Study
Inter-arm blood pressure difference in type 2 diabetes: a barrier to effective management?
Previous studies have identified a substantial prevalence of a blood pressure difference between arms in various populations, but not patients with type 2 diabetes. Recognition of such a difference would be important as a potential cause of underestimation of blood pressure. ⋯ A systolic inter-arm difference > or =10 mmHg was observed in 10% of patients with diabetes. Failure to recognise this would misclassify half of these as normotensive rather than hypertensive using the lower-reading arm. New patients with type 2 diabetes should be screened for an inter-arm blood pressure difference.
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Multicenter Study
Telephone consulting in primary care: a triangulated qualitative study of patients and providers.
Internationally, there is increasing use of telephone consultations, particularly for triaging requests for acute care. However, little is known about how this mode of consulting differs from face-to-face encounters. ⋯ Used appropriately, telephone consulting enhances access to health care, aids continuity, and saves time and travelling for patients. The current emphasis on use for acute triage, however, worried clinicians and patients. Given these findings, and until the safe use of telephone triage is fully understood and agreed upon by stakeholders, policymakers and clinicians should consider using the telephone primarily for managing follow-up appointments when diagnostic assessment has already been undertaken.