The British journal of general practice : the journal of the Royal College of General Practitioners
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Patients with chronic obstructive pulmonary disease (COPD) constitute a substantial burden to healthcare services. Analysis of national healthcare datasets offers the possibility to advance understanding about the changing epidemiology of COPD. ⋯ Given the peak in the incidence rate of COPD, we may be approaching the summit of COPD incidence and prevalence in England. However, the number of people affected remains high and poses a major challenge for health services, particularly those in the north east of the country and in the most deprived communities in England. The very limited decrease in smoking rates among the more deprived groups of patients with COPD is also a cause for concern.
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Multicenter Study
Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women.
Dipsticks are one of the most commonly used near-patient tests in primary care, but few clinical or dipstick algorithms have been rigorously developed. ⋯ A clinical score is of limited value in increasing diagnostic precision. Dipstick results can modestly improve diagnostic precision but poorly rule out infection. Clinicians need strategies to take account of poor NPVs.
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Multimorbidity is defined as the occurrence of two or more chronic diseases in one individual. Patients with multimorbidity generally have poorer health and functioning and higher rates of attendance in primary care and specialty settings. ⋯ This study provides information on the significant impact of multimorbidity from a professional perspective. It highlights potential elements of an intervention that could be designed and tested to achieve improvements in the management of multimorbidity, outcomes for individuals affected, and the experiences of those providing healthcare.
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Multicenter Study
Management of drug misuse: an 8-year follow-up survey of Scottish GPs.
This study repeated a Scotland-wide survey of one-in-four GPs from 2000, to compare findings with 2008. A 60% response was achieved (of 1065). Almost 44% of GPs were treating drug misusers (62% in 2000). ⋯ Seven per cent of responders were only comfortable prescribing below the recommended minimum dose of 60 mg methadone, (33% in 2000). Over 70% offered blood-borne virus screening and 71% were aware of patients using psychostimulants. Recent changes, particularly the new GP contract may have decreased GP involvement in treating drug misusers.