The British journal of general practice : the journal of the Royal College of General Practitioners
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GPs have been shown to be important providers of medical care during pregnancy, however, little evidence exists on their awareness of pregnancy when prescribing medication to women. ⋯ Results of this study indicate a potential issue with GP awareness about pregnancy status at the time medication with potential safety risks is prescribed. Although pregnancy registration by GPs improved over the years, inadequate use still seems to be made of the available information systems for appropriate drug surveillance.
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People who experience severe and multiple disadvantage (SMD - including combinations of homelessness, substance misuse, violence and abuse, and poor mental health) have high health need and poor access to primary care. Access to care requires the 'human fit' between the patient and healthcare staff. ⋯ Co-produced service-improvements to improve access to primary care for marginalised patients were valued, possible, and of benefit to patients, staff, and services. This study offers valuable insight into how we can better include and care for marginalised patients in primary care.
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Existing cardiovascular disease (CVD) risk prediction tools may not be applicable to the Chinese populations because of their development based on the mostly Western cohorts and limited list of covariates. ⋯ P-CARDIAC allows a more personalised approach for recurrent CVD prevention with dynamic baseline risk and concurrent medication effect. Such an approach with the potential for being recalibrated for other ethnicities will be used in primary care for managing CVD risk.
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GPs regularly prescribe lifelong treatments for long-term conditions, supported by clinical guidelines and encouraged by performance measures. However, GPs have a poor understanding of the absolute benefits and harms of these treatments, impairing their ability to engage in genuine shared decision making or optimally manage polypharmacy. There are few easily accessible and understandable sources of this kind of quantitative information. ⋯ It is possible to communicate quantitative information about the clinical evidence base behind treatments in a way that will be usable in practice and that complements existing clinical guidelines and normative practice. This has the potential to support shared decision making, improve the management of polypharmacy, and increase GPs' confidence in this area of practice.
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App-based treatment for female urinary incontinence (UI) is a cost-effective alternative to care as usual. For successful implementation it is of major importance to involve stakeholders like care providers. ⋯ Our results add to the existing knowledge about eHealth-related barriers and facilitators. These findings can be used to optimise implementation strategies for other apps and to enhance the uptake of app-based treatment for UI in the Netherlands.