The British journal of general practice : the journal of the Royal College of General Practitioners
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Patients with bladder and kidney cancer may experience diagnostic delays. ⋯ Older females with UTIs might be at increased risk of MDOs for cancer. Targeting barriers during the initial diagnostic assessment and follow-up might improve quality of diagnosis.
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Chronic back pain (CBP) is common among patients in primary care and is associated with significant personal and socioeconomic burden. Research has shown that physical activity (PA) is one of the most effective therapies to reduce pain; however, for GPs it remains challenging to advise and encourage individuals with CBP to exercise regularly. ⋯ To the best of the authors' knowledge, this is the first qualitative study exploring opinion and experience of PA in individuals with CBP and GPs in parallel. This study reveals a complex doctor- patient relationship and provides an important insight to motivation for, and adherence to, PA in individuals with CBP.
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Observational Study
Predicting the risk of acute kidney injury in primary care: derivation and validation of STRATIFY-AKI.
Antihypertensives reduce the risk of cardiovascular disease but are also associated with harms including acute kidney injury (AKI). Few data exist to guide clinical decision making regarding these risks. ⋯ This clinical prediction model enables GPs to accurately identify patients at high risk of AKI, which will aid treatment decisions. As the vast majority of patients were at low risk, such a model may provide useful reassurance that most antihypertensive treatment is safe and appropriate while flagging the few for whom this is not the case.
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Timely diagnosis of cancer in patients who present with symptoms in primary care is a quality-improvement priority. ⋯ In the 5-year period, including the year when national guidelines were updated (that is, 2015), there were substantial improvements to the diagnostic process of patients who present to general practice in England with symptoms of a subsequently diagnosed cancer.