The British journal of general practice : the journal of the Royal College of General Practitioners
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Parkinson's disease is a multisystem condition that usually presents as a movement disorder in clinical practice. There is no objective method for its diagnosis and therefore the current diagnostic process is based on characteristic clinical signs and symptoms. As the presenting symptoms can be vague and non-specific, there is often a delay in diagnosis leading to mismanagement and delayed treatment initiation. In the UK, GPs identify and initially assess individuals with Parkinson's disease and refer them to specialists for formal diagnosis and treatment initiation. ⋯ This scoping review shows that there are no well-conducted studies assessing the accuracy of Parkinson's disease diagnoses when made by GPs. This calls for more focused research in this area as diagnostic delays and errors may lead to potentially harmful but preventable delays in treatment initiation resulting in decreased quality of life for individuals with Parkinson's disease.
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Parkinson's disease is a multisystem condition that usually presents as a movement disorder in clinical practice. There is no objective method for its diagnosis and therefore the current diagnostic process is based on characteristic clinical signs and symptoms. As the presenting symptoms can be vague and non-specific, there is often a delay in diagnosis leading to mismanagement and delayed treatment initiation. In the UK, GPs identify and initially assess individuals with Parkinson's disease and refer them to specialists for formal diagnosis and treatment initiation. ⋯ This scoping review shows that there are no well-conducted studies assessing the accuracy of Parkinson's disease diagnoses when made by GPs. This calls for more focused research in this area as diagnostic delays and errors may lead to potentially harmful but preventable delays in treatment initiation resulting in decreased quality of life for individuals with Parkinson's disease.
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Meta Analysis
Preventive interventions to improve older people's health outcomes: systematic review and meta-analysis.
Systematic reviews of preventive, non-disease-specific primary care trials for older people often report effects according to what is thought to be the intervention's active ingredient. ⋯ Preventive primary care interventions are beneficial to older people's functional ability and SRH but not other outcomes. To improve primary care for older people, future programmes should consider delivering care in alternative settings, for example, home visits and phone contacts, and providing education to patients and health professionals as these may contribute to positive outcomes.
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Meta Analysis
Osteoporosis and fracture as risk factors for self-harm and suicide: a systematic review and meta-analysis.
Increase in presentations of self-harm to primary care, a risk factor of suicide, has led to a growing interest in identifying at-risk populations. ⋯ Patients with vertebral fractures, a risk potential factor for suicide, may benefit from clinical case finding for mood disorders with personalised primary care management. However, because of the limited number and quality of studies and mixed findings, further examination of these associations is warranted.