The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Multicenter Study
Health risk appraisal in older people 3: prevalence, impact, and context of pain and their implications for GPs.
Pain is a common experience in later life. There is conflicting evidence of the prevalence, impact, and context of pain in older people. GPs are criticised for underestimating and under-treating pain. ⋯ A multidimensional approach to assessing pain is appropriate. Primary care practitioners should also assess the impact of pain on activities of daily living.
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Randomized Controlled Trial Multicenter Study
Influence of magnetic resonance of the knee on GPs' decisions: a randomised trial.
Magnetic resonance imaging (MRI) of the knee for meniscus and ligament injuries is an accurate diagnostic test. Early and accurate diagnosis of patients with knee problems may prevent the onset of chronic problems such as osteoarthritis, a common cause of disability in older people consulting their GP. ⋯ Access to MRI did not significantly alter GPs' diagnoses or treatment plans compared with direct referral to an orthopaedic specialist, but access to MRI significantly increased their confidence in these decisions.
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Randomized Controlled Trial Multicenter Study
A randomised controlled trial to test the feasibility of a collaborative care model for the management of depression in older people.
Depression is the most common mental health disorder in people aged over 65 years. Late-life depression is associated with chronic illness and disability. ⋯ A model of collaborative care for older people with depression, used in a primary care setting with a facilitated self-help intervention is more effective than usual GP care. This study demonstrates that the implementation of a collaborative care model is feasible in UK primary care and that the intervention is effective and acceptable to patients.
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Randomized Controlled Trial Multicenter Study
Health risk appraisal in older people 2: the implications for clinicians and commissioners of social isolation risk in older people.
Social isolation is associated with poorer health, and is seen by the World Health Organisation (WHO) as one of the major issues facing the industrialised world. ⋯ The risk of social isolation is elevated in older men, older persons who live alone, persons with mood or cognitive problems, but is not associated with greater use of services. These findings would not support population screening for individuals at risk of social isolation with a view to averting service use by timely intervention. Awareness of social isolation should trigger further assessment, and consideration of interventions to alleviate social isolation, treat depression or ameliorate cognitive impairment.
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Randomized Controlled Trial Multicenter Study
Cluster randomised controlled trial of the effectiveness of primary care mental health workers.
Mental health issues are a core part of the work of primary care and are the second most common reason for consultations. There is some evidence that the quality of primary care mental health provision is variable. ⋯ For patients with common mental health problems, primary care mental health workers may be effective at increasing satisfaction with an episode of care.