The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Multicenter Study
Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial.
Hawthorn (Crataegus laevigata) leaves, flowers and berries are used by herbal practitioners in the UK to treat hypertension in conjunction with prescribed drugs. Small-scale human studies support this approach. ⋯ This is the first randomised controlled trial to demonstrate a hypotensive effect of hawthorn in patients with diabetes taking medication.
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Randomized Controlled Trial
Longer term outcomes from a randomised trial of prescribing strategies in otitis media.
There are limited data about the longer-term outcomes in acute otitis media (AOM) when comparing the realistic alternatives of immediate prescription of antibiotics and a 'wait and see' or delayed prescribing policy. ⋯ For most children, delayed prescribing is not likely to have adverse longer-term consequences. Children with recurrent AOM are more likely to have poorer outcomes. Secondary analysis should be treated with caution and requires confirmation, but suggests that treating such children with antibiotics immediately may not alter longer-term outcomes.
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Randomized Controlled Trial
The effect of a programme of organised and supervised peer support on the initiation and duration of breastfeeding: a randomised trial.
Peer support may improve breastfeeding rates but the evidence is inconclusive. Previous studies and reviews recommend trials in different healthcare settings. ⋯ Peer support did not increase breastfeeding in this population by a statistically significant amount.
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Randomized Controlled Trial Multicenter Study
Involving patients in primary care consultations: assessing preferences using discrete choice experiments.
Shared decision making (SDM) involves patients and doctors contributing as partners to treatment decisions. It is not known whether or to what extent SDM contributes to the welfare arising from a consultation, and how important this contribution is relative to other attributes of a consultation. ⋯ Shared treatment decisions were valued less than some other attributes of a consultation. However, patient utilities for such involvement appeared responsive to changes in experiences of consultations. This suggests that SDM may gain greater value among patients once they have experienced it.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of GP and nurse practitioner consultations: an observational study.
Studies show that satisfaction with nurse practitioner care is high when compared with GPs. Clinical outcomes are similar. Nurse practitioners spend significantly longer on consultations. ⋯ The provision of more information in the longer nurse consultations may explain differences in patient satisfaction found in other studies. Clinicians need to consider how much information it is appropriate to provide to particular patients.