The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Comparative Study Clinical Trial
Insulin therapy in poorly controlled type 2 diabetic patients: does it affect quality of life?
Strict glycaemic control in type 2 diabetic patients is recommended in a number of treatment protocols. However, although better glycaemic control prevents or postpones chronic diabetic complications, it remains uncertain how this affects quality of life in the short and long term. ⋯ Insulin therapy in poorly controlled type 2 diabetic patients from general practice resulted in a significant clinical improvement of glycaemic control, accompanied by a reduction of hyperglycaemic complaints, without an increase in hypoglycaemic complaints or an adverse influence on quality of life.
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Randomized Controlled Trial Clinical Trial
A randomised controlled trial of screening for adult hearing loss during preventive health checks.
Prophylactic strategies to counter acquired hearing impairment may involve routine audiometric screening of asymptomatic working-age adults attending general practice for regular health checks. ⋯ Preventive health checks with audiometry did not significantly affect hearing, but leisure noise exposure tended to become less frequent. The poor effect may be ascribed to inadequate audiological counselling or a higher priority to other advice, e.g. on cardiovascular risk or lifestyle.
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Randomized Controlled Trial Clinical Trial
Attitudes towards, and utility of, an integrated medical-dental patient-held record in primary care.
The need for closer coordination between primary care medical and dental services has been recognized. ⋯ Both professionals and patients have reasonably positive attitudes towards the use of patient-held records. Among patients, the experience of having the integrated medical-dental PHR led to greater enthusiasm towards the idea. Dentists in particular would benefit from the transfer of information from doctors, but better methods are needed to ensure that patients take the integrated medical-dental PHR with them. Given the current lack of ability to easily produce an integrated medical-dental PHR, further examination of the routine issue of a copy of their medical summary, by GMPs, to all patients would be worthwhile.
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Randomized Controlled Trial Clinical Trial
Randomized controlled trial of general practitioner versus usual medical care in a suburban accident and emergency department using an informal triage system.
We determined if care provided by general practitioners (GPs) to non-emergency patients, in a suburban accident and emergency (A&E) department using an informal triage system, differs significantly from care provided by usual A&E staff. One thousand eight hundred and seventy-eight patients participated. ⋯ This is the first study to report that sessional GPs working in an A&E department utilize similar or more resources than usual A&E staff. It emphasizes the need for the continued audit of initiatives that have been introduced into new settings.
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Randomized Controlled Trial Clinical Trial
Suprascapular nerve block for the treatment of frozen shoulder in primary care: a randomized trial.
Frozen shoulder is a common problem in general practice, but its treatment is difficult since none of the currently used therapies are proven to be effective. ⋯ This study suggests that suprascapular nerve block is a safe and effective treatment for frozen shoulder in primary care, and justifies a larger multicentred trial using independent blinded assessment. Such a study should include a third group treated by suprascapular nerve block without steroid; a more comprehensive assessment of patient debility.