The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Multicenter Study Clinical Trial
Radiography for low back pain: a randomised controlled trial and observational study in primary care.
Lumbar spine radiography has limited use in diagnosing the cause of acute low back pain. Consensus-based guidelines recommend that lumbar spine x-rays are not used routinely. However there have been no studies of the effect of referral for radiography at first presentation with low back pain in primary care. ⋯ Referral for lumbar spine radiography for first presentation of low back pain in primary care is not associated with improved physical functioning, pain or disability. The possibility of minor psychological improvement should be balanced against the high radiation dose involved.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomised trial of two approaches to screening for atrial fibrillation in UK general practice.
Atrial fibrillation is a common and treatable cause of stroke that often remains unrecognised. Screening has been suggested but there is very little evidence concerning the uptake of screening in the elderly population at risk, nor of the optimal method of screening in a general practice setting ⋯ Nurse-led screening for atrial fibrillation in UK general practice is both feasible and effective and will identify a substantial number of patients who could benefit from antithrombotic therapy. Although the majority of patients detected at first screening could be identified by careful scrutiny of medical records, review of record summaries was insufficient in the practices involved in this study and screening may be a more cost-effective option.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomised controlled trial of the effect of educational outreach by community pharmacists on prescribing in UK general practice.
Educational outreach visits are commonly used to promote changes in prescribing in family practice. However, the effectiveness of outreach visits has not been evaluated across a range of settings. ⋯ In large practices, educational outreach alone is unlikely to achieve worthwhile change. There is good evidence to support the use of educational outreach visits in small practices.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Telephone consultations to manage requests for same-day appointments: a randomised controlled trial in two practices.
General practitioners (GPs) in the United Kingdom have recently begun to adopt the use of telephone consultation during daytime surgery as a means of managing demand, particularly requests for same-day appointments. However, it is not known whether the strategy actually reduces GP workload. ⋯ Use of telephone consultations for same-day appointments was associated with time saving, and did not result in lower PEI scores. Possibly, however, this short-term saving was offset by higher re-consultation and less use of opportunistic health promotion.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A randomised controlled trial of a self-management plan for patients with newly diagnosed angina.
There are approximately 1.8 million patients with angina in the United Kingdom, many of whom report a poor quality of life, including raised levels of anxiety and depression. ⋯ The Angina Plan appears to improve the psychological, symptomatic, and functional status of patients newly diagnosed with angina.