The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice.
The ubiquitous use of communication technologies has led to an expectation that a similar approach should extend to health care. Despite considerable rhetoric about the need for general practices to offer alternatives to face-to-face consultations, such as telephone, email, and internet video consultations, the extent to which such technologies are actually used at present is unclear. ⋯ Despite policy pressure to introduce consultations by email and internet video, there is a general reluctance among GPs to implement alternatives to face-to-face consultations. This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future.
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Multicenter Study Comparative Study
Primary care clinician antibiotic prescribing decisions in consultations for children with RTIs: a qualitative interview study.
Respiratory tract infections (RTIs) are a major primary care challenge in children because they are common and costly, there is uncertainty regarding their diagnosis, prognosis, and management, and the overuse of antibiotics leads to illness medicalisation and bacterial resistance. ⋯ Prognostic uncertainty remains an important driver of HCPs' antibiotic prescribing. Experience and training in recognising severe RTIs, together with more evidence to help HCPs identify the children at risk of future illness deterioration, may support HCPs' identification of the children most and least likely to benefit from antibiotics.
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Multicenter Study Comparative Study
Unintended consequences of an 'all-clear' diagnosis for potential cancer symptoms: a nested qualitative interview study with primary care patients.
Nine out of 10 patients undergoing urgent cancer investigations receive an 'all-clear' diagnosis. ⋯ An all-clear diagnosis can influence help seeking for months or even years in case of new or recurrent alarm symptoms. Considering the increasing number of people undergoing investigations and receiving an all-clear, it is paramount to limit unintended consequences by providing appropriate information and support. Specific issues are identified that could be addressed.
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Randomized Controlled Trial Multicenter Study
Mindfulness-based stress reduction for GPs: results of a controlled mixed methods pilot study in Dutch primary care.
Burnout is highly prevalent in GPs and can have a negative influence on their wellbeing, performance, and patient care. Mindfulness-based stress reduction (MBSR) may be an effective intervention to decrease burnout symptoms and increase wellbeing. ⋯ The study shows that MBSR for GPs is feasible and might result in fewer burnout symptoms and increased work engagement and wellbeing. However, an adequately powered randomised controlled trial is needed to confirm the study's findings.
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Multicenter Study Observational Study
Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study.
Bipolar disorder is not uncommon, is associated with high disability and risk of suicide, often presents with depression, and can go unrecognised. ⋯ Among people aged 16-40 years prescribed antidepressants in primary care for depression or anxiety, there is a substantial proportion with unrecognised bipolar disorder. When seeing patients with depression or anxiety disorder, particularly when they are young or not doing well, clinicians should review the life history for evidence of unrecognised bipolar disorder. Some clinicians might find the MDQ to be a useful supplement to non-standardised questioning.