The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial
Experiences of urine collection devices during suspected urinary tract infections: a qualitative study in primary care.
Up to 30% of urine samples from women with suspected urinary tract infection (UTI) are contaminated and need to be repeated, burdening health services and delaying antibiotic prescription. To prevent contamination, midstream urine (MSU) sampling, which can be difficult to achieve, is recommended. Urine collection devices (UCDs) that automatically capture MSU have been proposed as a solution. There are few studies exploring women's experiences of using such devices. ⋯ Most women agreed there was a need for a user- and environmentally-friendly device to improve urine collection. Although using UCDs can be difficult for women experiencing UTI symptoms, they may be appropriate for asymptomatic sampling in other clinical populations.
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Randomized Controlled Trial
Diagnostic delays for breathlessness in primary care: a qualitative study to investigate current care and inform future pathways.
Evidence about the delays to diagnosis for patients presenting with breathlessness is lacking. ⋯ The findings indicate potential explanations for delays to diagnosis for patients with chronic breathlessness. Interventions are needed to enhance symptom recognition, include alternative approaches to incremental investigation, and expand the concept of diagnosis beyond a disease label to improve communication, with the ultimate aim of earlier diagnosis and management to improve patient outcomes.
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Randomized Controlled Trial
Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care.
Advance care planning (ACP) has been characterised as a complex process of communication and decision making. For ACP behaviour change, underlying processes such as self-efficacy and readiness are needed. However, studies about which patient characteristics are associated with ACP have mainly focused on whether ACP actions are completed, leaving behaviour change processes unexplored. ⋯ This study suggests that GPs providing information about ACP alone is not associated with a patient's ACP engagement; an important element is to listen to patients' worries regarding their future health.
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Randomized Controlled Trial
Home monitoring by pulse oximetry of primary care patients with COVID-19: a pilot randomised controlled trial.
Pulse oximetry as a home or remote monitoring tool accelerated during the pandemic for patients with COVID-19, but evidence on its use is lacking. ⋯ Home monitoring of patients with moderate-to-severe COVID-19 by pulse oximetry appeared feasible; adherence was high, patients reported a high feeling of safety, while the number of primary care consultations remained similar to usual care.
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Randomized Controlled Trial
GPs' willingness to prescribe aspirin for cancer preventive therapy in Lynch syndrome: a factorial randomised trial investigating factors influencing decisions.
The National Institute for Health and Care Excellence (NICE) 2020 guidelines recommends aspirin for colorectal cancer prevention for people with Lynch syndrome. Strategies to change practice should be informed by understanding the factors influencing prescribing. ⋯ It is unlikely that providing information on clinical guidance, trial results, and information comparing benefits and harms will increase aspirin prescribing for Lynch syndrome in primary care. Alternative multilevel strategies to support informed prescribing may be warranted.