The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial
Targeted encouragement of GP consultations for possible cancer symptoms: a randomised controlled trial.
For some common cancers, survival is lower in the UK than in comparable high-income countries. ⋯ Targeted interventions of this nature can change behaviour; there is a need to develop interventions that can be more effective at engaging patients with primary care. This study demonstrates that targeted interventions promoting both awareness of possible cancer symptoms and earlier health seeking, can change behaviour. There is a need to develop and test interventions that can be more effective at engaging the most at-risk patients.
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Randomized Controlled Trial
Patient-centred innovation for multimorbidity care: a mixed-methods, randomised trial and qualitative study of the patients' experience.
Patient-centred interventions to help patients with multimorbidity have had mixed results. ⋯ Overall, the intervention showed improvements only for patients who had an annual income of ≥C$50 000, implying a need to address the costs of intervention components not covered by existing health policies. Findings suggest a need to optimise team composition by revising the number and type of providers according to patient preferences and to enhance the hours of nurse follow-up to better support the patient in carrying out the case conference's recommendations.
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Randomized Controlled Trial
Associations with antibiotic prescribing for acute exacerbation of COPD in primary care.
C-reactive protein (CRP) point-of-care testing can reduce antibiotic use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in primary care, without compromising patient care. Further safe reductions may be possible. ⋯ Several demographic features and clinical signs and symptoms are associated with antibiotic prescribing in AECOPD. Diagnostic and prognostic value of these features may help identify further safe reductions.
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Randomized Controlled Trial
Effect of weight loss on cardiometabolic risk: observational analysis of two randomised controlled trials of community weight-loss programmes.
Guidelines recommend that clinicians identify individuals at high cardiometabolic risk and support weight loss in those with overweight or obesity. However, we lack individual level data quantifying the benefits of weight change for individuals to guide consultations in primary care. ⋯ Weight loss achieved through referral to community weight-loss programmes, which are commonly accessible in primary care, can lead to clinically relevant reductions in BP and glucose regulation, especially in those at highest risk.
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Randomized Controlled Trial
Effect of the OPTIMAL programme on self-management of multimorbidity in primary care: a randomised controlled trial.
Effective primary care interventions for multimorbidity are needed. ⋯ OPTIMAL was found to be ineffective in improving health-related quality of life or activity participation at 6-month follow-up. Existing multimorbidity interventions tend to focus on older adults; preplanned subgroup analyses results in the present study suggest that future research should target younger adults (<65 years) with multimorbidity.