The British journal of general practice : the journal of the Royal College of General Practitioners
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Randomized Controlled Trial Multicenter Study
A randomised controlled trial to test the feasibility of a collaborative care model for the management of depression in older people.
Depression is the most common mental health disorder in people aged over 65 years. Late-life depression is associated with chronic illness and disability. ⋯ A model of collaborative care for older people with depression, used in a primary care setting with a facilitated self-help intervention is more effective than usual GP care. This study demonstrates that the implementation of a collaborative care model is feasible in UK primary care and that the intervention is effective and acceptable to patients.
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Multicenter Study Comparative Study
How do patients referred to neurologists for headache differ from those managed in primary care?
Headache is the neurological symptom most frequently presented to GPs and referred to neurologists, but little is known about how referred patients differ from patients managed by GPs. ⋯ Patients who consult for headache experience severe disability and impact, and up to a third report anxiety and/or depression. Referral is not related to clinical severity of headaches, but is associated with higher consultation frequency and patients' anxiety and concern about their headache symptoms.
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Patients with asthma are particularly susceptible to serious complications from influenza. The Chief Medical Officer recommends annual influenza vaccination for adult patients with asthma. The uptake of influenza vaccination by patients with asthma is only 40% and, unlike other high-risk groups, has failed to increase in recent years. ⋯ Improving vaccination uptake in patients with asthma is unlikely unless individual health beliefs are taken into account.
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It is important that women know that the risk of breast cancer increases with age. Women's knowledge of the increased risk will help to inform their health-seeking behaviour. ⋯ Only 1% are correctly informed, believing that the oldest group of women are at the greatest risk of breast cancer. Those working in primary care need to be aware of this lack of knowledge when patients consult.