The British journal of general practice : the journal of the Royal College of General Practitioners
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GPs occupy a pivotal position in relation to providing services to opiate misusers in the UK, and this is now cited to support initiatives in other countries. ⋯ In 2001 nearly three times as many GPs were seeing opiate misusers than was the case in 1985. Half were prescribing substitute-opiate drugs such as methadone (to an estimated 30 000 patients). However, there are grounds for concern about the quality of this prescribing. Most doses were too low to constitute optimal methadone maintenance; widespread disregard of the availability of supervised or interval dispensing increases the risks of diversion to the blackmarket and deaths from methadone overdose. Increased quantity of care has been achieved. Increased quality is now required.
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Editorial Comment
Haemoglobinopathy screening: an end to institutional racism?
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Review Meta Analysis
Self-help books for depression: how can practitioners and patients make the right choice?
Depression is a common and important public health problem most often treated by GPs. A self-help approach is popular with patients, yet little is known about its effectiveness. ⋯ There are a number of self-help books for the treatment of depression readily available. For the majority, there is little direct evidence for their effectiveness. There is weak evidence that suggests that bibliotherapy, based on a cognitive behavioural therapy approach is useful for some people when they are given some additional guidance. More work is required in primary care to investigate the cost-effectiveness of self-help and the most suitable format and presentation of materials.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Randomised controlled trial of a hypothyroid educational booklet to improve thyroxine adherence.
Non-adherence with medication prescribed for chronic disease is ubiquitous and undermines the benefits of effective therapy. ⋯ Brief intervention with an educational booklet has no influence on thyroxine adherence or health in patients with primary hypothyroidism. These findings do not support the routine distribution of health educational materials to improve medication adherence.
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Multicenter Study Comparative Study
Coronary heart disease prevention and age inequalities: the first year of the National Service Framework for CHD.
The National Service Framework for Heart Disease sets national standards and defines service models for coronary heart disease (CHD). Little is known about the impact of this intervention on age inequalities. ⋯ There have been substantial improvements in both the recording of coronary risk factors and disease control measures following the implementation of the National Service Framework for Coronary Heart Disease. However, there needs to be an effort to strengthen the focus on the care of older patients.