The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection.
Diagnostic tests enabling general practitioners (GPs) to differentiate rapidly between pneumonia and other lower respiratory tract infections (LRTIs) are needed to prevent increase of bacterial resistance by unjustified antibiotic prescribing. ⋯ Most symptoms and signs traditionally associated with pneumonia are not predictive of pneumonia in general practice. The prediction rule for low-risk patients presented here, including a CRP of < 20, can considerably reduce unjustified antibiotic prescribing.
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Patients commonly present in primary care with symptoms for which no physical pathology can be found. This study is a review of published research on medically unexplained symptoms (MUPS) in primary care. A literature review and qualitative comparison of information was carried out. ⋯ There is substantial overlap between different symptoms and syndromes, suggesting they have much in common. Patients with MUPS may best be viewed as having complex adaptive systems in which cognitive and physiological processes interact with each other and with their environment. Cognitive behavioural therapy and antidepressant drugs are both effective treatments, but their effects may be greatest when the patient feels empowered by their doctor to tackle their problem.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A cluster randomised controlled trial of patient-held medical records for people with schizophrenia receiving shared care.
Patient-held records can improve communication across the primary-secondary interface. There has been no previous rigorous assessment of the utility of patient-held records for people with schizophrenia from a primary care perspective and their value for this population is unclear. ⋯ The trial provides no good evidence to suggest that patient-held records should be introduced as part of routine shared care for all patients with schizophrenia. However, the patient-held record was acceptable to patients with schizophrenia and acted as a communication tool, particularly between patients and keyworkers.
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Comparative Study
Electronic transfer of prescription-related information: comparing views of patients, general practitioners, and pharmacists.
The National Health Service (NHS) intends to introduce a system of electronic transfer of prescription-related information between general practitioners (GPs) and community pharmacies. The NHS Plan describes how this will be achieved. ⋯ Electronic transfer of prescription-related information is likely to be acceptable to all users, but concerns about patient confidentiality and an extended role for pharmacists in prescription management need to be addressed.