The British journal of general practice : the journal of the Royal College of General Practitioners
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Multicenter Study
Prevalence and costs of treating uncomplicated stage 1 hypertension in primary care: a cross-sectional analysis.
Treatment for uncomplicated stage 1 hypertension is recommended in most international guidelines but there is little evidence to indicate that therapy is beneficial. ⋯ Untreated, uncomplicated stage 1 hypertension is relatively common, affecting 1 in 12 patients aged 40-74 years in primary care. Current international guidelines and pay-for-performance targets, if followed, will incur significant costs for a patient benefit that is debatable.
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Older people living in care homes often have limited life expectancy. Practitioners and policymakers are increasingly questioning the appropriateness of many acute hospital admissions and the quality of end-of-life care provided in care homes. ⋯ For some care home residents there was an identifiable period when they were approaching the end-of-life and planned care was put in place. For others, death came unexpectedly or during a period of considerable uncertainty, with care largely unplanned and reactive to events.
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Multicenter Study Controlled Clinical Trial
The impact of NHS Health Checks on the prevalence of disease in general practices: a controlled study.
NHS Health Checks is a national case-finding and vascular risk assessment programme in England. No research has been published to assess the impact of NHS Health Checks on the prevalence of chronic disease in GP practices. ⋯ In practices providing NHS Health Checks, the change in the reported prevalence of diabetes, hypertension, CHD, CKD, and AF did not differ from that of practices providing usual care.
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Multicenter Study
Influence of primary care practices on patients' uptake of diabetic retinopathy screening: a qualitative case study.
The NHS Diabetic Eye Screening Programme aims to reduce the risk of sight loss among people with diabetes in England by enabling prompt diagnosis of sight-threatening retinopathy. However, the rate of screening uptake between practices can vary from 55% to 95%. Existing research focuses on the impact of patient demographics but little is known about GP practice-related factors that can make a difference. ⋯ A range of service-level opportunities to improve screening attendance were identified that are available to practices and screening teams. More research is needed into the complex interfaces of care that make up retinopathy screening.
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Randomized Controlled Trial Multicenter Study
Experiences of front-line health professionals in the delivery of telehealth: a qualitative study.
Telehealth is an emerging field of clinical practice but current UK health policy has not taken account of the perceptions of front-line healthcare professionals expected to implement it. ⋯ Health care professionals will need to develop a shared understanding of patient self-management through telehealth. This may require a renegotiation of their roles and responsibilities.