The European journal of general practice
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Community nurses and general practitioners evaluate their patient-related communication to be poor. However, their actual communication has hardly been investigated and specific strategies for improvement are unclear. ⋯ This exploratory study of actual community nurse-doctor telephone conversations in primary care identified communication structure and nurse self-confidence towards general practitioners as key targets for the improvement of interprofessional communication, which may increase the effectiveness of community nurse-general practitioner collaboration.
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Background: Undetected dementia in primary care is a global problem. Since general practitioners (GPs) act as the first step in the identification process, examining their routines could help us to enhance the currently low recognition rates. Objectives: The study aimed to explore, for the first time in Hungary, the dementia identification practices and views of GPs. ⋯ Longer consultation time was chosen as the most important facet of improvement needed for better identification of dementia in primary care (81%). Half of the GPs (49%) estimated dementia recognition rate to be lower than 30% in their practice. Conclusions: Hungarian GPs were aware of the benefits of early recognition, but the shortage of consultation time in primary care was found to be a major constraint on efficient case-finding.
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In Turkey, family physicians serve only during office hours, while emergency services have 7/24 free access. Non-urgent patients commonly use Paediatric Emergency departments (PEDs). In Turkey, there is little evidence as to why emergency services are used instead of family medicine for non-urgent paediatric healthcare. ⋯ Parents' perception of urgency and the thought that their child's condition will worsen are the main reasons for non-urgent using PED.
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Background: Physical inactivity implies a significant individual and society health burden. Objectives: To assess the feasibility of implementing a preventive physical exercise (PE) programme for the general population and to analyse changes in fitness-related variables and quality of life. Methods: Pre-post comparison study in which general practitioners and nurses recommended PE to participants with sedentary behaviour and hypertension or dyslipidaemia attending in primary care for primary prevention of ischaemic cardiovascular disease. ⋯ Results: The PE programme was offered to 6,140 eligible subjects; 5,077 (82.7%) accepted to participate and received a recommendation; 3,656 (69.6% women) started the programme and 2,962 subjects (80.9% women) finished the programme. After 10 weeks, there were significant improvements (mean difference, 95% CI) in aerobic fitness (2.55 ml/min/kg, 2.32-2.79), muscle strength (0.62 m, 0.57 to 0.67), flexibility (2.34 cm, 2.06 to 2.63) and balance (-0.46 falls, -0.60 to -0.33) as well as significant decreases in body weight (-0.41 kg, -0.64 to -0.17) and BMI (-0.27 kg/m2, -0.34 to -0.20). Conclusion: Implementation of a government-supported PE programme for the general population recruited in the primary care setting and recommended by healthcare professionals is feasible, and was associated with health benefits, mainly improvements in physical fitness.
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Observational Study
Availability of point-of-care culture and microscopy in general practice - does it lead to more appropriate use of antibiotics in patients with suspected urinary tract infection?
Urinary tract infection (UTI) is a common condition in general practice, and urine culture can help reduce inappropriate antibiotic prescriptions. In case of delay of the result, antibiotic treatment can be guided by one or more point-of-care (POC) tests. In Denmark, POC microscopy and POC urine culture are widely used for this purpose. ⋯ Availability of POC culture marginally increased appropriate treatment while waiting for the result from the microbiological laboratory. Practices should adopt a strategy where they either perform culture within the practice or send urine for culture at the microbiological laboratory.