The European journal of general practice
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Multicenter Study Observational Study
Non-random relations in drug use expressed as patterns comprising prescription and over-the-counter drugs in multimorbid elderly patients in primary care: Data of the exploratory analysis of the multicentre, observational cohort study MultiCare.
The elderly population deals with multimorbidity (three chronic conditions) and increasinged drug use with age. A comprehensive characterisation of the medication - including prescription and over-the-counter (OTC) drugs - of elderly patients in primary care is still insufficient. ⋯ The drug patterns demonstrate non-random relations in drug use in multimorbid elderly patients and systematic associations between drug patterns and multimorbidity clusters were found in primary care.
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Observational Study
To prevent being stressed-out: Allostatic overload and resilience of general practitioners in the era of COVID-19. A cross-sectional observational study.
Responsibility of general practitioners (GPs) in delivering safe and effective care is always high but during the COVID-19 pandemic they face even growing pressure that might result in unbearable stress load (allostatic overload, AO) leading to disease. ⋯ Under changing circumstances, resilience improvement through increasing time spent on recreation should be emphasised to prevent GPs from the adverse health consequences of stress load.
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Ischaemic stroke or cerebrovascular accident (CVA) due to occult atrial fibrillation (AF) may cause severe morbidity and mortality. Diagnosing occult AF can be challenging and there is no consensus regarding the optimal duration of screening. A 24-hour Holter electrocardiogram (ECG) is frequently employed to detect occult AF following ischaemic CVA. ⋯ 24-hour Holter has a low AF/AFL detection rate. Older persons and those with hypertension or CKD are more likely to be detected with AF/AFL using this method.
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In the migrant population, there is a higher risk of dementia. However, dementia is underdiagnosed in this population due to the underuse of appropriate screening tools. The Rowland Universal Dementia Assessment Scale (RUDAS) is designed for culturally and linguistically diverse populations. ⋯ GPs find screening for dementia in migrant patients a challenging act, mainly due to language barriers. GPs are not confident enough with the appropriate screening strategies and tools adjusted to the needs of migrant patients. Abbreviations: GP: general practitioner; RUDAS: Rowland Universal Dementia Assessment Scale; MMSE: Mini Mental State Examination.
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Hazardous alcohol use significantly affects health and wellbeing in society. General practitioners (GPs) are uniquely positioned to address this problem by integrating early identification and brief intervention (EIBI) in daily practice. Unfortunately, EIBI implementation remains low. Community-oriented strategies (COS), defined as public health activities directed to the general population, are suggested to address this implementation gap. COS aim to increase the understanding, engagement and empowerment within the population to facilitate EIBI delivery. However, no consensus on what COS should contain exists. ⋯ Stakeholders emphasise addressing the proactive role of GPs as most promising COS, though it should be delivered within a holistic multi-component approach.