The European journal of general practice
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Observational Study
Drug interactions detected by a computer-assisted prescription system in primary care patients in Spain: MULTIPAP study.
Drug interactions increase the risk of treatment failure, intoxication, hospital admissions, consultations and mortality. Computer-assisted prescription systems can help to detect interactions. ⋯ Drug interactions are prevalent in patients aged 65-74 years with multimorbidity and polypharmacy. The clinically relevant DDI frequency is low. The number of prescriptions taken is the most relevant factor associated with presenting a clinically relevant DDI.
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Patients with chronic conditions pose a major challenge to the Danish healthcare system. Since 2018, disease management programmes for patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2D) were introduced in Denmark. Treatment in hospitals should be reserved for those patients who require specialised treatment. Hence, more patients with COPD and T2D fall within the general practitioners' (GPs) responsibility. ⋯ According to the GPs, they continue to play an important role as treatment coordinators to ensure coherence and high quality in treating patients with COPD and type 2 diabetes.
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Growing prevalence of chronic diseases is a rising challenge for healthcare systems. The Primary Care Practice-Based Care Management (PraCMan) programme is a comprehensive disease management intervention in primary care in Germany aiming to improve medical care and to reduce potentially avoidable hospitalisations for chronically ill patients. ⋯ This study showed that the PraCMan intervention may be associated with a lower rate of hospital admissions and hospitalisation costs than usual care. Further studies may assess long-term effects of PraCMan and its efficacy in preventing known complications of chronic diseases.
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Telemedicine, once defined merely as the treatment of certain conditions remotely, has now often been supplanted in use by broader terms such as 'virtual care', in recognition of its increasing capability to deliver a diverse range of healthcare services from afar. With the unexpected onset of COVID-19, virtual care (e.g. telephone, video, online) has become essential to facilitating the continuation of primary care globally. Over several short weeks, existing healthcare policies have adapted quickly and empowered clinicians to use digital means to fulfil a wide range of clinical responsibilities, which until then have required face-to-face consultations. ⋯ Virtual care use in primary care saw a transformative change during the pandemic. However, despite the advances in the various governmental guidance offered, much work remains in addressing the shortcomings exposed during COVID-19 and strengthening viable policies to better incorporate novel technologies into the modern primary care clinical environment.
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In March 2020, the WHO declared the SARS CoV-2 pandemic. This had an immediate and dramatic impact on Romanian physicians. ⋯ Pandemic preparedness should focus on measures that make medical practice safe (supplies, working protocols, experience sharing with experts/colleagues from other countries).