The European journal of general practice
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Ankle sprain is frequently encountered, both in primary care and in emergency departments. Since 1992, the Ottawa ankle rules (OAR) can assist clinicians in determining whether an X-ray should be performed to exclude a fracture. Several guidelines recommend the use of OAR based on a systematic review from 2003. Ten years later, one can wonder if this recommendation should be changed. ⋯ The findings confirm the value of the OAR at ruling out fractures after an ankle sprain and propose other or additional tools to decrease the need for X-rays.
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Dementia with Lewy bodies (DLB) is an under recognized but frequent subtype of dementia. Misdiagnosis and delays in referral from primary care are common when compared to other forms of dementia. ⋯ Primary care has an important role in identifying those who are at risk for DLB and in referring these patients timely to the appropriate specialist. Adequate management of these patients in the community might reduce the burden associated with the DLB phenotype.
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Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. ⋯ There is only weak evidence on the effectiveness of patient involvement in patient safety. The recommendations of the panel can inform future policy and practice on patient involvement in safety in primary care.
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Despite awareness that comparative analysis of patient safety data from several data sources would promote risk reduction, there has been little effort to establish an incident classification system that is generally applicable to patient safety data in European primary care. ⋯ Classification systems are key tools in the analysis of patient safety incidents. A system that has relevance for primary care is now available.
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Drug treatment is an important clinical process in primary care that is associated with risk of error and adverse events. ⋯ A number of tools and interventions to investigate and enhance medication safety have been identified. Further research is necessary to implement and evaluate current concepts.