Canadian family physician Médecin de famille canadien
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To describe and evaluate the effectiveness of domestic violence education in improving physicians' knowledge, recognition, and management of abused women. ⋯ It was difficult to determine the most effective educational strategy, as the educational interventions and the outcome measures varied among the selected studies. Brief interventions for postgraduate trainee physicians improved knowledge but did not seem to affect behaviour. Online education using a problem-based learning format improved practising physicians' perceptions, knowledge, and skills in managing domestic violence. Physician training combined with system support interventions seemed to benefit domestic violence victims and increase referrals to domestic violence support resources.
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Canadian hypertension guidelines do not address blood pressure (BP) targets in the very old (older than 85 years of age), making BP management in this group difficult. ⋯ The development and use of a BP target tool increased prescriber consistency and confidence in managing BP in the very old. The tool filled a gap in the absence of guidelines specific to BP management in the very old. The BP target tool has implications for practice, as well as for the training of health care professionals involved in treating and monitoring BP in very old patients.
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To understand how the new guidelines for management of cardiovascular risk by the American Heart Association and the American College of Cardiology (AHA-ACC) can be interpreted and used in a Canadian setting. ⋯ Focus on the best evidence in CVD risk can simplify lipid management for both the physician and the patient.
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Clinical Trial
Tobacco use disorder treatment in primary care: implementing a clinical system pathway in Alberta.
To test a team-based, site-specific, multicomponent clinical system pathway designed for enhancing tobacco use disorder treatment by primary care physicians. ⋯ Our findings suggest that the provision of a tobacco clinical system pathway that incorporates other members of the health care team and builds on existing office infrastructures will support positive and sustainable changes in tobacco use disorder treatment by physicians in primary care. This study reaffirms the substantive and important role of supporting how treatment is delivered in physicians' practices.
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Observational Study
Delivering evidence-based smoking cessation treatment in primary care practice: experience of Ontario family health teams.
To report on the delivery of evidence-based smoking cessation treatments (EBSCTs) within a sample of 40 Ontario family health teams (FHTs). ⋯ Rates of smoking cessation advice were higher than previously reported for Canadian physicians; however, rates of assistance with quitting were lower. Future quality improvement initiatives should specifically target increasing the rates of screening and advising among low-performing FHTs and providers within FHTs, with a particular emphasis on doing so at all clinic appointments; and improving the rate at which assistance with quitting is delivered.