Canadian family physician Médecin de famille canadien
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Multicenter Study Comparative Study Pragmatic Clinical Trial
Assessing family history of chronic disease in primary care: Prevalence, documentation, and appropriate screening.
To assess the proportion of primary care patients who report a family history (FH) of type 2 diabetes, coronary artery disease, breast cancer, or colorectal cancer (CRC); assess concordance of FH information derived from the electronic medical record (EMR) compared with patient-completed health questionnaires; and assess whether appropriate screening was informed by risk based solely on FH. ⋯ A moderate prevalence of FH was found for 4 conditions for which screening recommendations vary with risk based on FH. Having patients self-complete an FH was thought to be feasible; however, questions about FH accuracy and completeness from both self-report and EMR remain. Work is needed to determine how to facilitate the adoption of FH tools into practice as well as strategies linking familial risk to appropriate screening.Trial registration number ISRCTN07170460 (ISRCTN Registry).
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Multicenter Study
Investigation of myocardial contusion with sternal fracture in the emergency department: multicentre review.
To describe the use of initial electrocardiogram (ECG), follow-up ECG or equivalent monitoring, and troponin I in patients presenting with sternal fracture who are assessed in emergency departments or by front-line physicians. ⋯ Emergency physicians must increase their use of ECG in initial or follow-up diagnosis for trauma patients presenting with sternal fracture to detect myocardial contusion and arrhythmia. The use of troponin in conjunction with ECG is also suggested for this population in order to identify patients at risk of complications secondary to myocardial contusion.
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Multicenter Study Comparative Study
Genetic education for primary care providers: improving attitudes, knowledge, and confidence.
To increase primary care providers' awareness and use of genetic services; increase their knowledge of genetic issues; increase their confidence in core genetic competencies; change their attitudes toward genetic testing for hereditary diseases; and increase their confidence as primary care genetic resources. ⋯ Educational interventions that include interactive peer resource workshops and educational modules can increase knowledge of and confidence in the core competencies needed for the delivery of genetic services in primary care.
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Multicenter Study Comparative Study
Collaboration between family physicians and community pharmacists to enhance adherence to chronic medications: opinions of Saskatchewan family physicians.
To ascertain the opinions of family physicians about medication adherence in patients with chronic diseases and the role of community pharmacists in improving adherence to chronic medications, as well as their opinions on increased collaboration with pharmacists to enhance medication adherence. ⋯ Saskatchewan family physicians appreciate the importance of medication nonadherence but currently seldom interact with community pharmacists on this issue. They believe that pharmacists have a role in supporting patients with medication adherence and indicate a willingness to work more collaboratively with them to promote adherence. For this type of collaboration to be effective, it appears that increased adherence-related communication between the 2 health care providers and additional health care funding are required.
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Multicenter Study Comparative Study
Demands, values, and burnout: relevance for physicians.
T o explore the interaction between workload and values congruence (personal values with health care system values) in the context of burnout and physician engagement and to explore the relative importance of these factors by sex, given the distinct work patterns of male and female physicians. ⋯ W orkload and values congruence make distinct contributions to physician burnout. Work overload contributes to predicting exhaustion and cynicism; professional values crises contribute to predicting exhaustion, cynicism, and low professional efficacy. The interaction of values and workload for women in particular has implications for the distinct work-life patterns of male and female physicians. Specifically, the congruence of individual values with values inherent in the health care system appeared to be of greater consequence for women than for men.