Articles: community-health-services.
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Randomized Controlled Trial Multicenter Study
Community falls prevention for people who call an emergency ambulance after a fall: randomised controlled trial.
To evaluate whether a service to prevent falls in the community would help reduce the rate of falls in older people who call an emergency ambulance when they fall but are not taken to hospital. ⋯ A service to prevent falls in the community reduced the fall rate and improved clinical outcome in the high risk group of older people who call an emergency ambulance after a fall but are not taken to hospital.
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Randomized Controlled Trial Multicenter Study Comparative Study
Multi-centre cluster randomised trial comparing a community group exercise programme with home based exercise with usual care for people aged 65 and over in primary care: protocol of the ProAct 65+ trial.
Regular physical activity reduces the risk of mortality from all causes, with a powerful beneficial effect on risk of falls and hip fractures. However, physical activity levels are low in the older population and previous studies have demonstrated only modest, short-term improvements in activity levels with intervention. ⋯ The ProAct65 trial will explore and evaluate the potential for increasing physical activity among older people recruited through general practice. The trial will be conducted in a relatively unselected population, and will address problems of selective recruitment, potentially low retention rates, variable quality of interventions and falls risk.
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Multicenter Study
Community health workers in health systems strengthening: a qualitative evaluation from rural Haiti.
Haiti is among the countries facing serious shortages in human resources for healthcare. In rural Haiti, the need for daily, long-term adherence to medication for HIV and TB was initially the driving factor for recruitment of community health workers (CHW) during scale-up of HIV services. Their role became broader over time. This qualitative study evaluated the role of CHW in the health system as a whole in both HIV and non-HIV-related services in rural Haiti and investigated the challenges and facilitating factors for their work. ⋯ CHW initially hired for HIV care represent an important part of the health system in rural Haiti in both HIV-related and primary healthcare services. CHW programmes have important potential for building capacity in the health workforce and thereby contributing to strengthening of the health system as a whole. Attention must be paid to adequate remuneration, training and provision of materials.
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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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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized controlled trial of anticipatory and preventive multidisciplinary team care: for complex patients in a community-based primary care setting.
T o examine whether quality of care (QOC) improves when nurse practitioners and pharmacists work with family physicians in community practice and focus their work on patients who are 50 years of age and older and considered to be at risk of experiencing adverse health outcomes. ⋯ Additional resources in the form of collaborative multidisciplinary care teams with intensive interventions in primary care can improve QOC for CDM in a population of older at-risk patients. The appropriateness of this intervention will depend on its cost-effectiveness. TRIAL REGISTRATION NUMBER NCT00238836 (CONSORT).