In the 50 years since the American Board of Family Medicine (ABFM) was established, the United States has gone from a shared perspective that high-quality care was being routinely delivered to […]» Read more
Lean management has been successfully employed in healthcare to improve outcomes and efficiencies. Facilitation is increasingly being used to support evidence-based practice uptake in healthcare. However, while both Lean and […]» Read more
Clinician well-being is a major priority for healthcare organizations. However, the impact of workplace environment on clinicians’ well-being is poorly understood. Integrated health systems are a particularly relevant type of […]» Read more
Performance of the Framingham coronary heart disease risk score for predicting 10-year cardiac risk in adult United Arab Emirates nationals without diabetes: a retrospective cohort study.
Primary prevention guidelines recommend the use of the Framingham risk score (FRS) to estimate the 10-year coronary heart disease (CHD) risk in patients without diabetes for statin eligibility. However, the […]» Read more
Understanding the role of GPs’ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence.
Growing evidence for the role of GPs’ gut feelings in cancer diagnosis raises questions about their origin and role in clinical practice.To explore the origins of GPs’ gut feelings for […]» Read more
GPs’ practice and attitudes to initiating isotretinoin for acne vulgaris in Ireland: a cross-sectional questionnaire survey in primary care.
Isotretinoin is prescribed in secondary care for severe acne vulgaris. Anecdotal reports suggest that GPs in Ireland currently initiate isotretinoin.To ascertain the prevalence and management of isotretinoin in Irish general […]» Read more
Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016 : Care for the asplenic patient in general practice.
Guidelines that detail preventive measures against Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b, and influenza are published annually in France to decrease the risk of severe infections in immunocompromised […]» Read more
Improving the quality of antibiotic prescribing through an educational intervention delivered through the out-of-hours general practice service in Ireland.
Antibiotic resistance is a threat to our health and health systems. Up to 70% of antibiotics are prescribed in general practice. In Ireland, Out-of-hours (OOH) services are mostly provided by […]» Read more
12-Month Evaluation of an EHR-Supported Staff Role Change for Provision of Tobacco Cessation Care in 8 Primary Care Safety-Net Clinics.
Guidelines urge primary care practices to routinely provide tobacco cessation care (i.e., assess tobacco use, provide brief cessation advice, and refer to cessation support). This study evaluates the impact of […]» Read more
Development of type 2 diabetes mellitus quality indicators in general practice by a modified Delphi method in Beijing, China.
The service capacity of primary care has improved in China. General practice also takes growing responsibility in the management of type 2 diabetes mellitus, but there are concerns about the […]» Read more
Primary care practices are ideal sites for integrating medication-assisted treatment (MAT) for opioid use disorder, but little is known about how practices have achieved this. Our study aimed to describe […]» Read more
Impact of Unannounced Standardized Patient Audit and Feedback on Care, Documentation, and Costs: an Experiment and Claims Analysis.
Meaningful variations in physician performance are not always discernible from the medical record.We used unannounced standardized patients to measure and provide feedback on care quality and fidelity of documentation, and […]» Read more
Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study.
Due to the perennial shortage of diabetes specialists, primary care physicians (PCPs) constitute the largest diabetes care manpower in Nigeria. However, the competence of the PCPs to undertake this task […]» Read more
General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research.
General practitioners (GPs) increasingly manage patients with multimorbidity but report challenges in doing so. Patients describe poor experiences with health care systems that treat each of their health conditions separately, […]» Read more
The Strengths and Difficulties Questionnaire is a usable way to address mental health at well-child visits in general practice – a qualitative study of feasibility.
Mental health problems is frequent among children and psychopathology in early childhood seems to predict mental disorders in adulthood. All Danish children are offered seven free well-child visits at their […]» Read more
Treatment of urinary tract infections in Swiss primary care: quality and determinants of antibiotic prescribing.
Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim – sulfamethoxazol as empiric first line antimicrobial […]» Read more
Prescription of suboptimal statin treatment regimens: a retrospective cohort study of trends and variation in English primary care.
Since 2014 English national guidance recommends ‘high-intensity’ statins, reducing low-density lipoprotein (LDL) cholesterol by ≥40%.To describe trends and variation in low-/medium-intensity statin prescribing and assess the feasibility of rapid prescribing […]» Read more
Click here to read the full article @ The British journal of general practice : the journal of the Royal College of General Practitioners» Read more
Opioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite […]» Read more
Osteoporosis is a major public health problem with the ageing population in the UK. However, there is no known national algorithm for the management of osteoporosis in primary care. Therefore, […]» Read more
Appropriate secondary prevention of stroke and transient ischaemic attack with antithrombotics: an audit in general practice.
Stroke is a major cause of death and disability worldwide. Major advances have occurred in secondary prevention of stroke/transient ischaemic attack (TIA) during the past three decades. Primary care is […]» Read more
Should diverticulitis be managed in primary care? An audit on the management of diverticulitis in primary care.
The prevalence of diverticulosis and acute diverticulitis is increasing in developed countries. For those with diverticulosis the lifetime risk of developing acute diverticulitis is about 4-25%. Mild, uncomplicated diverticulitis can […]» Read more
Vitamin D deficiency is associated with increased risk of postural hypotension in older men: a cross-sectional analysis from The British Regional Heart Study.
There is growing interest in the role of vitamin D in extra-skeletal health, including postural hypotension. Postural hypotension is found in 1 in 5 community-dwelling adults aged 60 years and […]» Read more
Antibiotic resistance of uropathogenic Escherichia coli and ESBL prevalence in general practice patients over 10 years.
Bacterial susceptibility to antibiotics changes over time. Knowledge of the susceptibility is important for antibiotic treatment guidelines in general practices.To determine the antibiotic-susceptibility of E. coli from uncomplicated UTI among […]» Read more
How do you diagnose asthma? A multiple case study design to understand and explain current use of national guidelines by primary care clinicians.
Clinical guidelines for asthma are available to UK clinicians but implementation is not straightforward. Diagnostic and treatment inadequacy contribute to patient morbidity and mortality and lack of adherence to guidelines […]» Read more
Gout is one of the most common inflammatory joint diseases in the UK managed by GPs. The recent (2017) guideline of the British Society for Rheumatology (BSR) changed the recommendation […]» Read more
Lung cancer screening with low-dose CT has been shown to decrease mortality. Low lung cancer survival rates in the UK, driven primarily by late-stage presentation, provide the impetus for implementing […]» Read more
Asthma imposes a substantial burden on individuals and societies. Patients with asthma need high-quality primary care management; however, evidence suggests the quality of this care can be highly variable. Here […]» Read more
Gestational diabetes and progression to type two diabetes mellitus: missed opportunities of follow up and prevention?
The incidence of type 2 diabetes (T2DM) is increasing. Having a pregnancy complicated by gestational diabetes mellitus (GDM) is a potent risk factor for the later development of T2DM.To explore […]» Read more
Incorporating the patient-centered approach into clinical practice helps improve quality of care in cases of hypertension: a retrospective cohort study.
Treating hypertensive patients by integrating the patient-centered approach would influence the practice and outcome of treatment. Our purpose was to determine whether the implementation of a patient-centered approach in health […]» Read more