Using Lean-Facilitation to Improve Quality of Hepatitis C Testing in Primary Care.

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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 […]

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Concerns of Primary Care Clinicians Practicing in an Integrated Health System: a Qualitative Study.

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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 […]

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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.

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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 […]

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Understanding the role of GPs’ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence.

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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 […]

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GPs’ practice and attitudes to initiating isotretinoin for acne vulgaris in Ireland: a cross-sectional questionnaire survey in primary care.

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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 […]

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Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016 : Care for the asplenic patient in general practice.

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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 […]

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Improving the quality of antibiotic prescribing through an educational intervention delivered through the out-of-hours general practice service in Ireland.

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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 […]

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12-Month Evaluation of an EHR-Supported Staff Role Change for Provision of Tobacco Cessation Care in 8 Primary Care Safety-Net Clinics.

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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 […]

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Development of type 2 diabetes mellitus quality indicators in general practice by a modified Delphi method in Beijing, China.

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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 […]

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Implementing Office-Based Opioid Treatment Models in Primary Care.

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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 […]

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Impact of Unannounced Standardized Patient Audit and Feedback on Care, Documentation, and Costs: an Experiment and Claims Analysis.

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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 […]

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Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study.

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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 […]

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General practitioner strategies for managing patients with multimorbidity: a systematic review and thematic synthesis of qualitative research.

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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, […]

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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.

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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 […]

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Treatment of urinary tract infections in Swiss primary care: quality and determinants of antibiotic prescribing.

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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 […]

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Prescription of suboptimal statin treatment regimens: a retrospective cohort study of trends and variation in English primary care.

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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 […]

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Opioid crisis in primary care? An audit of high-dose opioid prescribing at Bangholm GP Practice.

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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 […]

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A pilot project on the management of osteoporosis in primary care: results of the audit cycle.

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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, […]

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Appropriate secondary prevention of stroke and transient ischaemic attack with antithrombotics: an audit in general practice.

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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 […]

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Should diverticulitis be managed in primary care? An audit on the management of diverticulitis in primary care.

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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 […]

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Vitamin D deficiency is associated with increased risk of postural hypotension in older men: a cross-sectional analysis from The British Regional Heart Study.

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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 […]

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Antibiotic resistance of uropathogenic Escherichia coli and ESBL prevalence in general practice patients over 10 years.

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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 […]

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How do you diagnose asthma? A multiple case study design to understand and explain current use of national guidelines by primary care clinicians.

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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 […]

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Management of gout and adherence to current guidelines in general practice surgery.

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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 […]

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Healthcare professionals’ perspectives on lung cancer screening in the UK: a qualitative study.

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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 […]

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Gestational diabetes and progression to type two diabetes mellitus: missed opportunities of follow up and prevention?

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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 […]

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Incorporating the patient-centered approach into clinical practice helps improve quality of care in cases of hypertension: a retrospective cohort study.

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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 […]

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