(1/506) Guidelines; from foe to friend? Comparative interviews with GPs in Norway and Denmark.
(2/506) Patient safety in primary care: a survey of general practitioners in The Netherlands.
(3/506) The influence of ethnicity on the extent of, and reasons underlying, delay in general practitioner consultation in patients with RA.
(4/506) Procedures performed by hospitalist and non-hospitalist general internists.
(5/506) Worth fighting for--advocacy for general practice research.
General practitioners are well aware of the increasing burden being placed on the health care system by the rising prevalence of chronic diseases--they see its effects every day. It is estimated that health care costs will increase over 2.5 fold to $246.1 billion by 2033. Health and medical research (HMR) provides excellent return on investments (in fact a return of 117%; second only to the mining and wholesale/retail sectors) and delivers an economic benefit of some $30 billion. (+info)
(6/506) Impact of structured education and self management on rural asthma outcomes.
BACKGROUND: This study trialled the outcome for asthma patients of a brief, nurse led, patient education session with general practice review of an Asthma Action Plan. METHODS: Prospective cohort with before-after measures conducted in six rural general practices. Outcome measures were changes over 12 months in self reported asthma control, quality of life, device use, and unscheduled general practice and emergency department visits for asthma exacerbation. RESULTS: Eighty-three patients participated. Mean asthma control score decreased but did not reach statistical significance (p=0.124). Quality of life improved for adults (Wilcoxon rank signed test for two related samples p<0.001). The proportion of patients who had one or more unscheduled visits to their general practitioner over 12 months decreased from 23% to 13% (p=0.178) and emergency department presentations decreased from 9% to 4% (p=0.102). DISCUSSION: Structured general practice based education appears to be an effective preventive health care program, with the potential to reduce expensive unscheduled use of health services. (+info)
(7/506) Slipped upper femoral epiphysis in children--delays to diagnosis.
BACKGROUND: Slipped upper femoral epiphysis (SUFE) is a childhood condition requiring urgent admission for surgery. It is often complicated by delayed diagnosis. METHOD: This study investigated incidence and factors contributing to delayed diagnosis of SUFE, by retrospective and prospective review of children (n=120) presenting to a tertiary institution with SUFE from 2003-2007. RESULTS: The delay from initial presentation to a health professional to hospital admission ranged from 0-731 days. Most patients (76%) presented initially to their general practitioner. Of children with stable SUFE, the diagnosis was missed at the initial consultation in 62 (60%) of 103 children, and there was a delay after X-ray to diagnosis of 0-11 days. There were no delays from hip radiograph to confirmation in patients with unstable SUFE. DISCUSSION: A child presenting with hip, thigh or knee pain and reduced hip range of movement (particularly internal rotation) on the affected side, should arouse clinical suspicion of SUFE. This should prompt radiographic imaging of the hip with antero-posterior and lateral hip views. This study shows that most children presenting to The Royal Children's Hospital (Melbourne, Victoria) with SUFE from 2003-2007 presented first to their GP and some faced significant delays to diagnosis and admission. These delays are of concern as delays have been shown to result in increased severity of physeal slip and poorer long term outcomes. General practitioners play a crucial role in the early recognition and diagnosis of SUFE to ensure timely and appropriate referral and the best possible outcome for the child. (+info)
(8/506) Pharmacists in general practice--a proposed role in the multidisciplinary team.
Australia continues to explore methods to restructure primary health care services to meet stressors within the health system. The primary health care strategy and its support for larger general practices and multidisciplinary team contributions, raise opportunities for re-engineering general practice services. (+info)