Pub Date : 2016-03-10DOI: 10.1017/S1463423616000074
M. Gabbay, C. Shiels, J. Hillage
Aim To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. Background In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. Methods Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for ‘stress’. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any ‘may be fit’ advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive ‘may be fit’ advice on their CMD fit notes.
{"title":"Sickness certification for common mental disorders and GP return-to-work advice","authors":"M. Gabbay, C. Shiels, J. Hillage","doi":"10.1017/S1463423616000074","DOIUrl":"https://doi.org/10.1017/S1463423616000074","url":null,"abstract":"Aim To report the types and duration of sickness certification for different common mental disorders (CMDs) and the prevalence of GP advice aimed at returning the patient to work. Background In the United Kingdom, common mental health problems, such and depression and stress, have become the main reasons for patients requesting a sickness certificate to abstain from usual employment. Increasing attention is being paid to mental health and its impact on employability and work capacity in all parts of the welfare system. However, relatively little is known about the extent to which different mental health diagnoses impact upon sickness certification outcomes, and how the GP has used the new fit note (introduced in 2010) to support a return to work for patients with mental health diagnoses. Methods Sickness certification data was collected from 68 UK-based general practices for a period of 12 months. Findings The study found a large part of all sickness absence certified by GPs was due to CMDs (29% of all sickness absence episodes). Females, younger patients and those living in deprived areas were more likely to receive a fit note for a CMD (compared with one for a physical health problem). The highest proportion of CMD fit notes were issued for ‘stress’. However, sickness certification for depression contributed nearly half of all weeks certified for mental health problems. Only 7% of CMD fit notes included any ‘may be fit’ advice from the GP, with type of advice varying by mental health diagnostic category. Patients living in the most socially deprived neighbourhoods were less likely to receive ‘may be fit’ advice on their CMD fit notes.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89707310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-03-10DOI: 10.1017/S1463423616000013
H. Clarke, M. Voss
Objective To determine whether a community-based, multidisciplinary team consisting of home-based caregivers and supervised students could improve the functional status and quality of life of patients living with chronic obstructive pulmonary disease (COPD) in a low-income, peri-urban setting in South Africa. Methods This was a quasi-experimental study conducted over three months. Attention was paid to health literacy, inhaler technique, respiratory conditioning and nutrition. Results Health literacy was poor and most patients were not using their inhalers correctly. Five of 12 patients found exercising challenging and withdrew from the study early. In the remaining seven patients, statistically significant improvements in FEV1%, and quality of life scores were seen at three months. Improvements in exercise tolerance and BODE prognostic index did not reach statistical significance. Conclusion A home-based multidisciplinary student team can improve the functional status and the quality of life in patients living with COPD in a low-income setting. This approach offers a suitable model for community-based service learning.
{"title":"The role of a multidisciplinary student team in the community management of chronic obstructive pulmonary disease","authors":"H. Clarke, M. Voss","doi":"10.1017/S1463423616000013","DOIUrl":"https://doi.org/10.1017/S1463423616000013","url":null,"abstract":"Objective To determine whether a community-based, multidisciplinary team consisting of home-based caregivers and supervised students could improve the functional status and quality of life of patients living with chronic obstructive pulmonary disease (COPD) in a low-income, peri-urban setting in South Africa. Methods This was a quasi-experimental study conducted over three months. Attention was paid to health literacy, inhaler technique, respiratory conditioning and nutrition. Results Health literacy was poor and most patients were not using their inhalers correctly. Five of 12 patients found exercising challenging and withdrew from the study early. In the remaining seven patients, statistically significant improvements in FEV1%, and quality of life scores were seen at three months. Improvements in exercise tolerance and BODE prognostic index did not reach statistical significance. Conclusion A home-based multidisciplinary student team can improve the functional status and the quality of life in patients living with COPD in a low-income setting. This approach offers a suitable model for community-based service learning.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83824405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-03-02DOI: 10.1017/S1463423616000037
Kerstin Rydé, K. Hjelm
Aim The aim of this study was to explore how nurses can support patients who are crying in a palliative home care context. Background In palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse’s responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons. Methods A qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32–63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis. Findings It was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient’s wishes. A few examples of the patients’ need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.
{"title":"How to support patients who are crying in palliative home care: an interview study from the nurses’ perspective","authors":"Kerstin Rydé, K. Hjelm","doi":"10.1017/S1463423616000037","DOIUrl":"https://doi.org/10.1017/S1463423616000037","url":null,"abstract":"Aim The aim of this study was to explore how nurses can support patients who are crying in a palliative home care context. Background In palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse’s responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons. Methods A qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32–63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis. Findings It was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient’s wishes. A few examples of the patients’ need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91351501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-22DOI: 10.1017/S1463423616000049
J. Turvill, S. O'Connell, A. Brooks, Karen Bradley-Wood, James Laing, Swaminathan Thiagarajan, David Hammond, D. Turnock, A. Jones, R. Sood, A. Ford
Background National Institute for Health and Care Excellence have recommended faecal calprotectin (FC) testing as an option in adults with lower gastrointestinal symptoms for whom specialist investigations are being considered, if cancer is not suspected and it is used to support a diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome. York Hospital and Vale of York Clinical Commissioning Group have developed an evidence-based care pathway to support this recommendation for use in primary care. It incorporates a higher FC cut-off value, a ‘traffic light’ system for risk and a clinical management pathway. Objectives To evaluate this care pathway. Methods The care pathway was introduced into five primary care practices for a period of six months and the clinical outcomes of patients were evaluated. Negative and positive predictive values (NPV and PPV) were calculated. GP feedback of the care pathway was obtained by means of a web-based survey. Comparator gastroenterology activity in a neighbouring trust was obtained. Results The care pathway for FC in primary care had a 97% NPV and a 40% PPV. This was better than GP clinical judgement alone and doubled the PPV compared with the standard FC cut-off (<50 mcg/g), without affecting the NPV. In total, 89% of patients with IBD had an FC>250 mcg/g and were diagnosed by ‘straight to test’ colonoscopy within three weeks. The care pathway was considered helpful by GPs and delivered a higher diagnostic yield after secondary care referral (21%) than the conventional comparator pathway (5%). Conclusions A care pathway for the use of FC that incorporates a higher cut-off value, a ‘traffic light’ system for risk and supports clinical decision making can be achieved safely and effectively. It maintains the balance between a high NPV and an acceptable PPV. A modified care pathway for the use of FC in primary care is proposed.
{"title":"Evaluation of a faecal calprotectin care pathway for use in primary care","authors":"J. Turvill, S. O'Connell, A. Brooks, Karen Bradley-Wood, James Laing, Swaminathan Thiagarajan, David Hammond, D. Turnock, A. Jones, R. Sood, A. Ford","doi":"10.1017/S1463423616000049","DOIUrl":"https://doi.org/10.1017/S1463423616000049","url":null,"abstract":"Background National Institute for Health and Care Excellence have recommended faecal calprotectin (FC) testing as an option in adults with lower gastrointestinal symptoms for whom specialist investigations are being considered, if cancer is not suspected and it is used to support a diagnosis of inflammatory bowel disease (IBD) or irritable bowel syndrome. York Hospital and Vale of York Clinical Commissioning Group have developed an evidence-based care pathway to support this recommendation for use in primary care. It incorporates a higher FC cut-off value, a ‘traffic light’ system for risk and a clinical management pathway. Objectives To evaluate this care pathway. Methods The care pathway was introduced into five primary care practices for a period of six months and the clinical outcomes of patients were evaluated. Negative and positive predictive values (NPV and PPV) were calculated. GP feedback of the care pathway was obtained by means of a web-based survey. Comparator gastroenterology activity in a neighbouring trust was obtained. Results The care pathway for FC in primary care had a 97% NPV and a 40% PPV. This was better than GP clinical judgement alone and doubled the PPV compared with the standard FC cut-off (<50 mcg/g), without affecting the NPV. In total, 89% of patients with IBD had an FC>250 mcg/g and were diagnosed by ‘straight to test’ colonoscopy within three weeks. The care pathway was considered helpful by GPs and delivered a higher diagnostic yield after secondary care referral (21%) than the conventional comparator pathway (5%). Conclusions A care pathway for the use of FC that incorporates a higher cut-off value, a ‘traffic light’ system for risk and supports clinical decision making can be achieved safely and effectively. It maintains the balance between a high NPV and an acceptable PPV. A modified care pathway for the use of FC in primary care is proposed.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78722184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-09DOI: 10.1017/S1463423616000025
J. Boote, S. Julious, Michelle Horspool, H. Elphick, W. Henry Smithson, P. Norman
Aims We describe how patient and public involvement (PPI) was integrated into the design of an intervention for a randomised controlled trial (RCT) based within primary care. The RCT, known as the PLEASANT trial, aimed to reduce unscheduled medical contacts in children with asthma associated with start of the new school year in September with a simple postal intervention, highlighting the importance of maintaining asthma medication for helping to prevent increased asthma exacerbations. Background PPI is a key feature of UK health research policy, and is often a requirement of funding from the National Institute for Health Research. There are few detailed accounts of PPI in the design and conduct of clinical trials in the PPI literature for researchers to learn from. Methods We held PPI consultation events to determine whether the proposed intervention for the trial was acceptable to children with asthma and their parents, and to ascertain whether enhancements should be made. Two PPI consultation events were held with children with asthma and their parents, prior to the research commencing. Detailed field notes were taken by the research team at each consultation event. Findings At the first consultation event, parents and children endorsed the trial’s rationale, made suggestions to the wording of the trial intervention letter, and made recommendations about to whom the letter should be sent out. At the second consultation event, parents discussed the timing of the intervention, commented on the lay summary of the Research Ethics Application, and were invited to join the trial’s steering committee, while the children selected a logo for the study. PPI has resulted in enhancements to the PLEASANT study’s intervention. A further PPI consultation event is scheduled for the end of the trial, in order for children with asthma and their parents to contribute to the trial’s dissemination strategy.
{"title":"PPI in the PLEASANT trial: involving children with asthma and their parents in designing an intervention for a randomised controlled trial based within primary care","authors":"J. Boote, S. Julious, Michelle Horspool, H. Elphick, W. Henry Smithson, P. Norman","doi":"10.1017/S1463423616000025","DOIUrl":"https://doi.org/10.1017/S1463423616000025","url":null,"abstract":"Aims We describe how patient and public involvement (PPI) was integrated into the design of an intervention for a randomised controlled trial (RCT) based within primary care. The RCT, known as the PLEASANT trial, aimed to reduce unscheduled medical contacts in children with asthma associated with start of the new school year in September with a simple postal intervention, highlighting the importance of maintaining asthma medication for helping to prevent increased asthma exacerbations. Background PPI is a key feature of UK health research policy, and is often a requirement of funding from the National Institute for Health Research. There are few detailed accounts of PPI in the design and conduct of clinical trials in the PPI literature for researchers to learn from. Methods We held PPI consultation events to determine whether the proposed intervention for the trial was acceptable to children with asthma and their parents, and to ascertain whether enhancements should be made. Two PPI consultation events were held with children with asthma and their parents, prior to the research commencing. Detailed field notes were taken by the research team at each consultation event. Findings At the first consultation event, parents and children endorsed the trial’s rationale, made suggestions to the wording of the trial intervention letter, and made recommendations about to whom the letter should be sent out. At the second consultation event, parents discussed the timing of the intervention, commented on the lay summary of the Research Ethics Application, and were invited to join the trial’s steering committee, while the children selected a logo for the study. PPI has resulted in enhancements to the PLEASANT study’s intervention. A further PPI consultation event is scheduled for the end of the trial, in order for children with asthma and their parents to contribute to the trial’s dissemination strategy.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90345366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-15DOI: 10.1017/S1463423615000481
P. Keogh, P. Weatherburn, D. Reid
Aim To explore the experiences of people with HIV (PWHIV) using general practitioner (GP) services in order to identify barriers to use. Background Traditionally, GPs have little involvement in the care of PWHIV. However, as HIV becomes a chronic condition and the population of PWHIV ages, there is a need to increase this involvement. Despite high levels of GP registration, the majority of PWHIV in London report that their GP is not involved in their HIV care. Methods This paper presents qualitative findings from a mixed method study of PWHIV’s experiences of clinical services. Survey respondents were purposively sampled to recruit 51 PWHIV who took part in eight focus groups. Participants were asked about their experience of using GP services. Findings Three factors emerged which mediated experiences of GP care. Competence: respondents were concerned about the potential for misdiagnosis of symptoms, lack of awareness of the health needs of PWHIV and experiences of prescribing, which could lead to drug interactions. Continuity: not being able to get appointments quickly enough, not being able to see the same doctor twice and not being able to keep the same GP when one changed address were experienced as impediments to use. Communication: lack of communication between GPs and HIV specialists led to what participants called ‘patient ping-pong’ where they found themselves acting as a go-between for different clinical specialists trying to make sense of their care. Conclusion Meaningful contact between HIV specialists and GPs is likely to allay concerns about competency as treatment and care decisions can be taken collaboratively between the GP, HIV specialist and patient. A key component of acceptable GP care for PWHIV is likely to be the application of long-term condition management approaches, which includes empowered patient self-management.
{"title":"Learning from the experiences of people with HIV using general practitioner services in London: a qualitative study","authors":"P. Keogh, P. Weatherburn, D. Reid","doi":"10.1017/S1463423615000481","DOIUrl":"https://doi.org/10.1017/S1463423615000481","url":null,"abstract":"Aim To explore the experiences of people with HIV (PWHIV) using general practitioner (GP) services in order to identify barriers to use. Background Traditionally, GPs have little involvement in the care of PWHIV. However, as HIV becomes a chronic condition and the population of PWHIV ages, there is a need to increase this involvement. Despite high levels of GP registration, the majority of PWHIV in London report that their GP is not involved in their HIV care. Methods This paper presents qualitative findings from a mixed method study of PWHIV’s experiences of clinical services. Survey respondents were purposively sampled to recruit 51 PWHIV who took part in eight focus groups. Participants were asked about their experience of using GP services. Findings Three factors emerged which mediated experiences of GP care. Competence: respondents were concerned about the potential for misdiagnosis of symptoms, lack of awareness of the health needs of PWHIV and experiences of prescribing, which could lead to drug interactions. Continuity: not being able to get appointments quickly enough, not being able to see the same doctor twice and not being able to keep the same GP when one changed address were experienced as impediments to use. Communication: lack of communication between GPs and HIV specialists led to what participants called ‘patient ping-pong’ where they found themselves acting as a go-between for different clinical specialists trying to make sense of their care. Conclusion Meaningful contact between HIV specialists and GPs is likely to allay concerns about competency as treatment and care decisions can be taken collaboratively between the GP, HIV specialist and patient. A key component of acceptable GP care for PWHIV is likely to be the application of long-term condition management approaches, which includes empowered patient self-management.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88474886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-01-08DOI: 10.1017/S1463423615000602
Barbara M Daly, B. Arroll, N. Sheridan, T. Kenealy, R. Scragg
Background: Diabetes prevalence continues to increase, with most diabetes patients managed in primary care. Aim: This report quantifies the number of diabetes consultations undertaken by primary healthcare nurses in Auckland, New Zealand. Methods: Of 335 primary healthcare nurses randomly selected, 287 (86%) completed a telephone interview in 2006–2008. Findings: On a randomly sampled day (from the past seven) for each nurse, 42% of the nurses surveyed (n=120) consulted 308 diabetes patients. From the proportion of nurses sampled in the study, it is calculated that the number of diabetes patients consulted by primary healthcare nurses per week in Auckland between September 2006 and February 2008 was 4210, with 61% consulted by practice, 23% by specialist and 16% by district nurses. These findings show that practice nurses carry out the largest number of community diabetes consultations by nurses. Their major contribution needs to be incorporated into future planning of the community management of diabetes.
{"title":"Quantification of diabetes consultations by the main primary health care nurse groups in Auckland, New Zealand","authors":"Barbara M Daly, B. Arroll, N. Sheridan, T. Kenealy, R. Scragg","doi":"10.1017/S1463423615000602","DOIUrl":"https://doi.org/10.1017/S1463423615000602","url":null,"abstract":"Background: Diabetes prevalence continues to increase, with most diabetes patients managed in primary care. Aim: This report quantifies the number of diabetes consultations undertaken by primary healthcare nurses in Auckland, New Zealand. Methods: Of 335 primary healthcare nurses randomly selected, 287 (86%) completed a telephone interview in 2006–2008. Findings: On a randomly sampled day (from the past seven) for each nurse, 42% of the nurses surveyed (n=120) consulted 308 diabetes patients. From the proportion of nurses sampled in the study, it is calculated that the number of diabetes patients consulted by primary healthcare nurses per week in Auckland between September 2006 and February 2008 was 4210, with 61% consulted by practice, 23% by specialist and 16% by district nurses. These findings show that practice nurses carry out the largest number of community diabetes consultations by nurses. Their major contribution needs to be incorporated into future planning of the community management of diabetes.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90582291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-21DOI: 10.1017/S1463423615000468
S. Kendall, R. Bryar
At the end of August 2015, the European Forum for Primary Care (EFPC) held its 10th conference in Amsterdam. This represented a significant moment in the history of the EFPC and for Primary Health Care Research and Development (PHCRD). The conference brought together primary care researchers, practitioners and decision makers from across all parts of Europe as well as participants from the United States and Canada. The theme of the conference was ‘Integrated Primary Care: Research, Policy & Practice’. The keynote presentations and additional sessions represented a range of European and international perspectives on this theme and can be viewed on the EFPC website (http://www.euprimarycare. org/amsterdam/efpc-2015-amsterdam-conference30-august-1-september). Notably, the conference was well represented from a multi-disciplinary perspective with primary care participants including nurses, midwives, occupational health practitioners, physiotherapy, pharmacy as well as GPs and others. This in itself provides a very positive message about a European position on integration of primary care services in order to provide a more systematic and effective service for our communities. The Editors in Chief of PHCRD were honoured to announce that the journal is now formally affiliated with EFPC. This means that members of EFPC will be able to access the journal online, contribute to the editorial board, author new papers, propose and edit special issues and publish their position papers in the journal. This is a really positive step for the journal and for EFPC as we will be able to disseminate research and development activities that uphold our shared values and aims in the light of the wider global goals of primary care. The main aim of the EFPC is:
{"title":"Bringing Europe together through primary care","authors":"S. Kendall, R. Bryar","doi":"10.1017/S1463423615000468","DOIUrl":"https://doi.org/10.1017/S1463423615000468","url":null,"abstract":"At the end of August 2015, the European Forum for Primary Care (EFPC) held its 10th conference in Amsterdam. This represented a significant moment in the history of the EFPC and for Primary Health Care Research and Development (PHCRD). The conference brought together primary care researchers, practitioners and decision makers from across all parts of Europe as well as participants from the United States and Canada. The theme of the conference was ‘Integrated Primary Care: Research, Policy & Practice’. The keynote presentations and additional sessions represented a range of European and international perspectives on this theme and can be viewed on the EFPC website (http://www.euprimarycare. org/amsterdam/efpc-2015-amsterdam-conference30-august-1-september). Notably, the conference was well represented from a multi-disciplinary perspective with primary care participants including nurses, midwives, occupational health practitioners, physiotherapy, pharmacy as well as GPs and others. This in itself provides a very positive message about a European position on integration of primary care services in order to provide a more systematic and effective service for our communities. The Editors in Chief of PHCRD were honoured to announce that the journal is now formally affiliated with EFPC. This means that members of EFPC will be able to access the journal online, contribute to the editorial board, author new papers, propose and edit special issues and publish their position papers in the journal. This is a really positive step for the journal and for EFPC as we will be able to disseminate research and development activities that uphold our shared values and aims in the light of the wider global goals of primary care. The main aim of the EFPC is:","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82753754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-18DOI: 10.1017/S1463423615000584
D. Trivedi
This Cochrane review contained 10 randomised controlled trials targeting infants and children aged six months to six years with or without a history of AOM (n = 16 707) (Norhayati et al., 2015). Six were based in high-income countries and four were multicentre trials from high-, middleand low-income countries. They were delivered in health care settings, hospital and day centres. Included studies had to evaluate any influenza vaccine with placebo or no intervention and report a minimum six months follow-up after vaccination for primary outcomes. Treatment included trivalent vaccine, reassortant and a combination of monovalent and bivalent with seven trials administering live attenuated vaccine. They were given intranasally, intramuscularly or subcutaneously as one or two courses from one to three doses. AOM had to be diagnosed by clinicians and excluded studies were those in which diagnosis was based solely on participant or carer report. Nine trials declared funding from vaccine manufacturers.
这篇Cochrane综述纳入了10项随机对照试验，目标是有或没有AOM病史的6个月至6岁的婴儿和儿童(n = 16707) (Norhayati et al.， 2015)。其中6项基于高收入国家，4项是来自高、中、低收入国家的多中心试验。这些婴儿是在保健机构、医院和日托中心分娩的。纳入的研究必须评估任何带有安慰剂或无干预的流感疫苗，并报告接种后至少6个月的主要结果随访。治疗包括三价疫苗、重组疫苗以及单价和二价疫苗的组合，其中7项试验使用减毒活疫苗。他们被给予鼻内，肌肉注射或皮下注射作为一个或两个疗程，从一到三剂量。AOM必须由临床医生诊断，排除的研究是那些诊断完全基于参与者或护理人员报告的研究。9项试验宣布由疫苗制造商资助。
{"title":"Cochrane review summary: influenza vaccines for preventing acute otitis media in infants and children","authors":"D. Trivedi","doi":"10.1017/S1463423615000584","DOIUrl":"https://doi.org/10.1017/S1463423615000584","url":null,"abstract":"This Cochrane review contained 10 randomised controlled trials targeting infants and children aged six months to six years with or without a history of AOM (n = 16 707) (Norhayati et al., 2015). Six were based in high-income countries and four were multicentre trials from high-, middleand low-income countries. They were delivered in health care settings, hospital and day centres. Included studies had to evaluate any influenza vaccine with placebo or no intervention and report a minimum six months follow-up after vaccination for primary outcomes. Treatment included trivalent vaccine, reassortant and a combination of monovalent and bivalent with seven trials administering live attenuated vaccine. They were given intranasally, intramuscularly or subcutaneously as one or two courses from one to three doses. AOM had to be diagnosed by clinicians and excluded studies were those in which diagnosis was based solely on participant or carer report. Nine trials declared funding from vaccine manufacturers.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88243497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2015-12-02DOI: 10.1017/S1463423615000572
S. Johnston, Matthew Hogel, A. Burchell, Gabriel Rebick, T. Antoniou, Meaghan McLaren, M. Loutfy, C. Liddy, C. Kendall
Objectives People with human immunodeficiency virus (HIV) are living longer lives and like many other patients, need a health system better adapted for the management of complex chronic conditions. A key element of system transformation is measuring and reporting on system performance indicators relevant to the different stakeholders. Our objective was to produce a performance measurement framework for assessing the quality of comprehensive community-based primary healthcare for people with HIV. Methods Semi-structured interviews were performed with HIV providers, advocates, and policy-makers to obtain input on a draft performance framework, constructed using existing HIV-specific indicators, as well as the use of performance data in improving care for people with HIV. Results Stakeholders were overwhelmingly supportive of the framework’s comprehensiveness. Many noted the absence of indicators addressing social determinants of health and had mixed opinions on the importance of indicators addressing access to after-hours care and the frequency of routine screening for behavioural risk factors. The draft framework was modified to reflect stakeholder input, triangulated against expert opinion and recently released HIV care guidelines, and finalized at 79 indicators. The resources and infrastructure to collect and use performance data will have to be improved for performance measurement to contribute to improving care for people with HIV. Conclusions This framework presents a comprehensive though not exhaustive tool to support performance measurement and improvement in the care for people with HIV. However, advances in data collection and use across the system will be needed to support performance measurement driving quality improvement.
{"title":"Developing a performance framework for measuring comprehensive, community-based primary healthcare for people with HIV","authors":"S. Johnston, Matthew Hogel, A. Burchell, Gabriel Rebick, T. Antoniou, Meaghan McLaren, M. Loutfy, C. Liddy, C. Kendall","doi":"10.1017/S1463423615000572","DOIUrl":"https://doi.org/10.1017/S1463423615000572","url":null,"abstract":"Objectives People with human immunodeficiency virus (HIV) are living longer lives and like many other patients, need a health system better adapted for the management of complex chronic conditions. A key element of system transformation is measuring and reporting on system performance indicators relevant to the different stakeholders. Our objective was to produce a performance measurement framework for assessing the quality of comprehensive community-based primary healthcare for people with HIV. Methods Semi-structured interviews were performed with HIV providers, advocates, and policy-makers to obtain input on a draft performance framework, constructed using existing HIV-specific indicators, as well as the use of performance data in improving care for people with HIV. Results Stakeholders were overwhelmingly supportive of the framework’s comprehensiveness. Many noted the absence of indicators addressing social determinants of health and had mixed opinions on the importance of indicators addressing access to after-hours care and the frequency of routine screening for behavioural risk factors. The draft framework was modified to reflect stakeholder input, triangulated against expert opinion and recently released HIV care guidelines, and finalized at 79 indicators. The resources and infrastructure to collect and use performance data will have to be improved for performance measurement to contribute to improving care for people with HIV. Conclusions This framework presents a comprehensive though not exhaustive tool to support performance measurement and improvement in the care for people with HIV. However, advances in data collection and use across the system will be needed to support performance measurement driving quality improvement.","PeriodicalId":20471,"journal":{"name":"Primary Health Care Research & Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87196512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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