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Biomedical subjects

Charles Campion-Smith

Publications and source records attributed to Charles Campion-Smith.

6 recordsLinked to original sources
PubMed2006

The effect of patient self-completion agenda forms on prescribing and adherence in general practice: a randomized controlled trial.

BACKGROUND: What the patient wants from a general practice consultation and what the doctor believes they want are not always the same thing. This mismatch may lead to unwanted and unnecessary prescribing. AIM: To study the effect of a one-page form completed by patients before their consultation and given to the doctor at the start of the consultation, in terms of a reduction in prescribing, satisfaction with the consultation and adherence with prescribed medication. DESIGN: Randomized controlled trial. SETTING: Ten general practices in Devon and Dorset, UK. METHODS: Unselected patients attending general practice appointments were randomised to receive (or not) a self-completed agenda form (SCAF) asking five questions, including whether the patient considered they should receive a prescription. RESULTS: Approximately 4125 patients were offered entry; 3124 (76%) agreed to randomisation. In 1783 (57%) of these prescribing or satisfaction outcomes were identified. 457 of 811 (56.4%) of SCAF patients received a prescription, at a median (IQR) cost of pound 5.60 (inter-quartile range pound 2.12- pound 16.10), compared with 418 of 799 (52.3%) of controls, at a median cost of pound 5.94 ( pound 2.46- pound 18.90); both results non-significant (P=0.10 for prescribing and 0.30 for cost). Satisfaction was also similar in both groups: mean satisfaction score in SCAFs 5.37 and in controls 5.40 (P=0.64), as was adherence: at 12 weeks, adherence of 75% or greater was reported by 92 of 136 SCAF patients (68%) and 105 of 145 controls (72%) (P=0.31). CONCLUSION: The negative result could have two explanations. Either the intervention did not achieve the intention of communicating the patients' agendas, or if it did, patients may have been persuaded by doctors' explanations in the consultation.

Adult↗
PubMed2006

"You feel so hopeless": a qualitative study of GP management of acute back pain.

BACKGROUND: Biopsychosocial management of non-specific back pain in general practice has been problematical, with frequent inappropriate referral for imaging and secondary care interventions and lack of self-confidence in the ability to provide evidence-based care. AIMS: To examine GP attitudes to managing back pain as a biopsychosocial problem in order to inform future educational strategies that may improve practice. METHODS: Twenty-one GPs from separate practices within the Dorset and Somerset Strategic Health Authority area (UK) participated in telephone interviews leading to the development of vignettes to refine the theoretical framework for subsequent focus group interviews about evidence-based back pain management. Transcripts were analysed thematically. RESULTS: There were 5 main emergent themes. These were generally negative and dominated by concerns about doctor-patient interaction. They included feelings of frustration, mismatches of perceptions in the doctor-patient relationship, problems in relation to time, challenges and discord between stakeholders in the process (for example, over sickness certification) and a lack of resources for education, awareness and local services to refer to. Psychosocial aspects of the actual care process were rarely raised. Participants favoured education that is multidisciplinary, in small group format and involves the participation of patients. CONCLUSIONS: This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation.

Acute Disease↗
PubMed2002

One Dorset practice's experience of using a quality improvement approach to practice professional development planning.

There has been considerable discussion on and recommendation of the idea that Practice Professional Development Plans (PPDPs) should develop the whole practice as a healthcare resource, integrating and improving the educational process. In this study the PPDP concept was launched in a practice in Dorset, following the Bournemouth PPDP framework. The practice linked the educational activities of individuals, small working groups and the whole team to meeting the needs of the patients using a continuous quality improvement approach. The learning needs of the practice team were identified and learning actions were planned leading to a better response to patients' needs.

Education, Medical, Continuing↗
PubMed2002

The Dorset Seedcorn Project: interprofessional learning and continuous quality improvement in primary care.

There is a need to develop models of practice-based learning that are effective in bringing about improvement in the quality of care that patients receive. This paper describes a facilitated practice-based project where five general practices in Dorset formed interprofessional teams that worked over a six-month period using a continuous quality improvement (CQI) approach to make a change in areas of importance to them. All the teams completed the project and planned and implemented demonstrable changes. Qualitative enquiry showed changes in relationships and teamworking that extended beyond the specific topic of the project with teams reporting an enhanced sense of competence and achievement. The project facilitators were able to develop a model of learning that acknowledges and utilises the depth of experience and understanding within interprofessional practice teams. Protected time and an environment and processes that encourage full partcipation of a wide range of team members is essential.

Education, Medical, Continuing↗