Prescribing patient information leaflets may be better than prescribing drugs.
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Biomedical subjects
Publications and source records attributed to I N Purves.
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This article reviews the usefulness and importance of written information, specifically leaflets, being given to patients. Evidence suggesting how both patient and doctor may benefit from the giving of written information is reviewed. Identification of good practice relating to the content and readability of leaflets is discussed. An argument is put forward that the giving of written information is an under-utilized resource in contributing to improving patient outcomes but that this may be changing with the increasing use of patient leaflet databases. The advantages and disadvantages of computer-generated patient leaflets are discussed and desirable further areas of research on computer-generated leaflets are proposed.
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This paper proposes a clinical method for general practice which is patient-centred and which ensures that the doctor's agenda is supported to secure 'best practice'. It encompasses self-learning for GPs which is patient-focused and describes the encouragement and support of patient self-care. The method attempts to be pragmatic and usable within GPs' available time. The method, however, is not solely focused on the GP; it encompasses the primary health care team and the patient. It uses clinical information systems to assist in the management of the patient care plan, to supply information to the GP and patient, in order to aid shared decision making and to quality assure clinical activity. It goes further by extending the care process to handle 'virtual' encounters in which the clinical information systems play a central role.
A new model of the medical record is introduced which can incorporate context, structure, process and use of the medical record within a single narratological framework. It is claimed that the analysis of narrative and, in particular, the study of the story metaphor can provide a theoretical model which provides coherence within the broad discipline of Medical Informatics. It is argued that this framework maintains different levels of abstraction, is useful for teaching and clinical practice, and that its concepts can be readily understood by those in both lay and technical healthcare professions.
This paper aims to describe why we need to change the health care record paradigm that is currently accepted. The paper goes on to describe the new paradigm of a goal oriented health record (GOHR) and the relevance of computerization.
OBJECTIVE: To examine and compare the prescribing unit and a new prescribing index adjusting for age and sex in assessing general practice prescribing. DESIGN: Analysis of all prescriptions issued by two practices in one year. Use of data to derive a prescribing index adjusting for age and sex. Comparison of effect of prescribing unit and new index on relation between 80 practices' prescribing data and family health services authority average. SETTING: Newcastle and Gateshead Family Health Services Authorities. Two urban practices with eight doctors and combined list size of 16,300 patients. MAIN OUTCOME MEASURES: Cost and number of prescriptions issued to each age and sex group. Effect of index on relation between practice data and family health services authority average. RESULTS: The number of items prescribed and total costs rose with age. Although total costs were greater for women than for men, individual items cost more for men aged 25-84. Comparison of data adjusted by the prescribing unit and the new index with authority averages produced no significant differences except in a few practices with skewed age-sex demography. Results with the two indexes differed by over 5% in 34% (27/80) of practices for costs and in 14% (11/80) for items prescribed. CONCLUSIONS: The age and sex profile of a practice does not explain interpractice variation in prescribing patterns. Other unidentified factors need to be considered.