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Biomedical subjects

P Campion

Publications and source records attributed to P Campion.

18 recordsLinked to original sources
PubMed2004

Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: a randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128].

BACKGROUND: This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. DESIGN: The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole.

Aged↗
PubMed2001

Smoking cessation. Pulling out the stops.

The launch of smoking-cessation drug Zyban in June last year greatly increased demand on a local smoking-cessation service. It is important to use local media to increase awareness of local services. Health authorities and pharmaceutical companies should work with the media when new drugs may put extra strain on local services.

Bupropion↗
PubMed1999

Achieving a patient-centred consultation by giving feedback in its early phases.

The traditional medical consultation comprises history, examination, and investigations, followed by explanation to the patient of diagnosis and management. In the course of studying a series of tape-recorded consultations in a specialist medical clinic for chronic fatigue, we have observed a different structure. In some consultations, those categorized as more 'patient-centred', doctors introduced explanation and education into the early history-taking stage. This strategy is contrasted with the traditional approach, where the doctor only elicits information during the history, and gives an explanation later. The 'early feedback' strategy may result in patients with chronic illnesses achieving greater understanding of their symptoms. We discuss the implication of these findings for medical training.

Communication↗
PubMed1996

Tracking skin integrity: a template for hospital and vendor collaboration.

Collaborative endeavors are particularly attractive in a time when resources are under extensive demand, but for organizations to be successful at collaboration, many shared values and qualities are necessary. In 1992, a hospital and a vendor of therapeutic bed surfaces entered into a collaborative partnership to test clinical indicator ability to track skin care outcomes. The vendor contributed major funding for the project, a national database from which clinical indicators on pressure ulcers were determined, and data processing and analysis. The hospital provided project coordination, clinical knowledge, data collectors, and access to patients. The article describes the process, problems, and benefits of collaboration and underscores the need for a trusting psychological climate, strong mutual interest in the project, clearly stated goals with resources to meet them, collaborator consideration of each other as peers, and skill in tension management if collaboration is to be successful.

Humans↗
PubMed1995

How do desk-top computers affect the doctor-patient interaction?

General practice consultations were video-recorded before and after the introduction of a desk-top computer system into the practice. The recordings were analysed by detailed qualitative scrutiny of tape and transcripts (conversation analysis) to discover regular patterns of interaction. This analysis confirmed that the introduction of computers into the consultation had a significant impact on the communication between patient and doctor. In particular, we found that computer technology has had an impact on the practitioners' conduct and on the disclosure of information by the patient. The analysis also points to some recommendations both for training general practitioners in the use of computerized systems in the consultation, and for the (re)design of the technologies themselves.

Computer Terminals↗
PubMed1994

Evaluation of a mass media campaign on smoking and pregnancy.

Two surveys were conducted among pregnant women throughout England, before (n = 625) and after (n = 607) a mass media campaign on smoking and pregnancy targeted at women aged 15-24 years, in the social grade C2DE. The majority of the post-campaign sample recalled having seen at least one of the campaign's series of press advertisements. There was a significant increase among this sample in those considering smoking to be very dangerous to the unborn child, in those understanding the term passive smoking and in those considering passive smoking to be very dangerous. During the campaign there was a 14% increase in the number of calls to a cessation helpline from pregnant women. Over the campaign there were no significant changes in smoking prevalence and consumption among pregnant women or partners or in the numbers of partners offering suggestions to pregnant women about their smoking behaviour.

Adolescent↗
PubMed1992

Audit in general practice: students and practitioners learning together.

OBJECTIVES: To describe and evaluate the use of medical audit in general practice as an educational activity shared by undergraduate medical students and general practitioners. DESIGN: A descriptive study, evaluated by a questionnaire survey of all participating practices and by results of completed student projects on general practice audit topics during three weeks in the first year of completed projects (1990-1). SETTING: One university department of general practice, collaborating with 18 general practices in contract with Liverpool Family Health Services Authority. PARTICIPANTS: 150 medical students, working in groups of two to six, and the general practitioners with whom they worked in 18 practices. MAIN MEASURES: The nature of topics proposed by practices and chosen by the students; methods of audit used by students; reported effects of the audits on the practices; general practitioners' opinions of the projects' usefulness to the practice. RESULTS: The range of topics was wide, and both quantitative and qualitative methods were used. Fifteen of the 18 questionnaires sent out were completed. Six practices reported that the final project had changed substantially after joint planning with the students. Two thirds (10) attached high value to the audits and were making changes in the delivery of care as a result. CONCLUSIONS: Medical audit "project work" by medical undergraduates is an effective tool for motivating students to learn and can lead to change in the clinical setting in which it occurs. IMPLICATIONS: By meeting the learning needs of both undergraduates and established practitioners audit project work has wider application within medical education.

Education, Medical, Undergraduate↗
PubMed1988

Self-help in primary care: preliminary findings of a study in Liverpool.

Self-help groups are an important, but often neglected, resource in primary care. This paper reports the preliminary findings of a study of the origins and natural history of self-help groups in Liverpool, and considers the role for general practitioners in mobilizing resources to facilitate community participation in health through this diverse, and informal, sector of the health care system.

England↗
PubMedDate not supplied

Compliance in a screening program for neuroblastoma.

BACKGROUND: The Quebec Screening Program for neuroblastoma was undertaken to determine if routine screening of infants for neuroblastoma would decrease the mortality rate from this cancer. All 476,603 children born in Quebec during a 5-year period (1989 to 1994) were offered this screening at ages 3 weeks and 6 months. Through various strategies, an attempt was made to attain the highest level of voluntary compliance possible. METHODS: Each screening consisted of the analysis of the catecholamine metabolites vanillylmandelic acid and homovanillic acid on a dry, urine-saturated filter paper mailed to a central laboratory by the parents. The strategies employed to optimize compliance consisted of increasing the awareness of the parents, health professionals, and the public about neuroblastoma and the screening program. RESULTS: The population responded well to this public health measure, with a 91% compliance rate at 3 weeks and a 74% compliance rate at 6 months. CONCLUSIONS: A well-informed population accustomed to voluntary screening for metabolic disease in infants responds well to screening for cancer.

Female↗
PubMedDate not supplied

Clinical terminology: anxiety and confusion amongst families undergoing genetic counseling.

Genetic counseling is a rapidly expanding, but highly demanding, domain of doctor-patient communication. This paper reports results from an ethnographic study of families (n = 30) attending a genetic counseling clinic in Northern England. We suggest that the language used in this particular specialty is often confusing and misunderstood by the families involved. We found that unfamiliar terms may also conjure up also conjure up alarming images. It is important therefore, that physicians, and in particular geneticists, try to use simple, understandable language, and give clear explanations for unfamiliar terms that cannot be avoided. The careful choice of words, and detailed explanation, not only reduces the risks of "labelling" and stigmatization, but may also prevent the unnecessary anxiety experienced by patients when they hear unfamiliar medical terms, such as the eponyms frequently employed by geneticists when giving a diagnosis.

Anxiety↗
PubMedDate not supplied

Assessing physicians' interpersonal skills via videotaped encounters: a new approach for the Royal College of General Practitioners Membership examination.

The Royal College of General Practitioners' Membership examination, the only postgraduate qualification in family medicine in the United Kingdom, has developed a direct assessment of candidates' interpersonal skills performance using videotaped consultations of the actual doctor-patient encounters. At present about 1,200 doctors are examined each year. The methodology has been developed and piloted over a period of eight years. The central tenet of the methodology is a clear definition, which is known both to the candidate and to the examiner, of the clinical and consulting competencies that are required to be demonstrated in order to pass the examination. The candidate is required to provide evidence of his or her competence usually by selecting appropriate patient encounters that demonstrate the fulfillment of the required performance criteria, effectively producing a portfolio of his or her communicative competence. The methodology is intended to encourage the learning and teaching of communication skills by making it part of an important examination and clearly defining the competencies required to pass. Reliability has been demonstrated to be satisfactory and refinement of the marking processes is likely to improve this further.

Evaluation Studies as Topic↗