PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “General Practice”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed2005

Does the North Staffordshire slot system control demand of orthopaedic referrals from primary care?: A population-based survey in general practice.

BACKGROUND: Attempts to manage general practice demand for orthopaedic outpatient consultations have been made in several areas of the NHS, with little robust evidence on whether or not they work. AIM: To evaluate the effect of the North Staffordshire 'orthopaedic slot system' on the demand for general practice referrals to orthopaedic outpatients. METHOD: A prospective study of 12 general practices in the slot system, 24 controls, and the 63 other general practices in North Staffordshire. Comparison periods were the baseline year (0); the first calendar year (1); and the first half of the second calendar year (2). A multifactor linear regression model was used. RESULTS: Mean referral rate decreased 22% in the slot group in period 1, and was maintained in period 2 (9.40, 7.29, 7.31 referrals per 10,000 population per month for periods 0, 1 and 2, respectively). The control and other groups showed a small decrease in period 1, but in period 2 higher referral rates were observed. The reduction in referrals of 20-40% in participating practices compared to other practices equates to 2-4 referrals per 10,000 patients per month. CONCLUSIONS: Our study suggests that practices willing and able to take up an offer of a slot system for managing their orthopaedic referrals will be able to significantly reduce referral rates for their patients when compared to similar practices who do not. Further research on the generalisability, effectiveness and cost-effectiveness of such systems is warranted.

Adolescent↗
PubMed2004

Feasibility and acceptability of a physical activity promotion programme in general practice.

BACKGROUND: Physical activity promotion in general practice is advocated though not incorporated into daily practice. Several barriers must be overcome to develop a feasible and acceptable programme. OBJECTIVE: The aim of this study was to conduct a process evaluation of a physical activity promotion programme in general practice (PACE), in which patients visited their provider (GP or practice nurse) twice. METHODS: Process evaluation was conducted by means of telephone-administered, semi-structured interviews with providers and practice assistants. The main topics of the interviews were overall impression of PACE, PACE training, content and usability of the intervention materials, counselling, implementation of the intervention, and opportunities for future use. RESULTS: In the 15 participating general practices, a total of 17 providers and 12 practice assistants were interviewed. The overall impression of the PACE programme was positive. Most providers experienced the provided material and training as helpful. Some problems concerning the number of forms used and patients having difficulties completing the forms were mentioned. Most providers (70.6%) spend 10 min or more discussing PACE during the first consultation. The second consultation mostly was completed within 10 min. Patients overestimating their level of physical activity was mentioned as the main barrier in providing the counselling. PACE was evaluated as suitable for implementation in Dutch general practice, and 60% of the providers actually intended using PACE in the future. CONCLUSION: The PACE programme was evaluated as being both acceptable and feasible in a selection of Dutch general practices. Positive adaptations will be made in order to implement PACE successfully in general practice at a wider scale.

Attitude of Health Personnel↗
PubMed1993

Avoiding the pitfalls of sponsored multicentre research in general practice.

Research in general practice is becoming increasingly popular, and most general practitioners will sooner or later have to decide whether to become involved with clinical trials sponsored by drug companies. This paper outlines the advantages and disadvantages of multicentre research--based on experience of running a research group since the early 1980s--to enable doctors to reach the appropriate decision and to avoid involvement in trials which are either unethical or ineffective.

Clinical Trials as Topic↗
PubMed2006

A future career in general practice? A longitudinal study of medical students and pre-registration house officers.

OBJECTIVE: To monitor the future career preferences of medical students throughout their undergraduate years and into their postgraduate career, and to evaluate which factors may influence career choice intentions, and when this happens, over time. DESIGN: Longitudinal study. METHODS: Questionnaire to all Aberdeen, United Kingdom, Medical School entrants in 1996, and five annual follow-ups (four undergraduate, one postgraduate). RESULTS: Response rates: year 1, 100%; year 2, 78%; year 3, 70%; year 4, 64%; year 5, 65%; pre-registration house officer (PRHO), 60%. Throughout the study, females were more positive about a career in general practice. General practice was the first choice for 13% of students in year 1; year 2, 9%; year 3, 22%; year 4, 24%; year 5, 27%; PRHO, 29%. Those choosing general practice were more likely than those choosing other specialties to be female, have their family home in Scotland, rate their academic abilities lower and their non-academic abilities as average, and have decided on their future career earlier. Reasons for general practice included: working in and being part of a community; continuity of patient contact; variety of illnesses and people encountered; undergraduate teaching experiences; dislike of or disillusionment with hospital medicine; and an increasing awareness of part-time opportunities. CONCLUSION: As medical undergraduates progressed through the curriculum and became PRHOs, general practice became more popular as a career choice, particularly with females. This may be partly explained by the increased exposure to general practitioners and patients in the new community-based teaching programme and the increasing awareness of lifestyle advantages with the particular benefits of more regular hours and working part time.

Adolescent↗
PubMed1987

Detection of group A streptococcal antigen from throat swabs by use of a latex agglutination test kit in general practice.

In 11 general practice offices, with a total of 29 general practitioners, throat swabs from 468 patients with acute pharyngotonsillitis were assayed for group A streptococci with a commercial antigen detection test kit (Culturette Brand Ten-Minute Group A Strep ID; Marion Scientific, Div. of Marion Laboratories, Inc., Kansas City, MO 64114, USA). Compared to aerobic cultures carried out in our laboratory, the sensitivity of the antigen detection test was 73%; the specificity, 98%; the positive predictive value, 96%; the negative predictive value, 84%; and the overall agreement with laboratory findings, 88%. The prevalence of group A streptococci was 42%. Tests performed by assistants were significantly less sensitive (52%) than tests carried out by the physicians themselves (77%). The sensitivity of office cultures was 83% for blood agar plates supplemented with bacitracin discs, and 77% for Streptocult. We conclude that antigen detection tests should not presently be substituted for office cultures in the diagnosis of group A streptococcal throat infections.

Acute Disease↗
PubMed1991

Small business, cash budgets and general practice.

In practice management, general practice falls into the category of small business with all its attendant generic problems. Disciplined planning and good financial management are not often seen in small business. These are required if general practitioners are to continue (or return to) the provision of high quality medical services. An effective budget process, especially cash-flow budgeting, is the key to successful planning and financial management. Budgeting will bring Control, Co-ordination, and Credibility to your practice. It will enable you to set goals and to achieve them.

Budgets↗
PubMed1994

The hospital component of vocational training for general practice.

Trainees and educationalists in general practice have some grounds for suggesting that the hospital component of vocational training should be restructured and teaching improved. However, the implications for other trainees and secondary care have to be considered. Changes that are needed include a curriculum for senior house officers in each specialty; appointment of training consultants with the necessary skills; and a different attitude by everyone towards study leave, including arrangements for funding. The optimum duration of hospital posts for trainees in general practice might be shorter than now, but the effects on others must be considered and competencies guaranteed in a briefer training period. Changes in the regulations for vocational training could help to improve specialist experience if trainees in general practice were allowed to be supernumerary. Alternatively, senior house officer posts for trainees in general practice could be split between secondary and primary care, thus encouraging a broader perspective.

Clinical Clerkship↗
PubMedDate not supplied

[A model for monitoring drug prescribing in general practice].

When prescribing drugs, general practitioners at the same should satisfy the requirements of medical science and their vocation, being aware of their task of a rational disposal of the limited resources allocated for health care. The aim of the paper was to determine the characteristics of monitoring model for drug prescription in general practice, taking into consideration the characteristics of the population, morbidity, drugs and physicians. A prospective monitoring of prescribing drug during one month was carried out in six doctor's offices of general practice/family medicine at the Dugave-Travno Health Station of the Novi Zagreb Health Center. In processing data on patients, drugs and physicians the following were used: distribution description and analysis, pair's tests and General Factorial Anova. Out of 3397 patients who visited the above mentioned doctor's offices, 2320 (68.3%) patients were prescribed 4796 prescriptions--an average of 2.07 prescriptions per patient (from 2.00 to 2.42). The total cost of drug prescription was 360,117.33 kunas (from 43,632 to 77,910 kunas). The number of prescriptions and the cost of prescribed drugs increased significantly in terms of statistics with the age of patients (Spearman's correlation coefficient 0.2263; p < 0.001). By General Factorial Anova statistically significant difference was determined in the cost variable among the physicians with the impact of covariate age and number of prescriptions. Professionally, the most appropriate and most rational prescribing was observed among physicians who had the highest educational level and the longest experience in practice. In order to analyze and assess the appropriatness of drug prescription in general practice, the first essential step is to collect data on what is being prescribed, for whom it is being prescribed, and to enable access to data for physicians. This paper has indicated some of the characteristics of a monitoring model for drug prescription in general practice. Formulation and implementation of this model would considerably promote the professional appropriateness and rationality in drug prescription in general practice.

Adolescent↗
PubMed2003

Meeting the challenge of chronic illness in general practice.

Seven of every 10 general practice encounters are for chronic conditions. Three common chronic conditions managed by GPs are depression, diabetes and asthma. Two of these are National Health Priority Areas (NHPAs), while depression is the focus of the mental health NHPA. General practice care for people with depression is being strengthened by the "Better outcomes in mental health care initiative", which includes a 3 Step Mental Health Process - assessment, mental health plan, and review. GPs have the opportunity to screen patients for diabetes and manage their condition. For those with risk factors who screen negative, GPs are well placed to encourage lifestyle interventions. Two of the four components of the National Integrated Diabetes Program focus on general practice. The Asthma 3+ Visit Plan, which incorporates diagnosis and assessment of asthma, development of a written asthma plan, and review of asthma management, has been shown to improve GPs' management of asthma. These initiatives to improve general practice interventions for chronic illness, although welcomed, put further pressure on already overstretched GPs coping with multiple changes in the primary-care sector.

Asthma↗
PubMed2004

[Modular training in practical medicine: electronic evaluation of student education in general practice].

Effective from spring 2004, new regulations for undergraduate medical education in Germany require a two-week practical training in general practice. Similar to other forms of medical education, this practical training should be regularly evaluated by students. With regard to special conditions of the training, we preferred a web based evaluation. Since adequate models were not available, we designed, implemented and tested an electronic way of evaluation. The following aspects turned out to be of special importance: teamwork, time, data protection and cost. Meanwhile, the evaluation is established and still accessible as demo-version for visitors of the home page. This electronic evaluation of medical training in general practice is highly appropriate for a timely evaluation allowing us to obtain a comparison between students' expectations and actual experience as well as a continuous supervision and to provide feedback to the participating practices. This is an important step for quality assurance of medical education in practices inside and outside the university.

Computer-Assisted Instruction↗
PubMed1995

Computerised data collection: practicability and quality in selected general practices.

The objective of the study as to assess the consistency with which a set of pre-defined data about three fictitious patients was entered into a sample group of practice computer systems, and to measure the time required for routine data capture of this kind. The study design was a prospective, piloted, postal survey, in which respondents were requested to enter a variety of general sample data onto their systems, to time the process, and record details of any difficulties. The subjects were 76 (39%) responding general practices in England and Ulster, from a random sample of members of a GP computer specialist group. These results (which in view of the highly motivated characteristics of the responding sample are likely to represent best practice) showed that differing conventions were applied in entering patient data, even among practices using the same type of computer system. Potentially significant errors and distortions were found in the data as recorded in the systems, such as the 29% of immunisation sequences which were slightly inaccurately entered. The main problems with the data entry comprised simple operator errors, inconsistency in the use of terms entered, and difficulties in recording negative data (only 20% of practices could enter patient 'not incontinent'). Practices varied widely in the way they allocated data recording responsibilities to staff, with only 6% of practices involving all staff in data entry.(ABSTRACT TRUNCATED AT 250 WORDS)

Bias↗
PubMed2000

Applying the results of a systematic review in general practice.

OBJECTIVE: To assess how general practitioners might interpret and apply the results of a systematic review relevant to general practice. DESIGN: Cross-sectional postal survey of general practitioners in August 1997. PARTICIPANTS: 51 general practitioners in the Southern Division of General Practice in Adelaide and 11 professors or heads of departments of general practice. MAIN OUTCOME MEASURES: Extent to which comments on the implications for practice and implications for research coincided with the evidence presented in a systematic review of antibiotics for the treatment of acute otitis media in children; and reported probability that respondents would prescribe antibiotics in three brief case scenarios. RESULTS: There was considerable variation in the comments made by general practitioners on the implications of the review for clinical practice. After reading the review, respondents with training in critical appraisal were more likely to state that children with acute otitis media would usually recover spontaneously and reported a lower probability of prescribing antibiotics in two of the three case scenarios. CONCLUSIONS: Providing systematic reviews is not sufficient for the results of such evidence to be translated into clinical practice. There is an association between critical appraisal skills and the application of evidence-based practice.

Adult↗
PubMed2000

[Practice patterns, physicians' characteristics and patient-evaluated quality of general practice in Norway].

BACKGROUND: Norwegian general practice is a conglomerate of organisational forms. Studies of quality differences between types of practice have not been published. There is scant knowledge of how physician characteristics may influence patients' experience of the quality of care. MATERIALS AND METHODS: In this study of patient experiences with quality in primary care, we received answers to a questionnaire from more than 1,600 patients who had made office visits to 61 GPs working in 44 different practices. The patients expressed their opinion of the quality of medical-technical performance, doctor-patient relationship, information and support, accessibility and the organisation of general practice. Using multilevel analysis we compared solo-practices with group practices, and conventional types of practices with list-patient practices. RESULTS: No significant differences in patient experienced quality were found for different practices with traditional organisation. List-patient practices scored lower on quality than conventional practices, especially on accessibility and organisation. There were no significant differences in patient evaluation related to the doctor's gender. GPs with more than ten years in a practice were rated lower on quality than GPs with ten or fewer years of experience. INTERPRETATION: The way general practice is organised and the number of years the GP has worked in the same practice appear to influence how patients experience the quality of primary health care.

Family Practice↗