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At least 649 records · Page 36Linked to original sources

PubMed2005

Patients' views on chronic illness and its care in general practice.

BACKGROUND: General practitioners have described barriers to the uptake of incentives such as the Enhanced Primary Care items introduced to support care of chronic illness. However patients' attitudes toward chronic illness and planned care are not known. METHODS: A qualitative study of adult patients with chronic illnesses using semi-structured interviews and a focus group, examining their experience of chronic illness and their attitudes toward health care. RESULTS: Sixteen patients were interviewed; five participated in the focus group. Patients believed that their illnesses were permanent and progressive, and that GPs had little influence over their prognosis. They preferred to access GPs for acute problems rather than anticipatory care, and most could not see a need for care planning. DISCUSSION: Patient preferences for care delivery may be in conflict with the current reform agenda focussing on anticipatory care provision. Efforts to reform chronic illness care may falter unless this is addressed.

Adult↗

PubMed1990

[Use of fetal ultrasonic detectors in general practice].

50 general practitioners (GPs) in Norway answered a questionnaire on their use of ultrasonic fetal heart detectors in 1979-80 and 1989. 21 of 50 GPs (42%) had an ultrasonic fetal heart detector in 1979-80, and 32 of 44 GPs (73%) had such a device in 1989 (p less than 0.01). The use of the detector had not changed much over the years. 85% of the doctors who had such a device used it on all or most pregnant women. 70% of the GPs usually listened to the fetal heart beat for 10-30 seconds each time, and about 1/3 of the GPs used the detector more than eight times during each pregnancy. There was a linear relationship between the GPs' conception of the energy output level of the fetal heart beat detector and his/her use of the instrument. GPs who believed the device to have a relatively high energy output level compared with standard B-scan equipment used the device for shorter time periods (r = -0.49, p less than 0.05) and less often during pregnancy (r = -0.54, p less than 0.01).

Echocardiography↗

PubMed2005

Workplace assessment for licensing in general practice.

With the redesign of general practice training implicit in the Department of Health's programme of reform, Modernising Medical Careers, there is the opportunity to bring summative assessment and the MRCGP examination together into a unified assessment framework for licensing. It is likely that assessment in the workplace will play a central role in such a process. Workplace assessment is of high validity and has the potential to reconnect teaching and testing in general practice. Five principles to underpin the design of a workplace assessment are proposed, namely that it should be: competency-based, developmental, evidential, locally assessed, and triangulated. Successful implementation of workplace assessment will not only serve to reduce the current testing burden on trainees, but will also harness the involvement of medical teachers. In doing so, general practice has the opportunity to create a powerful tool for professional development.

Education, Medical, Continuing↗

PubMed2001

Choosing antidepressant drugs in general practice.

BACKGROUND: General practitioners provide most of the mental health care to patients with common forms of anxiety or depression. There is a range of mental health therapies available, both pharmacological and nonpharmacological. In order to individualize treatment, practitioners need to consider the range of choices now available. OBJECTIVE: To outline reasons for choosing between different antidepressant compounds in different clinical settings. DISCUSSION: Newer antidepressant drugs, especially the selective serotonin reuptake inhibitors, now account for most of the antidepressant prescriptions written. Practitioners may find it useful to differentiate the severity and types of depressive disorders that patients commonly present with. Such differentiation may assist in the selection of appropriate second line choices or alternative first line choices in some situations.

Antidepressive Agents↗

PubMed2006

Field testing a complaints register proposal as a requirement of Australian general practice.

OBJECTIVE: To investigate the feasibility, achievement and acceptance of indicators of quality general practice in the RACGP Standards for general practices (third edition), using complaints registers as a case study. DESIGN, SETTING AND PARTICIPANTS: A purposive sample of convenience of 200 general practices (stratified according to location and size) participated in a field test of quality and safety proposals during an accreditation survey visit between October 2004 and February 2005. Included was a test of the proposal for a complaints register (a document where complaints made to the practice are recorded). MAIN OUTCOME MEASURES: Achievement of the complaints register proposal, assessed by accreditation surveyors; questionnaire rating of the feasibility and acceptance of the proposal. RESULTS: Few practices used a formal complaints register (79/200; 39.5%), with large practices more likely (12/20; 60.0%) and very remote practices less likely (1/11; 9.1%) to use one. The proposal for complaints registers was rated feasible by 123 general practices (61.5%) and rated acceptable by 121 general practices (60.5%). CONCLUSIONS: The proposal for complaints registers in general practice, while popular with policymakers, gained limited support when tested in Australian general practice. This shows the need for a balance between the expectations of policymakers, the need to increase performance by setting standards, and the practicalities of every-day general practice.

Accreditation↗

PubMed1959