Search results for " primary care"
showing 10 items of 28 documents
Chronic non-cancer pain in primary care: an Italian cross-sectional study
2021
Chronic non-cancer pain is a complex health condition that affects more than a quarter of the Italian population who mainly refers to general practitioners and primary care for their treatment. There are little information on the epidemiological and clinical characteristics and types of treatments for these patients who suffer from chronic pain. The aim of the study was to provide epidemiological and clinical information about patients with chronic non-cancer pain who refers to GPs for their treatment. An observational, multicentre, cross-sectional study was carried out using retrospectively reviewed clinical records from 29 GPs. Some pharmacoeconomic aspects were also investigated. A total…
Catching allergy by a simple questionnaire
2014
Background Identifying allergic rhinitis requires allergy testing, but the first-line referral for rhinitis are usually primary care physicians (PCP), who are not familiar with such tests. The availability of easy and simple tests to be used by PCP to suggest allergy should be very useful. Methods The Respiratory Allergy Prediction (RAP) test, based on 9 questions and previously validated by a panel of experts, was evaluated in this study. Results An overall number of 401 patients (48.6% males, age range 14–62 years) with respiratory symptoms was included. Of them, 89 (22.2%) showed negative results to SPT, while 312 (77.8%) had at least one positive result to SPT. Cohen’s kappa coefficient…
Efficacy of a blended low-intensity internet-delivered psychological programme in patients with multimorbidity in primary care: study protocol for a …
2019
BackgroundThe World Health Organization (WHO) has included comorbidity between depression and a chronic disease among the 10 leading global health priorities. Although there is a high prevalence of multimorbidity, health care systems are mainly designed for the management of individual diseases. Given the difficulty in delivering face-to-face psychological treatments, alternative models of treatment delivery have been proposed, emphasizing the role of technologies such as the Internet. The aim of this study is to assess the efficacy in Primary Care (PC) of a blended low-intensity psychological intervention applied using information and communication technologies (ICTs) for the treatment of …
What is the impact of rerouting a cancer diagnosis from emergency presentation to GP referral on resource use and survival? Evidence from a populatio…
2018
Background Studies on alternative routes to diagnosis stimulated successful policy interventions reducing the number of emergency diagnoses and associated mortality risk. A dearth of evidence on the costs of such interventions might prevent new policies from achieving more ambitious targets. Methods We conducted a retrospective cohort study on the population of colorectal (88,051), breast (90,387), prostate (96,219), and lung (97,696) cancer patients diagnosed after a GP referral or an emergency presentation and reported in the Cancer Registry of England. Resource use and survival were compared 1 year before and 5 years after diagnosis (3 years for lung), including the costs of GP referrals…
Rectal bleeding and prolapse… not always benign diseases rather anal cancer. The importance of a correct decision making since primary care
2016
Rectal bleeding is very common in general population with a prevalence of 10-20 %. Primary care physicians have to stratify patients basing on urgency and on the colo-rectal cancer risk and to conduct a decision making for the correct management. We report a case of a 61-years-old woman, complaining rectal bleeding and an anal mass attended to their family doctor who does a visit but without a digital rectal examination and diagnosed a hemorrhoidal prolapse suggesting medical therapy. For the persistence of symptoms she comes to our service from emergency attention. Inspection and digital rectal examination revealed an anal mass. CT scan was performed showing a large anal mass involving hal…
A coordinated preventive care approach for healthy ageing in five European cities: A mixed methods study of process evaluation components
2019
To evaluate specific process components of the Urban Health Centres Europe (UHCE) approach; a coordinated preventive care approach aimed at healthy ageing by decreasing falls, polypharmacy, loneliness and frailty among older persons in community settings of five cities in the United Kingdom, Greece, Croatia, the Netherlands and Spain.Mixed methods evaluation of specific process components of the UHCE approach: reach of the target population, dose of the intervention actually delivered and received by participants and satisfaction and experience of main stakeholders involved in the approach.The UHCE approach intervention consisted of a preventive assessment, shared decision-making on a care …
Intervenciones preventivas en el ámbito de la atención primaria. El ejemplo del PAPPS. Informe SESPAS 2012
2012
ResumenObjetivosEl Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS), que la Sociedad Española de Medicina de Familia y Comunitaria (semFYC) puso en marcha a finales de la década de 1980, tiene como objetivo la integración de las actividades preventivas y de promoción de la salud en el seno de las tareas desarrolladas en las consultas de atención primaria. Se pretende conocer el grado de cumplimentación del PAPPS en atención primaria.MétodosSe ha realizado una búsqueda bibliográfica de las publicaciones relacionadas con el PAPPS con el fin de evaluar su implementación y el impacto sus programas.ResultadosLas evaluaciones periódicas que se han ido realizando desde su ini…
Predictors of emergency department referral in patients using out-of-hours primary care services
2016
Background Out of hours (OOH) doctors could manage many cases limiting the inappropriate accesses to ED. However the possible determinants of referral to ED by OOH doctors are poorly studied. We aimed to characterize patients referred from the OOH to ED service in order to explore the gate-keeping role of OOH service for hospital emergency care and to facilitate future research in improving its cost-effectiveness. Methods A retrospective study was made through data collection of 5217 contacts in a local OOH service in the North-East of Italy (from 10/01/2012 to 03/31/2013). Results Only 8.7% (=454 people) of the total contacts were referred to ED. In the multivariate analysis, the significa…
How common is bipolar disorder in general primary care attendees? A systematic review and meta-analysis investigating prevalence determined according…
2016
Objective: There are mounting calls for bipolar disorder to be managed in primary care, yet the exact prevalence remains unclear. We conducted a meta-analysis to investigate the prevalence of bipolar disorder in general primary care attendees without other comorbid psychiatric diagnosis. Method: We systematically searched major electronic databases from inception till 03/2015. Articles were included that reported the prevalence of bipolar disorder determined in line with structured clinical assessment in primary care settings. Two independent authors conducted searches, completed methodological appraisal and extracted data. A random effects meta-analysis and meta-regression were performed. …
A Classification System for Decision-Making in the Management of Patients with Chronic Conditions
2021
Patients with chronic diseases are frequent users of healthcare services. The systematic use of stratification tools and predictive models for this group of patients can be useful for health professionals in decision-making processes. The aim of this study was to design two new classifier systems for detecting the risk of hospital admission for elderly patients with chronic conditions. In this retrospective cohort study, a set of variables related to hospital admission for patients with chronic conditions was obtained through focus groups, a health database analysis and statistical processing. To predict the probability of admission from the set of predictor variables, a logistic regression…