The European journal of general practice (Eur J Gen Pract )

Publisher: Taylor & Francis

Description

Created in 1995, the European Journal of General Practice is the official journal of WONCA Europe (the European Society of General Practice/Family Medicine) and supports its aims and objectives. The EJGP is an international scientific journal. Its objectives are: To foster scientific research in general practice/family medicine (GP/FM) by the publication of original papers and reports; To present background papers, and papers stimulating discussion and debate relevant for the development of GP/FM; To facilitate the communication between the members of the ESGP/FM, the international network organisations and the national colleges and societies involved in general practice.

  • Impact factor
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  • 5-year impact
    0.00
  • Cited half-life
    0.00
  • Immediacy index
    0.00
  • Eigenfactor
    0.00
  • Article influence
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  • Website
    European Journal of General Practice, The website
  • ISSN
    1751-1402
  • OCLC
    162283978
  • Material type
    Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Taylor & Francis

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Some individual journals may have policies prohibiting pre-print archiving
    • On author's personal website or departmental website immediately
    • On institutional repository or subject-based repository after either 12 months embargo for STM, Behavioural Science and Public Health Journals or 18 months embargo for SSH journals
    • Publisher's version/PDF cannot be used
    • On a non-profit server
    • Published source must be acknowledged
    • Must link to publisher version
    • Set statements to accompany deposits (see policy)
    • The publisher will deposit in on behalf of authors to a designated institutional repository including PubMed Central, where a deposit agreement exists with the repository
    • STM: Science, Technology and Medicine
    • SSH: Social Science and Humanities
    • Publisher last contacted on 25/03/2014
    • 'Taylor & Francis (Psychology Press)' is an imprint of 'Taylor & Francis'
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Previous studies reported moderate to good agreement between patients' self-reported diseases and physicians' registered diseases. Disagreement might hamper a good doctor-patient relationship and hamper good quality of care. Disagreement can be associated with demographic and psychosocial patient characteristics. Objectives: To evaluate the level of agreement on reported chronic diseases between patients and their general practitioners (GPs); to assess whether disagreement relates to patient characteristics. Methods: This study is embedded in a large GP based prospective cohort. Questionnaires of 2893 patients reporting on 14 chronic diseases are used. The agreement (percentage) between self-reported chronic diseases and the medical records was assessed first by descriptive statistics. To control for agreement by chance alone Cohen's kappa value was calculated. Type of (dis) agreement was further evaluated and associated with patient characteristics. Results: Despite high agreement on diseases between patients and GPs, kappa's varied from 0.17 (inflammatory joint diseases and rheumatoid arthritis) to 0.86 (diabetes mellitus). Most often under-reporting and over-reporting was related to a decreased physical and mental quality of life and higher age. Conclusion: kappa values between patients and GPs appeared to be low in this study.
    The European journal of general practice 05/2014;
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    ABSTRACT: Background: Methadone maintenance treatment in primary care is cost-effective and improves outcomes for opiate-dependent patients. A more developed understanding of the evolving needs of this important cohort will facilitate further improvements in their integrated care within the community. Objectives: The aim of this study was to compare the burden of chronic disease, multi-morbidity and intensity of health-service use between methadone-maintained patients (MMPs) and matched controls in primary care. Method: This is a retrospective matched case-control design. Data on chronic disease and health service use was collected in 13 computerized GP surgeries on 414 patients (207 MMPs and 207 controls). Twelve months of records were examined. MMPs were compared with controls matched by gender, age, socio-economic status (SES) and GP surgery. Results: MMPs suffered more chronic disease (OR = 9.1, 95% CI: 5.4-15.1, P < 0.001) and multi-morbidity (OR = 6.6, 95% CI: 4.3-10.2, P < 0.001). They had higher rates of respiratory, psychiatric and infectious disease. MMPs of lower SES had more chronic disease than their peers (OR = 7.2, 95% CI: 2.4-22.0, P < 0.001). MMPs attended the doctor more often with medical problems (OR = 15.4, 95% CI: 8.2-28.7, P < 0.001), with a frequent requirement to have medical issues addressed during methadone-management visits. Their care generated more telephone calls (OR = 4.4, 95% CI: 2.8-6.8, P < 0.001), investigations (OR = 1.8, 95% CI: 1.2-2.7, P = 0.003), referrals (2.6, 95% CI: 1.7-4.0, P < 0.001), emergency department visits (2.1, 95% CI: 1.3-3.6, P = 0.004), outpatient attendances (2.3, 95% CI: 1.51-1.43, P < 0.001) and hospital admissions (3.6, 95% CI: 1.6-8.1, P = 0.001). Conclusion: Correcting for routine methadone care and drug-related illnesses, MMPs had a higher burden of chronic disease and used both primary and secondary health services more intensively than matched controls.
    The European journal of general practice 05/2014;
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    ABSTRACT: Background: Guideline and reimbursement modifications have been introduced to optimize prescribing of antisecretory medication in Danish general practice. Impacts of the interventions have not been evaluated. Objectives: To analyse developments in prescribing of antisecretory medication in Denmark 2001-2011 and to assess the impacts of interventions on prescribing of antisecretory medication. Methods: Register-based cohort study covering the entire Danish population of currently 5.5 million inhabitants. Developments in the prescribing of antisecretory medication over time in Denmark between 2001 and 2011 and association with age and gender of users along with the impact of interventions on the prescribing of drug subgroups are analysed. Results: 96.8% of all antisecretory drugs sold are proton pump inhibitors (PPIs) and 94.4% of the PPIs are prescribed in primary care. Prescribing of PPIs has increased substantially during the past decade. Both number of users and the average individual use have increased. The prescribing of ulcerogenic drugs to the elderly has stagnated in the same time range. Reimbursement modifications and scientific guidelines do not seem to have had a substantial influence on the steadily increasing prescribing of PPIs. Conclusion: Use of PPIs has increased substantially during the past decade, without a change in indications for use of PPIs in the same time range. Interventions to enhance adherence to guidelines and promote rational use of PPIs do not seem to have had a substantial influence on the overall prescribing rate.
    The European journal of general practice 04/2014;
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    ABSTRACT: Background: Translations of questionnaires need to be carefully validated to assure that the translation measures the same construct(s) as the original questionnaire. The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-report questionnaire measuring distress, depression, anxiety and somatization. Objective: To evaluate the equivalence of the English version of the 4DSQ. Methods: 4DSQ data of English and Dutch speaking general practice attendees were analysed and compared. The English speaking group consisted of 205 attendees, aged 18-64 years, in general practice, in Canada whereas the Dutch group consisted of 302 general practice attendees in the Netherlands. Differential item functioning (DIF) analysis was conducted using the Mantel-Haenszel method and ordinal logistic regression. Differential test functioning (DTF; i.e., the scale impact of DIF) was evaluated using linear regression analysis. Results: DIF was detected in 2/16 distress items, 2/6 depression items, 2/12 anxiety items, and 1/16 somatization items. With respect to mean scale scores, the impact of DIF on the scale level was negligible for all scales. On the anxiety scale DIF caused the English speaking patients with moderate to severe anxiety to score about one point lower than Dutch patients with the same anxiety level. Conclusion: The English 4DSQ measures the same constructs like the original Dutch 4DSQ. The distress, depression and somatization scales can employ the same cut-off points as the corresponding Dutch scales. However, cut-off points of the English 4DSQ anxiety scale should be lowered by one point to retain the same meaning as the Dutch anxiety cut-off points.
    The European journal of general practice 04/2014;
  • The European journal of general practice 04/2014;
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    ABSTRACT: Background: Recent systematic reviews have established that brief interventions in primary care are effective and economic at promoting physical activity. Lack of training has previously been identified as a barrier to lifestyle counselling in Ireland. Objectives: This study evaluates frequency of exercise counselling (EC), in patients with six chronic illnesses (type 2 diabetes mellitus, stable coronary heart disease, hypertension, depression, obesity, osteoarthritis) and healthy adults, by general practitioners (GPs) in the mid-west of Ireland, as well as, whether training in EC influences the frequency of EC. Methods: A questionnaire survey of GPs based in the mid-west of Ireland was conducted during February and March 2012. The questionnaire was distributed to 39 GPs at two continuing medical education meetings and posted to 120 other GPs in the area. The questionnaire assessed the frequency of EC, use of written advice and frequency of recommending resistance exercise in the above patient groups. It also assessed training in EC. Results: 64% of GPs responded (n = 102). Frequency of EC varied among the chronic illnesses evaluated. Use of written advice and advice on resistance exercise in EC was low. Only 17% of GPs had previous training in EC. If available, 94% of GPs would use guidelines to prescribe exercise in chronic illness. The association of previous training in EC with frequency of EC was variable, with significantly higher counselling rates found in T2DM, obesity and healthy adults. Conclusion: Improved training of GPs and development of guidelines may increase the frequency of EC in Ireland.
    The European journal of general practice 04/2014;
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    ABSTRACT: Background: Patients do not often discuss anal symptoms, resulting in late diagnosis of proctological disorders and impacting health. Poor epidemiological knowledge is a contributing factor to this, which can be a significant problem in general medicine. Authors evaluated the role of family doctors in proctological disorders by assessing how many of these are spontaneously diagnosed and how many are diagnosed after questioning the patient. Methods: Thirty-nine general practitioners completed a targeted questionnaire to assess all patients seen prospectively over 2.5 days of consultations. Results: A total of 1079 questionnaires were completed, 621 (58%) for females and 458 (42%) for males with a median age of 54. Twenty-two patients (2%) were seen primarily for anal symptoms. Following questioning, an anal symptom was found in 153 patients (14%). Symptoms reported were: bleeding (32%), pain (31%), pruritus ani (22%), swelling (22%), oozing (14%), and anal discharge (14%). Physicians' diagnoses were: haemorrhoids, anal fissure, anal discharge, dermatology disease, and functional disorder. In 35% of patients, questioning alone was used to make these diagnoses. Anal incontinence was the only factor associated with referral to a specialist (OR = 5; 95% CI: 1.4-17.8). Conclusion: The role of proctology in the general population appears to be significant. In five out of six cases, patients conceal anal symptoms. The high proportion of unexamined patients with anal symptoms is probably multifactorial. Further studies are needed to identify these and put in place the improvement of diagnosis and treatment of anal disorder.
    The European journal of general practice 04/2014;
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    ABSTRACT: Background: Historically, semi-structured interviews (SSI) have been the core of the Dutch selection for postgraduate general practice (GP) training. This paper describes a pilot study on a newly designed competency-based selection procedure that assesses whether candidates have the competencies that are required to complete GP training. Objectives: The objective was to explore reliability and validity aspects of the instruments developed. Methods: The new selection procedure comprising the National GP Knowledge Test (LHK), a situational judgement tests (SJT), a patterned behaviour descriptive interview (PBDI) and a simulated encounter (SIM) was piloted alongside the current procedure. Forty-seven candidates volunteered in both procedures. Admission decision was based on the results of the current procedure. Results: Study participants did hardly differ from the other candidates. The mean scores of the candidates on the LHK and SJT were 21.9 % (SD 8.7) and 83.8% (SD 3.1), respectively. The mean self-reported competency scores (PBDI) were higher than the observed competencies (SIM): 3.7(SD 0.5) and 2.9(SD 0.6), respectively. Content-related competencies showed low correlations with one another when measured with different instruments, whereas more diverse competencies measured by a single instrument showed strong to moderate correlations. Moreover, a moderate correlation between LHK and SJT was found. The internal consistencies (intraclass correlation, ICC) of LHK and SJT were poor while the ICC of PBDI and SIM showed acceptable levels of reliability. Conclusion: Findings on content validity and reliability of these new instruments are promising to realize a competency based procedure. Further development of the instruments and research on predictive validity should be pursued.
    The European journal of general practice 03/2014;
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    ABSTRACT: Background: Although diabetes mellitus (DM) is often associated with painful neuropathic syndromes, a significant number of DM patients suffer from non-neuropathic (nociceptive) pain. Unfortunately, there is insufficient data on the epidemiology of nociceptive pain in DM patients and its effect on their quality of life. Objective: To characterize pain in type 2 DM patients, and assess its effect on their quality of life. Methods: The study population included 342 type 2 DM patients, 18 years of age and above (mean age 70.7 ± 9.7), who reported having pain. The study questionnaires included the Brief Pain Inventory (BPI), the S-LANSS scale to assess pain with neuropathic features, life impact, and socio-demographic data. Results: One hundred and fifty-five DM patients (46.5%) reported having pain of predominantly neuropathic origin. Almost 75% of patients with neuropathic pain were females, compared to 57.8% of patients with nociceptive pain (P = 0.002). More patients with neuropathic pain reported constant daily pain (57.6% vs. 42.4%, P < 0.0001), and worse pain during the night (53.3% vs. 46.7%, P = 0.045). The pain affected daily activities, walking capacity, and mood. Patients with neuropathic pain reported a greater negative effect of pain on their quality of life than those with nociceptive pain (41.0% vs. 15.3%, P < 0.0001). Conclusion: The impact of neuropathic pain in DM patients is much more significant than nociceptive pain and affects their quality of life and daily function to a greater degree.
    The European journal of general practice 03/2014;
  • The European journal of general practice 03/2014; 20(1):85.
  • The European journal of general practice 03/2014; 20(1):1-2.
  • The European journal of general practice 03/2014; 20(1):86.
  • The European journal of general practice 03/2014; 20(1):80.
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    ABSTRACT: Abstract Background: Several studies have shown that vitamin D supplementation could be useful for treating diffuse musculoskeletal (DMS) pain in adults. Objectives: The aim of this study was to evaluate the effects of correcting a vitamin D deficiency (≤ 50 nmol/l) on DMS pain and quality of life in adults. Methods: A pragmatic prospective study was conducted in a general practice setting in the Rhone-Alps area between 1 February and 30 April 2009. Patients between the ages of 18 and 50 years old who consulted their general practitioner (GP) for DMS pain or chronic unexplained asthenia and had a deficient serum 25 (OH) D level with no signs of any other disease were enrolled in this study. The patients received high doses of vitamin D supplements (400 000 to 600 000 units). Mean pain evaluation scores were evaluated before and after vitamin D supplementation using mixed models and accounting for repeated measures. Results: Before vitamin D supplementation, the adult study cohort (n = 49) had an adjusted mean serum 25 (OH) D level of 23.7 nmol/l, a mean pain evaluation score of 5.07 and a mean quality of life score of 3.55. After vitamin D supplementation, the adjusted mean serum 25 (OH) D level increased to 118.8 nmol/l (P < 0.001), the mean quality of life score increased to 2.8 nmol/l (P < 0.001) and the mean pain evaluation score decreased to 2.8 (P < 0.001). Conclusion: In this small before-and-after study, vitamin D supplementation decreased pain scores in adult patients with diffuse musculoskeletal pain and vitamin D deficiency. These results must be confirmed by further studies.
    The European journal of general practice 03/2014; 20(1):3-9.
  • The European journal of general practice 03/2014; 20(1):79.
  • The European journal of general practice 03/2014; 20(1):87-8.