Science topics: MedicinePrimary Care
Science topic

Primary Care - Science topic

The primary research focus is on the prevention, early diagnosis and management of common illness in general practice - particularly childhood infection, cancer, cardiovascular disease and stroke. Primary care has recently developed a new stream of clinical research which seeks to improve the conceptual understanding and effectiveness of early and more reliable diagnosis and monitoring in a number of chronic diseases. The primary aim is that Primary care has an international reputation for developing innovative methods of research synthesis and research use to ensure that research findings change clinical practice.
Filters
All publications are displayed by default. Use this filter to view only publications with full-texts.
Publications related to Primary Care (10,000)
Sorted by most recent
Research Proposal
Full-text available
Message from the Guest Editor Prof. Dr. Filipe Prazeres: Primary care services play an important role in preventing ill health, both physically and mentally, not only of our patients and their families but also of migrants and refugees. The purpose of this Special Issue is to gather recent research that shows the importance of primary care service...
Article
Full-text available
Background: Chronic obstructive pulmonary disease (COPD) is a prevalent lung disease. It is assumed that severe patients will receive better treatment in specialised care centres but the prevalence of severe COPD in primary care is high. Integrated primary care services combine input from several sources and advice from pulmonologists to provide ge...
Article
Full-text available
This article, the fifth in a series aiming to provide practical guidance for qualitative research in primary care, introduces three qualitative approaches with co-creative characteristics for addressing emerging themes in primary care research: experience-based co-design, user-centred design and community-based participatory research. Co-creation a...
Article
Full-text available
Background Emergency departments (EDs) are operating at or above capacity, which has negative consequences on patients in terms of quality of care and morbi-mortality. Redirection strategies for low-acuity ED patients to primary care practices are usually based on subjective eligibility criteria that sometimes necessitate formal medical assessment....
Article
Full-text available
Complex interventions, such as innovation platforms, pose challenges for evaluators. A variety of methodological approaches are often required to build a more complete and comprehensive understanding of how complex interventions work. In this paper, we outline and critically appraise a methodologically pluralist evaluation of an innovation platform...
Article
Full-text available
In many countries, osteoporosis is predominantly managed by primary care physicians; however, management after a fragility fracture has not been widely investigated. We describe osteoporosis care gaps in a real-world patient cohort. Our findings help inform initiatives to identify and overcome obstacles to effective management of patients after fra...
Article
Full-text available
Background In Denmark, chiropractors in primary care work as independent private contractors regulated by the Danish National Health Authorities. The regulation includes partial reimbursement intended for standardised care packages for lumbar and cervical radiculopathy and lumbar spinal stenosis. Random checks have shown lower use than expected. Th...
Article
Full-text available
In Spanish primary care (PC), the prevalence of fragility fractures (FF) in subjects ≥ 70 years old is high, especially in women. One-third of subjects with an FF lacked osteoporosis (OP) diagnosis and >50% were not currently receiving OP medication. An improvement of the FF management in this population is needed. Purpose In Spanish PC, the preva...
Article
Full-text available
Background The recent Austrian Primary Care Act established new primary health care units (PHCUs) and obliged them to draw up a “care strategy” specifying their focal care tasks and objectives and emphasizing the health care needs of the population in their catchment area with its specific local health and epidemiological profile. The main purpose...
Article
Full-text available
Background Opioid use disorders (OUD), co-occurring with either depression and/or PTSD, are prevalent, burdensome, and often receive little or low-quality care. Collaborative care is a service delivery intervention that uses a team-based model to improve treatment access, quality, and outcomes in primary care patients, but has not been evaluated fo...
Article
Full-text available
Background Primary Spine Care (PSC) is an innovative model for the primary management of patients with spine-related disorders (SRDs), with a focus on the use of non-pharmacological therapies which now constitute the recommended first-line approach to back pain. PSC clinicians serve as the initial or early point of contact for spine patients and ut...
Article
Full-text available
Background The inappropriate use of lumbar spine imaging remains common in primary care despite recommendations from evidence-based clinical practice guidelines to avoid imaging in the absence of red flags. This study aimed to explore factors influencing ordering behaviours and adherence to radiographic guidelines for low back pain (LBP) in chiropr...
Article
Full-text available
Background Two sequelae of pediatric COVID-19 have been identified, the multisystem inflammatory syndrome in children (MIS-C) and the long COVID. Long COVID is much less precisely defined and includes all the persistent or new clinical manifestations evidenced in subjects previously infected by SARS-CoV-2 beyond the period of the acute infection an...
Article
Full-text available
Respiratory diseases remain a significant cause of global morbidity and mortality and primary care plays a central role in their prevention, diagnosis and management. An e-Delphi process was employed to identify and prioritise the current respiratory research needs of primary care health professionals worldwide. One hundred and twelve community-bas...
Article
Full-text available
Background Training non-specialist workers in mental healthcare improves knowledge, attitude, confidence, and recognition of mental illnesses. However, still little information is available on which type of mental health training is important in the improvement of these capacities. Methods We studied web-based survey data of 495 public health work...
Article
Full-text available
Abstract Background The use of lung ultrasound (LU) with COVID-19 pneumonia patients should be validated in the field of primary care (PC). Our study aims to evaluate the correlation between LU and radiographic imaging in PC patients with suspected COVID-19 pneumonia. Methods This observational, prospective and multicentre study was carried out wit...
Article
Full-text available
Background It is unclear if the use of imaging for low back pain (LBP) is impacted by patient beliefs. This study aimed to: (1) describe beliefs about the importance of imaging and whether patients wanted imaging when presenting for chiropractic care for LBP; (2) describe associations between baseline patient characteristics and imaging beliefs and...
Article
Full-text available
Background Introducing interprofessional education (IPE) in healthcare curricula can prepare students for healthcare practices that have become increasingly complex. The use of simulation is promoted to support IPE. This study explores healthcare students’ experiences of participating in common, sub-acute patient scenarios that routinely occur in c...
Article
Full-text available
Background: Meticillin-resistant Staphylococcus pseudintermedius (MRSP) infections in companion animals are increasing and are difficult to treat. Environmental contamination with MRSP in small animal primary care hospitals may pose an exposure risk to animal patients. Methods: This longitudinal study assessed the genotypic relationships of MRSP...
Article
Full-text available
Background The Russian Federation has introduced a vertical large-scale program of ‘dispensarization’ (Program) that includes health check-ups and screenings for the entire adult population. It is expected to improve the results of medical interventions and ensure health gains at a relatively low cost. The major research question: Does the design a...
Article
Full-text available
Background Long COVID-19 syndrome is a complex of symptoms that occurs after the acute SARS-CoV-2 infection, in the absence of other possible diagnoses. Studies on Long COVID-19 in pediatric population are scanty and heterogeneous in design, inclusion criteria, outcomes, and follow-up time. The objective of the present study is to assess the preval...
Article
Full-text available
Currently, there are a few detailed guidelines on the overall management of children and adolescents with moderate-severe atopic dermatitis. AD is a complex disease presenting with different clinical phenotypes, which require an individualized and multidisciplinary approach. Therefore, appropriate interaction between primary care pediatricians, ped...
Article
Full-text available
The COVID-19 pandemic has resulted in nosocomial transmission of COVID-19 within hospitals and other healthcare settings such as residential homes and primary care settings. Here, we discuss how a 5G network can be used to reduce such infections. Wen et al. discuss how implementing a 5G network in hospitals can be used to reduce nosocomial infectio...
Article
Full-text available
The IOF Epidemiology and Quality of Life Working Group has reviewed the potential role of population screening for high hip fracture risk against well-established criteria. The report concludes that such an approach should strongly be considered in many health care systems to reduce the burden of hip fractures. Introduction The burden of long-term...
Article
Full-text available
Background Whiplash injury is common following road traffic crashes affecting millions worldwide, with up to 50% of the injured developing chronic symptoms and 15% having a reduced working capability due to ongoing disability. Many of these patients receive treatment in primary care settings based upon clinical and diagnostic imaging findings. Desp...
Article
Full-text available
Background Patient-reported outcomes (PROs) are used increasingly in routine clinical care and inform policies, reimbursements, and quality improvement. Less is known regarding PRO implementation in routine clinical care for diverse and underrepresented patient populations. Objective This review aims to identify studies of PRO implementation in di...
Article
Full-text available
Background International guidelines do not recommend routine imaging, including magnetic resonance imaging (MRI), and seek to guide clinicians only to refer for imaging based on specific indications. Despite this, several studies show an increase in the use of MRI among patients with low back pain (LBP) and an imbalance between appropriate versus i...
Article
Full-text available
We studied whether elderly women at risk for fractures receive primary care treatment to prevent fracture. We found that across Europe, women at risk are often not identified, and less than half of such women receive appropriate treatment. Finally, women diagnosed with osteoporosis are much more likely to receive treatment. Purpose: To examine th...
Poster
Full-text available
Integrated Care settings emerged to address psychosocial needs endemic to the primary care setting. Patients often present within the primary care setting with anxiety and other psychosocial needs. Despite this, there are no current studies which identify associations of anxiety within integrated care settings to include racial discrimination, stre...
Article
Full-text available
Background/AimsScreening for gastric intestinal metaplasia (GIM) may lead to early gastric cancer detection. We developed and validated a pre-endoscopy risk prediction model for detection of GIM based on patient-level risk factors in a U.S. population.Methods We used data from 423 GIM cases and 1796 controls from a cross-sectional study among prima...
Article
Full-text available
The objective of this study is to use data from the National Survey of Children with Special Health Care Needs (NS-CSHCN) to test whether Medicaid physician fees are correlated with access to health services and adequacy of insurance coverage among CSHCN. We start with a difference-in-differences method, comparing the effects of Medicaid physician...
Article
Full-text available
Purpose of Review Patients remain at risk for persistent and de novo postpartum hypertension related to pregnancy. This review aims to summarize the current definitions, clinical practices, and novel systems innovations and therapies for postpartum hypertension. Recent Findings Recent changes to the definitions of hypertension outside of pregnancy...
Article
Full-text available
Better integration is a priority for most international health systems. However, multiple interventions are often implemented simultaneously, making evaluation difficult and providing limited evidence for policy makers about specific interventions. We evaluate a common integrated care intervention, multi‐disciplinary group (MDG) meetings for discus...
Presentation
Full-text available
Community Oriented Primary Care (COPC) - Toplum Yönelimli Sağlık Hizmeti (TOYS)
Article
Full-text available
Background: Current evidence suggests that up to 70% of COVID-19 survivors develop post-COVID symptoms during the following months after infection. Fatigue and dyspnea seem to be the most prevalent post-COVID symptoms. Objective: To analyze whether a tele-rehabilitation exercise program is able to improve self-perceived physical exertion in pati...
Article
Full-text available
Background There is unfinished reform in primary care in Russia and other former Soviet Union (FSU) countries. The traditional ‘Semashko’ multi-specialty polyclinic model has been retained, while its major characteristics are increasingly questioned. The search for a new model is on a health policy agenda. It is relevant for many other countries....
Article
Full-text available
Background and objectives To understand the utility of glycated haemoglobin (HBA 1C ) in screening for diabetes and Abnormal Glucose Regulation (AGR) in primary care, we compared its performance to that of the fasting plasma glucose (FPG) test. Methods This was a prospective diagnostic accuracy study conducted in eastern Uganda. Patients eligible...
Article
Full-text available
Objective Asthma is a common chronic illness affecting 19 million US adults. Inhaled corticosteroids are a safe and effective treatment for asthma, yet, medication adherence among patients remains poor. Shared decision-making, a patient activation strategy, can improve patient adherence to inhaled corticosteroids. This study aimed to explore whethe...
Article
Full-text available
Abstract Background The pandemic disrupted society and health services through lockdowns and resource reallocation to care for COVID-19 patients. Reductions in numbers of cancer patients having surgery, being diagnosed pathologically or via 2-week wait, and screening programs pauses have been described. The effect on emergency presentation, which r...
Article
Full-text available
In order to encourage residents to go to primary care facilities, China has set up differentiated basic medical insurance reimbursement ratios. The study aims to use the dynamic point of view of longitudinal data to examine the changes in the impact of basic medical insurance on primary care. The data for this study comes from the Chinese Family Pa...
Poster
Full-text available
Objectives: Emotional disorders (EDs) are the most common mental health problems and produce a great burden in the national health system. This protocol aims to compare the economic feasibility of implementing in primary care a brief, transdiagnostic, cognitive-behavioural therapy (tCBT) for mild to moderate EDs with that of the treatment usually a...
Article
Full-text available
This study provides a macro-level societal and health system focused analysis of child vaccination rates in 30 European countries, exploring the effect of context on coverage. The importance of demography and health system attributes on health care delivery are recognized in other fields, but generally overlooked in vaccination. The analysis is bas...
Poster
Full-text available
Objectives: This study aims to explore the transdiagnostic variables that predict emotional symptom severity in primary care adult patients. Methods: Data from a previous trial was used to conduct the analyses. Scores from emotional symptom scales were used to create a dependent variable with two categories: “not severe” and “severe”. After treatin...
Poster
Full-text available
Expert Perspectives on the Comprehensive Management of Migraine Headachefor Primary Care Providers
Article
Full-text available
Background The UK’s “Getting It Right First Time” programme recommends that management of people with fibromyalgia should centre on primary care. However, it remains unclear as to how best to organise health systems to deliver services to optimise patient outcomes. Aim To profile UK healthcare services for people with fibromyalgia: provision of Na...
Article
Full-text available
Aim To map integrated and non-integrated self-management support interventions provided by primary care nurses to persons with chronic diseases and common mental disorders and describe their characteristics. Design A scoping review. Data sources In April 2020, we conducted searches in several databases (Academic Research Complete, AMED, CINAHL, E...
Article
Full-text available
Objetivo: Avaliar o atributo derivado orientação comunitária na perspectiva de enfermeiros atuantes nas Estratégias Saúde da Família (ESF). Método: Trata-se de um estudo descritivo, transversal de abordagem quantitativa, realizado no período de março a maio de 2021 em uma cidade da região central do Rio Grande do Sul. A coleta de dados foi realizad...
Article
Full-text available
Global health authorities have emphasized the vital role of healthcare professionals (HCPs) as a reliable source of vaccination information for patients in primary care. However, HCPs are concerned whether COVID-19 vaccinations can be used off-label. Hence, the current study was conducted to assess their perspectives towards off-label COVID-19 immu...
Article
Full-text available
Understanding early childhood mental health service utilization in community-based clinical settings is important. Project Linking Actions for Unmet Needs in Children’s Health (Project LAUNCH) provided mental health-related services for young children and families within pediatric medical homes. Using data from the Project LAUNCH evaluation (n = 10...
Article
Full-text available
Objective To determine the test–retest reliability of the Brain Injury Screening Tool (BIST), which was designed to support the initial assessment of mild traumatic brain injury (mTBI) across a variety of contexts, including primary and secondary care. Design Test–retest design over a 2-week period. Setting Community based. Participants Sixty-ei...
Article
Full-text available
The adherence to the CDC guideline on screening non-U.S. born persons for hepatitis B virus infection was assessed. A retrospective cohort study was conducted at University of Washington primary care clinics using the electronic medical records. Persons from hepatitis B virus prevalent countries were identified using country of origin and language....
Article
Full-text available
Background COVID-19 vaccination significantly reduces the risk of infection and its associated morbidity and mortality. However, poor uptake of the COVID-19 vaccination was reported among the high-risk group of older people amidst emerging variants of concern. This community case study reports an outreach program in Singapore, COVE (COVID-19 Vaccin...
Article
Full-text available
Background Increased morbidity/mortality due to vaccine preventable diseases (VPD) is encountered in type 2 diabetes (T2D) people. Aim of this study was to assess their vaccination coverage and describe trends possibly affecting compliance. Methods Information on vaccination coverage was retrieved from either documents or interview provided by pat...
Article
Full-text available
Purpose The rapidly increasing number of prostate cancer survivors in tandem with a forthcoming shortage of oncology specialists in our health system poses a barrier to ensuring that high-quality survivorship care is available to support this population. As such, there is a need to consider ways to optimize survivorship care, while taking health sy...
Article
Full-text available
Purpose We prospectively evaluated the association between quality of plant-based diets and 10-year first fatal/non-fatal cardiovascular disease (CVD) incidence. Methods ATTICA study was conducted in the greater metropolitan Athens area, Greece, during 2001–2002 studying men and women (aged > 18 years old) free of CVD at baseline. Follow-up CVD as...
Article
Full-text available
Background: Follow-up for cancer typically occurs in secondary care, and improved survival has increased demands on these services. Other care models may alleviate this burden, such as moving (parts of) follow-up care for curatively treated patients from secondary to primary care (care substitution). Aim: To explore the opinions of GPs regarding...
Article
Full-text available
Objective To examine the relative risk of suicide mortality in patients with Huntington’s disease (HD). Methods A case–control study design was used. We used linked electronic records from primary care, secondary care and Office for National Statistics from England from 2001 through 2019. Controls were matched to cases by general practice and suic...
Article
Full-text available
Introduction Studies have shown mixed findings regarding the impact of immigration policy changes on immigrants’ utilization of primary care. Methods We used a difference-in-differences analysis to compare changes in missed primary care appointments over time across two groups: patients who received care in Spanish, Portuguese, or Haitian Creole,...
Article
Full-text available
Background Plasma cardiac markers may assist in prediction of incident cardiovascular disease. Methods The incremental value of cardiac Troponins (T and I) and NT-proBNP added to risk factors in the PREDICT score for incident cardiovascular disease (CVD) in primary care, was assessed in 4102 asymptomatic participants in a randomised controlled tri...
Article
Full-text available
Purpose Diabetes is a prevalent comorbid condition among many women with breast cancer. The roles and responsibilities of managing diabetes during cancer care are unclear, as oncologists lack interest and clinical expertise and many patients stop seeing their primary care providers (PCPs). Uncertainty around who should manage diabetes for cancer pa...