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.
Publications related to Primary Care (10,000)
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La eutanasia como soporte del final de la vida es una práctica sanitaria auspiciada legislativamente, hecho que la convierte en una prestación incluida en la cartera de servicios de los distintos sistemas sanitarios autonómicos. Su puesta en marcha exige de la figura del médico responsable, quien, por defecto, será el médico de familia o atención p...
Background
Care gaps in routine and preventive care are common among youth. To close care gaps, health systems should take a population health approach and create opportunities for partnership, collaboration, shared learning, and scale via learning networks (LNs).
Methods
We describe the Pediatric Improvement Network for Quality (PINQ), a regional...
Objective: To qualitatively explore Medicaid-enrolled parents’ and young adult patients’ perspectives and experiences with telemedicine in pediatric primary care.
Methods: We conducted semi-structured interviews with participants to explore their experiences with telemedicine. Participants consisted of English- and Spanish-speaking parents and youn...
A BSTRACT
Background
In India, the Ayushman Bharat Program aims to provide comprehensive healthcare coverage to underprivileged communities, guided by the 2017 National Health Policy and aligned with Sustainable Development Goals. This study explores healthcare workers’ perspectives on the implementation, impact, and challenges of Ayushman Bharat...
The United States faces a growing scarcity of primary care resources within an already overstressed and poorly accessible health care system. Many health care organizations are evaluating novel models of care and adoption of digital technologies to improve primary care access and efficiency of health care delivery. This article describes a virtual...
Options to address the problem -
Four policy options have been identified to address the problem of antimicrobial
resistance. Most of the systematic reviews included address programs or interventions to optimize the management of antimicrobials (antimicrobial stewardship).
Option 1. Management programs and combined interventions with antimicrobial...
Introduction: Haitian migrants in Chile face significant challenges in accessing healthcare services due to language barriers. Objective: this scoping review aimed to identify the main linguistic barriers and facilitators that impact healthcare access for this population. Method: a systematic search was conducted across multiple databases, identify...
Aims
The Drug Utilization 90% Index (DU90%), the number of medicines making up 90% of a doctor's prescribing, is a simple tool that can be used to describe core prescribing patterns. This research aimed to pilot the application of the DU90% in the Irish context, to investigate the relationship between the DU90% and prescriber and practice character...
Hypertension is one of the major risk factors for stroke and cardiovascular disease, and a leading cause of death globally. Although antihypertensive therapy is proven to be effective, many patients are not well controlled. To address this issue, innovative care models such as interprofessional collaboration (ICP) involving pharmacists, nurses and...
Introduction/Objectives
With redistribution of resources and time during the COVID-19 pandemic, the Thrive Bridge Clinic altered its focus, alongside the changes in the healthcare system and needs of the population. This paper describes how the Thrive clinic services have been altered between 2019 and 2022 as a result of COVID-19.
Methods
Data was...
This paper investigates the impact of workload pressure on primary care outcomes using a unique dataset from English general practices. Leveraging the absence of General Practitioner (GP) colleagues as an instrumental variable, we find that increased workload leads to an increase in prescription rates of antibiotics as well as in the share of asses...
Background Inappropriate use of antimicrobial agents in healthcare settings is one area that has received attention as a possible route to mitigate the threat of antimicrobial resistance. Globally, the highest consumption of antimicrobials in human healthcare originates from antibiotic prescriptions in Primary Care. Strategies to increase appropria...
Background/Objectives: People with a severe mental illness die much earlier than the rest of the population from a preventable physical illness. Annual health checks are a way of assessing the person to then offer the appropriate interventions. Integrated Care Northampton, England used the long-term plan baseline funding allocated to them from the...
Firearm ownership is associated with an increased risk of adverse health outcomes, including violence, suicide, and accidental firearm injury. Numerous medical governing bodies have placed emphasis on firearm screening and counseling within the healthcare setting. However, few physicians discuss firearm ownership and safety with patients, likely du...
Background and objectives: Quadrivalent live attenuated influenza vaccines (LAIV-4) offer an alternative to inactivated influenza vaccines (IIV) for children aged 2-17 years, but data on their comparative effectiveness are limited. This study assessed vaccination rates and real-world effectiveness of LAIV-4 and IIV in preventing influenza and influ...
Importance: Incidence, prevalence, and survival are important measures to inform the management and provision of head and neck cancer care.
Objective To calculate the incidence, prevalence, and survival rates for head and neck cancers and subsites in the UK from 2000 to 2021.
Design, Setting, and Participants: This population-based cohort study use...
Objectives
Although primary care is central to healthcare provision, inconsistent methods and data sources mean that relatively little is known about long-term trends in general practice consultation rates. We aimed to explore long-term trends in English general practice consultation rates using two electronic health records databases, Clinical Pra...
Background: Chest pain is one of the most common reasons for emergency department (ED) visits. Patients presenting with inconclusive symptoms complicate the diagnostic process and add to the burden upon the ED. This study aimed to determine factors possibly influencing ED decisions on hospitalization versus discharge for patients with the diagnosis...
The iSOLVE implementation project established and evaluated integrated processes and pathways, including a decision-making tool and educational interventions for general medical practitioners (GPs) and the upskilling of allied health professionals (AHPs). The study used a mixed-methods (parallel) design comprising surveys, qualitative methodologies...
Background
Individuals with chronic musculoskeletal conditions experience persistent pain and disability that has deleterious impacts on physical function, psychological health, social engagement, relationships, and work participation. This impact is greater in people with psychosocial risk factors, and best practice musculoskeletal care recommends...
Background
In the United States, discourse on COVID-19 vaccination has become polarized, and the positions of public health officials are met with skepticism by many vaccine-hesitant Americans. This polarization may impact future vaccination efforts as well as clinician-patient relationships.
Methods
We interviewed 77 vaccine-hesitant patients and...
Background: As the foundation and core strength of the healthcare system, the primary care initial diagnosis system has been receiving attention from both the medical and management communities. This study aimed to analyze residents’ attitudes toward the system and explore the influencing factors relating to the system in Beijing; Methods: Differen...
Background/Objectives: Previous studies have shown that primary care (PC) professionals have a low knowledge about the management of patients with type 2 diabetes, despite being one of the most common chronic diseases. The objective of this study is to analyze the impact of an educational program for health professionals on the metabolic control of...
Background
Prescribing cascades, which occur when a medication is used to treat the side effect of another medication, are important contributors to polypharmacy. There is an absence of studies that evaluate interventions to address them. We describe an application of the Behaviour Change Wheel (BCW) to design theory-informed interventions for addr...
Background
Care home residents are a highly vulnerable group, but identifying care home residents in routine data is challenging. This study aimed to develop and validate Natural Language Processing (NLP) methods to identify care home residents from primary care address records.
Methods
The proposed system applies an NLP sequential filtering and p...
Background
Antidepressants’ effects are established in randomised controlled trials (RCTs), but not in the real world.
Aims
To investigate real-world comparative effects of antidepressants for depression and compare them with RCTs.
Method
We performed a cohort study based on the QResearch database. We included people with a newly recorded diagnos...
Background
In Canada, HIV transmission continues to disproportionately affect the same communities of gay men, bisexual men and men who have sex with men (gbMSM); members of African, Caribbean or Black communities (ACB); people who use injection drugs; Indigenous people; and women who belong to the aforementioned groups. While primary care is an id...
Stroke is a very serious life-threatening condition. It is the second cause of death worldwide [5], while even in non-fatal cases it can result in severe disability and complications [5, 8]. Of all cases, ischaemic stroke is the most common, accounting for 87% of all ischaemic stroke cases [4]. Some hope is offered by the fact that modifiable risk...
Background
Primary care is usually the entry point for preventing cardiovascular disease (CVD). Quality indicators can be used to assess and monitor the quality of care provided in a primary care setting. In this systematic review, we aimed to identify, summarise, and assess the methodological quality of indicators reported in the articles for the...
Background
Despite European guidelines recommending anti‐hepatitis D virus (HDV) screening for all hepatitis B surface antigen (HBsAg)‐positive cases, screening rates remain insufficient.
Aims
We analysed anti‐HDV screening rates in primary care and implemented prospective HDV screening in HBsAg‐positive cases identified in the preventive medical...
Despite the ubiquity of guided self-help (GSH) interventions in Primary Care psychological services, there have been no previous studies of the relationship between the competence of qualified practitioners and treatment outcomes. This study compared competence-outcome associations in two types of GSH. Competence and clinical outcome measures were...
Background
Norwegian Municipal Inpatient Acute Care (MIPAC) services were established as part of the 2012 Coordination Reform. The intention was to prevent unnecessary hospital admissions by redirecting and maintaining less urgent patients at the primary care level, which provides inpatient acute healthcare services closer to patients’ home. Howeve...
Introduction
With the rising prevalence of type 2 diabetes (T2D), three care initiatives for T2D are being scaled-up in Cambodia to improve availability and accessibility of integrated care for T2D: (1) hospital-based care, (2) health centre-based care, and (3) community-based care. This case study aims to share learnings from an in-depth analysis...
Introduction
To evaluate the long-term risk of developing type 2 diabetes (T2D) among women with a history of gestational diabetes mellitus (GDM) compared with those with impaired glucose tolerance (IGT).
Research design and methods
Using data from a primary care dataset linked with multiple health registries, this longitudinal study analyzed demo...
Background
Diagnostic scope is the range of diagnoses found in a clinical setting. Although the diagnostic scope is an essential feature of training and evaluating artificial intelligence (AI) systems to promote diagnostic excellence, its impact on AI systems and the diagnostic process remains under-explored.
Content
We define the concept of diagn...
Background
Suboptimal control of BP is common, although safe and effective treatments are widely available. Conventional management relies on office visits, but this can be an inefficient path to medication optimization.
Objective
To assess the effectiveness of an intensive, 6-month remote BP management program among patients with uncontrolled hyp...
Background
General medical practitioners and other staff at primary care medical practices have an important role in facilitating patient access to online services in the National Health Service in England. These services range from online ordering of repeat prescriptions to conducting online consultations with health care professionals. We have de...
Street medicine is a health delivery model designed to provide direct patient care to people experiencing unsheltered homelessness where they are physically located, whether that be on the streets or in encampments. The model has developed in response to the barriers people experiencing homelessness (PEH) encounter when accessing care through tradi...
Objectives
To assess the effectiveness of the ICAN Discussion Aid in improving patients’ experience of receiving care for their chronic conditions and health professionals’ experience of providing their care.
Methods
We conducted a pragmatic, mixed-methods, cluster-randomized trial of the ICAN Discussion Aid at 8 clinics in 4 independent health sy...
Background. Nephroblastoma (Wilms tumour) is one of the most common solid tumours of all paediatric cancers (prevalence of 5%
globally and 13.5% in South Africa (SA)), with suboptimal survival outcomes, impacting children’s lives. Consequently, there is an urgent
need for enhanced early detection strategies, addressing survival rate disparities and...
RESUMO Introdução: os medicamentos são essenciais para assegurar a integralidade do cuidado e o seu acesso é um direito garantido por lei. Entretanto, a falta de familiaridade dos prescritores com o elenco de fármacos padronizados e com os fluxos de fornecimento podem interferir no acesso a esses insumos pelos pacientes. Método: relato de experiênc...
Health-related quality of life (HRQol) is a crucial dimension of care outcomes. Many HRQoL measures exist, but methodological and implementation challenges impede primary care (PC) use. We aim to develop and evaluate a novel machine learning (ML) algorithm that predicts binary risk levels among PC patients by combining validated elements from exist...
Objectives
To evaluate the accessibility of multispecialty advice for primary care providers (PCPs) within correctional facilities, catering to the healthcare needs of individuals in federal custody in Ontario, Canada, through the utilization of electronic consultation (eConsult).
Design
Retrospective, cross-sectional, descriptive analysis.
Setti...
O objetivo deste trabalho foi desenvolver e implementar um plano de cuidado interdisciplinar para uma idosa de 80 anos com sinais de depressão, visando melhorar sua qualidade de vida. O cuidado buscou fortalecer sua autonomia, bem-estar físico e emocional, e reintegração social, considerando suas necessidades e particularidades. O estudo foi realiz...
Hydroxychloroquine (HCQ) retinal toxicity is an important entity that can be challenging to differentiate from its mimickers. Bull's eye maculopathy is the classical presentation of HCQ retinopathy; however, its differential includes several drug‐related retinal toxicities, inherited retinal disorders, and systemic conditions with associated retino...
The revised biomarker framework for diagnosis and staging of Alzheimer's disease (AD) relies on amyloid beta (Aβ) and tau pathologies as core markers, and markers for adjacent pathophysiology, such as neurodegeneration and inflammation. Many of the core fluid biomarkers are phosphorylated tau (p‐tau) fragments, with p‐tau217 showing a prominent ass...
The diagnosis and treatment capability levels of healthcare professionals directly affect the overall quality of medical services. Enhancing these capability levels requires strengthening the professional skill training of healthcare workers, especially those in primary care settings in economically underdeveloped areas. To understand the actual ne...
The Screening Tool of Older Person's Prescriptions (STOPP) is used to detect potentially inappropriate medication. Version 2 includes 80 criteria, whereof two can be considered implicit as their detection primarily relies on the assessor's expertise: (A1) drugs without indication and (A2) drug treatment beyond recommended duration. To explore the i...
Background
As the world’s population ages, there is a growing concern with frailty, marked by reduced strength and greater vulnerability to stress. Overcoming obstacles like reluctance towards screening methods in this process is crucial for identifying and addressing frailty at an early stage. Understanding older people’s perspectives can help ada...
Potentially Inappropriate Prescribing (PIP) poses a significant risk to patient safety and associated with poor healthcare outcomes in Gulf Cooperation Council (GCC) countries. This study aimed to assess PIP prevalence and patterns in older adults across all care settings in GCC.
A comprehensive search was conducted on six medical databases to iden...
Background
To address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines. The aims of this study were to: identify the suppo...
Chronic kidney disease (CKD), a long-term condition in which kidney function declines over time, is a growing global healthcare concern. CKD can have a major impact on the quality of life of patients and their caregivers. Recent research by the International Society of Nephrology highlights that current treatment strategies and policies do not full...
Background
Understanding the prevalence of diseases and where it is detected and recorded in healthcare settings is important for planning effective prevention and care provision. We examined inequalities in the prevalence of 205 chronic conditions and in the care setting where the related diagnoses were recorded in the English National Health Serv...
Introduction
Live attenuated influenza vaccine (LAIV) is recommended in Ireland for all children aged 2–17 years. Quadrivalent influenza vaccine (QIV) is recommended for all others eligible for vaccination, including those ≥ 18 years with underlying medical conditions and all aged ≥ 65 years. We aimed to estimate influenza vaccine effectiveness (IV...
Aim
This article outlines the implementation and deployment strategy defined by the Catalan healthcare system which sought to promote a plan to strengthen and transform primary care in order to provide high-quality healthcare services whilst making an optimal use of resources across the Catalan region.
Background
Following the COVID-19 pandemic, t...
Abstract: (1) Background: Dentistry is innately stressful and demanding. However, the extent of
perceived chronic stress and the contributing factors within the dental practice at Primary Health
Care Corporation (PHCC) in Qatar are largely unknown. (2) Methods: This study is quantitative,
hypothesis-testing, correlational, and cross-sectional, usin...
The COVID-19 pandemic required substantial changes in delivery of team-based primary care, impacting both how and which patients accessed the more comprehensive services teams provide. We sought to explore changes in access to primary care rehabilitation services during the first year of the COVID-19 pandemic to identify potential new problems and...
Objective: to analyze the prevalence of self-reported depression in the Brazilian population and its association with individual and contextual characteristics in a multilevel analysis. Methods: Cross-sectional study with a quantitative approach, using data from the National Health Survey. The outcome was developed based on the question: Has a doct...
Muscle symptoms in long covid
Globally, there are more than 700,000 suicide completions every year. With the continued shortage of mental health professionals, people are increasingly seeking care for mental health concerns in primary care settings. With the expansion of telehealth since the COVID-19 pandemic, more patients and providers are connecting virtually for appointment...
Purpose
To describe the area-level rate of breast cancers, the percentage of early-stage diagnoses (stage I-IIa), and associations between area-level measures of poverty, racial/ethnic composition, primary care shortage, and urban/rural/frontier status for the UC Davis Comprehensive Cancer Center (UCDCCC) catchment area.
Methods
Using data from th...
Objectives
Health inequities are unjust and avoidable differences in health outcomes across populations and between population groups. Though these arise predominantly from social determinants of health, healthcare is estimated to contribute around 20 % and primary healthcare reduces inequities in healthcare outcomes. As each provider works in thei...
Background
Youth mental health care access has been an escalating crisis in the United States. The number of youths using emergency services for behavioral health has been rising for decades and has further increased immediately following the pandemic. Early identification and timely connection to care continue to be significant barriers.
Objectiv...
Despite progress to define primary care practice transformation models, there remains gaps in translating evidence-based guidelines into routine clinical care. Primary care providers (MD, DO, NP, PA) and researchers need tools to assess modifiable factors that improve practice performance to inform practice transformation efforts. We aimed to devel...
Description
Primary care providers (PCPs) focus on patients presenting for care, but access limitations may create care gaps for those impacted by social determinants of health. Proactive Care Coordination Assistants (PCCAs) at Edmonton Southside Primary Care Network proactively outreach to patients, ensuring equitable access for 212 participating...
Hypertension or high blood pressure, is a prevalent condition and a leading cause of cardiovascular morbidity and mortality worldwide. This review provides an in-depth analysis of the current epidemiology, diagnosis and management of hypertension, with a focus on integrating guidelines from major health organizations such as the American College of...
