Reported differences in management strategies by primary care physicians and psychiatrists in older patients who are depressed

Benign prostatic hyperplasia (BPH), and its clinical manifestation as lower urinarytract symptoms (LUTS), is a major health concern for aging men. There havebeen significant advances in the diagnosis and treatment of BPH in recentyears. There has been a renewed interest in medical therapies and less invasivesurgical techniques. As a consequence, the treatment needs of men withmild to moderate LUTS without evidence of prostate cancer can now be accomplishedin a primary care setting. There are differences in the way urologistsand primary care physicians approach the evaluation and management of LUTSdue to BPH, which is not reflected in Canadian Urological Association (CUA)and American Urological Association (AUA) guidelines. A “shared care” approachinvolving urologists and primary care physicians represents a reasonable andviable model for the care of men suffering from LUTS. The essence of the modelcentres around educating and communicating effectively with the patient onBPH. This article provides primary care physicians with an overview of the diagnosticand management strategies outlined in recent CUA and AUA guidelinesso that they may be better positioned to effectively deal with this patient population.It is now apparent that we must move away from the urologist as thefirst-line physician, and allow primary care physicians to accept a new role inthe diagnosis and management of BPH.

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O2-07-06: The effects of computerized cognitive testing of older patients on primary care physicians' care strategies

Alzheimer s & Dementia ◽

10.1016/j.jalz.2015.07.170 ◽

2015 ◽

Vol 11 (7S_Part_4) ◽

pp. P190-P191

Author(s):

Mary C. Tierney ◽

Jocelyn Charles ◽

R. Liisa Jaakkimainen ◽

Ross Upshur ◽

Gary Naglie ◽

...

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Older Patients ◽

Cognitive Testing

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Apps for Older People’s Pain Self-Management: Perspectives of Primary Care and Allied Health Clinicians

Pain Medicine ◽

10.1093/pm/pnz218 ◽

2019 ◽

Vol 21 (4) ◽

pp. 686-694 ◽

Cited By ~ 1

Author(s):

Priyanka Bhattarai ◽

Toby Newton-John ◽

Jane L Phillips

Keyword(s):

Primary Care ◽

Older People ◽

Older Patients ◽

Allied Health ◽

Management Strategies ◽

Data Access ◽

Careful Consideration ◽

Self Management ◽

Semistructured Interview ◽

Time Data

Abstract Background Chronic arthritic pain is one of the major causes of physical suffering and disability among older people. Primary care and allied health clinicians use various approaches to help their older clients better manage their arthritic pain. The growing uptake of technology among older people offers the potential for clinicians to integrate an arthritic pain app into their patients’ self-management plans. This study explored the perspectives of Australian primary care and allied health clinicians regarding the use of pain self-management apps to help their older patients/clients better manage their arthritic pain. Methods Qualitative design using a semistructured interview approach. Interviews were conducted via telephone with primary and allied health clinicians (N = 17) across Australia. Results The overarching theme underlying participants’ views on integration of apps into older people’s pain self-management strategy was that this approach is an idealistic but uniquely challenging endeavor. Four subthemes emerged, namely: 1) self-management apps are a potentially useful tool but require careful consideration; 2) clinicians’ involvement is crucial yet potentially onerous; 3) no single app is right for every older person with arthritic pain; and 4) patient data access is beneficial, but caution is needed for real-time data access. Discussion The predominant clinician perspective of integrating apps into their older patients/clients’ pain self-management strategies was that this approach is an idealistic but uniquely challenging endeavor. Apps were seen as having potential to support various aspects of patients’ self-management behaviors; however, there were notable concerns with regards to the challenges inherent in this approach for both clinicians and older users (patients/clients).

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Managing the transition to non-driving in patients with dementia in primary care settings: facilitators and barriers reported by primary care physicians

International Psychogeriatrics ◽

10.1017/s1041610218002326 ◽

2019 ◽

Vol 32 (12) ◽

pp. 1419-1428 ◽

Cited By ~ 4

Author(s):

T. L. Scott ◽

J. Liddle ◽

N. A. Pachana ◽

E. Beattie ◽

G. K. Mitchell

Keyword(s):

Primary Care ◽

Health Professionals ◽

Primary Care Physicians ◽

Management Strategies ◽

Cost Effective ◽

Driving Cessation ◽

Major Life ◽

The Individual ◽

Primary Care Practices ◽

The Impact

ABSTRACTObjectives:This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.Methods:Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.Results:Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.Conclusions:The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.

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