scholarly journals Associations between antidepressant therapy, work ability, and sick leave for patients with common mental disorders within a two-year perspective – A longitudinal observational cohort study in Swedish primary care

Heliyon ◽  
2021 ◽  
Vol 7 (5) ◽  
pp. e07116
Author(s):  
Dominique Hange ◽  
Nashmil Ariai ◽  
Cecilia Björkelund ◽  
Irene Svenningsson ◽  
Shabnam Nejati ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Mental Disorders ◽  
Sick Leave ◽  
Work Ability ◽  
Common Mental Disorders ◽  
Observational Cohort Study ◽  
Antidepressant Therapy ◽  
Observational Cohort

scholarly journals Assessing and predicting adolescent and early adulthood common mental disorders using electronic primary care data: analysis of a prospective cohort study (ALSPAC) in Southwest England

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053624
Author(s):  
Daniel Smith ◽  
Kathryn Willan ◽  
Stephanie L Prady ◽  
Josie Dickerson ◽  
Gillian Santorelli ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Mental Disorders ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Common Mental Disorders ◽  
Free Text ◽  
Primary Care Data ◽  
Time Point

ObjectivesWe aimed to examine agreement between common mental disorders (CMDs) from primary care records and repeated CMD questionnaire data from ALSPAC (the Avon Longitudinal Study of Parents and Children) over adolescence and young adulthood, explore factors affecting CMD identification in primary care records, and construct models predicting ALSPAC-derived CMDs using only primary care data.Design and settingProspective cohort study (ALSPAC) in Southwest England with linkage to electronic primary care records.ParticipantsPrimary care records were extracted for 11 807 participants (80% of 14 731 eligible). Between 31% (3633; age 15/16) and 11% (1298; age 21/22) of participants had both primary care and ALSPAC CMD data.Outcome measuresALSPAC outcome measures were diagnoses of suspected depression and/or CMDs. Primary care outcome measure were Read codes for diagnosis, symptoms and treatment of depression/CMDs. For each time point, sensitivities and specificities for primary care CMD diagnoses were calculated for predicting ALSPAC-derived measures of CMDs, and the factors associated with identification of primary care-based CMDs in those with suspected ALSPAC-derived CMDs explored. Lasso (least absolute selection and shrinkage operator) models were used at each time point to predict ALSPAC-derived CMDs using only primary care data, with internal validation by randomly splitting data into 60% training and 40% validation samples.ResultsSensitivities for primary care diagnoses were low for CMDs (range: 3.5%–19.1%) and depression (range: 1.6%–34.0%), while specificities were high (nearly all >95%). The strongest predictors of identification in the primary care data for those with ALSPAC-derived CMDs were symptom severity indices. The lasso models had relatively low prediction rates, especially in the validation sample (deviance ratio range: −1.3 to 12.6%), but improved with age.ConclusionsPrimary care data underestimate CMDs compared to population-based studies. Improving general practitioner identification, and using free-text or secondary care data, is needed to improve the accuracy of models using clinical data.

scholarly journals An observational cohort study to produce and evaluate an improved tool to screen older women with back pain for osteoporotic vertebral fractures (Vfrac): study protocol

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
T. K. Khera ◽  
A. Burston ◽  
S. Davis ◽  
S. Drew ◽  
R. Gooberman-Hill ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Back Pain ◽  
Older Women ◽  
Vertebral Fractures ◽  
Screening Tool ◽  
Observational Cohort Study ◽  
Binary Output ◽  
Osteoporotic Vertebral Fractures ◽  
Observational Cohort

Abstract Summary The aim of this study is to produce an easy to use checklist for general practitioners to complete whenever a woman aged over 65 years with back pain seeks healthcare. This checklist will produce a binary output to determine if the patient should have a radiograph to diagnose vertebral fracture. Purpose People with osteoporotic vertebral fractures are important to be identified as they are at relatively high risk of further fractures. Despite this, less than a third of people with osteoporotic vertebral fractures come to clinical attention due to various reasons including lack of clear triggers to identify who should have diagnostic spinal radiographs. This study aims to produce and evaluate a novel screening tool (Vfrac) for use in older women presenting with back pain in primary care based on clinical triggers and predictors identified previously. This tool will generate a binary output to determine if a radiograph is required. Methods The Vfrac study is a two-site, pragmatic, observational cohort study recruiting 1633 women aged over 65 years with self-reported back pain. Participants will be recruited from primary care in two sites. The Vfrac study will use data from two self-completed questionnaires, a simple physical examination, a lateral thoracic and lateral lumbar radiograph and information contained in medical records. Results The primary objective is to develop an easy-to-use clinical screening tool for identifying older women who are likely to have vertebral fractures. Conclusions This article describes the protocol of the Vfrac study; ISRCTN16550671.

scholarly journals Alarm signs and antibiotic prescription in febrile children in primary care: an observational cohort study

2013 ◽  
Vol 63 (612) ◽  
pp. e437-e444 ◽  
Author(s):  
Gijs Elshout ◽  
Yvette van Ierland ◽  
Arthur M Bohnen ◽  
Marcel de Wilde ◽  
Rianne Oostenbrink ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Antibiotic Prescription ◽  
Observational Cohort Study ◽  
Observational Cohort

scholarly journals Translation of clinical prediction rules for febrile children to primary care practice: an observational cohort study

2015 ◽  
Vol 65 (633) ◽  
pp. e224-e233 ◽  
Author(s):  
Yvette van Ierland ◽  
Gijs Elshout ◽  
Marjolein Y Berger ◽  
Yvonne Vergouwe ◽  
Marcel de Wilde ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Primary Care Practice ◽  
Observational Cohort Study ◽  
Care Practice ◽  
Clinical Prediction ◽  
Clinical Prediction Rules ◽  
Prediction Rules ◽  
Observational Cohort

scholarly journals Inequalities in primary care management of knee pain and disability in older adults: an observational cohort study

Rheumatology ◽  
2011 ◽  
Vol 50 (10) ◽  
pp. 1869-1878 ◽  
Author(s):  
C. Jinks ◽  
K. Vohora ◽  
J. Young ◽  
J. Handy ◽  
M. Porcheret ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cohort Study ◽  
Knee Pain ◽  
Care Management ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Primary Care Management

scholarly journals Common Infections and Antibiotic Prescribing during the First Year of the COVID-19 Pandemic: A Primary Care-Based Observational Cohort Study

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1521
Author(s):  
Josi A. Boeijen ◽  
Alike W. van der Velden ◽  
Saskia Hullegie ◽  
Tamara N. Platteel ◽  
Dorien L. M. Zwart ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Primary Care ◽  
Cohort Study ◽  
Respiratory Tract ◽  
Observational Cohort Study ◽  
Antibiotic Prescribing ◽  
Prescription Rates ◽  
Observational Cohort ◽  
Ear Infections ◽  
Common Infections

Presentation and antibiotic prescribing for common infectious disease episodes decreased substantially during the first COVID-19 pandemic wave in Dutch general practice. We set out to determine the course of these variables during the first pandemic year. We conducted a retrospective observational cohort study using routine health care data from the Julius General Practitioners’ Network. All patients registered in the pre-pandemic year (n = 425,129) and/or during the first pandemic year (n = 432,122) were included. Relative risks for the number of infectious disease episodes (respiratory tract/ear, urinary tract, gastrointestinal, and skin), in total and those treated with antibiotics, and proportions of episodes treated with antibiotics (prescription rates) were calculated. Compared to the pre-pandemic year, primary care presentation for common infections remained lower during the full first pandemic year (RR, 0.77; CI, 0.76–0.78), mainly attributed to a sustained decline in respiratory tract/ear and gastrointestinal infection episodes. Presentation for urinary tract and skin infection episodes declined during the first wave, but returned to pre-pandemic levels during the second and start of the third wave. Antibiotic prescription rates were lower during the full first pandemic year (24%) as compared to the pre-pandemic year (28%), mainly attributed to a 10% lower prescription rate for respiratory tract/ear infections; the latter was not accompanied by an increase in complications. The decline in primary care presentation for common infections during the full first COVID-19 pandemic year, together with lower prescription rates for respiratory tract/ear infections, resulted in a substantial reduction in antibiotic prescribing in Dutch primary care.

Implementation of the Primary Spine Care Model in a Multi-Clinician Primary Care Setting: An Observational Cohort Study

2020 ◽  
Vol 43 (7) ◽  
pp. 667-674
Author(s):  
James M. Whedon ◽  
Andrew W.J. Toler ◽  
Serena Bezdjian ◽  
Justin M. Goehl ◽  
Robb Russell ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Observational Cohort Study ◽  
Care Model ◽  
Spine Care ◽  
Observational Cohort ◽  
Primary Spine

scholarly journals Alarming Signs and Symptoms in Febrile Children in Primary Care: An Observational Cohort Study in The Netherlands

PLoS ONE ◽  
2014 ◽  
Vol 9 (2) ◽  
pp. e88114 ◽  
Author(s):  
Gijs Elshout ◽  
Yvette van Ierland ◽  
Arthur M. Bohnen ◽  
Marcel de Wilde ◽  
Henriëtte A. Moll ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
The Netherlands ◽  
Signs And Symptoms ◽  
Observational Cohort Study ◽  
Observational Cohort
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