Depression and heart failure associated with clinical COPD questionnaire outcome in primary care COPD patients: a cross-sectional study

BackgroundComorbidity is common in heart failure, but previous prevalence estimates have been based on a limited number of conditions using mainly non-primary care data sources.AimTo compare prevalence rates of comorbidity and polypharmacy in those with and without chronic heart failure due to left ventricular systolic dysfunction (LVSD).Design and settingA cross-sectional study of 1.4 million patients in primary care in Scotland.MethodData on the presence of LVSD, 31 other physical, and seven mental health comorbidities, and prescriptions were extracted from a database of 1 424 378 adults. Comorbidity prevalence was compared in patients with and without LVSD, standardised by age, sex, and deprivation. Pharmacology data were also compared between the two groups.ResultsThere were 17 285 patients (1.2%) who had a diagnosis of LVSD. Compared with standardised controls, the LVSD group had greater comorbidity, with the biggest difference found for seven or more conditions (odds ratio [OR] 4.10; 95% confidence interval (CI] = 3.90 to 4.32). Twenty-five physical conditions and six mental health conditions were significantly more prevalent in those with LVSD relative to standardised controls. Polypharmacy was higher in the LVSD group compared with controls, with the biggest difference found for ≥11 repeat prescriptions (OR 4.81; 95% CI = 4.60 to 5.04). However, these differences in polypharmacy were attenuated after controlling for the number of morbidities, indicating that much of the additional prescribing was accounted for by multimorbidity rather than LVSD per se.ConclusionExtreme comorbidity and polypharmacy is significantly more common in patients with chronic heart failure due to LVSD. The efficient management of such complexity requires the integration of general and specialist expertise.

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Overdiagnosis of heart failure in primary care: a cross-sectional study

British Journal of General Practice ◽

10.3399/bjgp16x685705 ◽

2016 ◽

Vol 66 (649) ◽

pp. e587-e592 ◽

Cited By ~ 25

Author(s):

Mark J Valk ◽

Arend Mosterd ◽

Berna DL Broekhuizen ◽

Nicolaas PA Zuithoff ◽

Marcel AJ Landman ◽

...

Keyword(s):

Heart Failure ◽

Primary Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Associations of age-dependent IGF-1 standard deviation scores to cardiovascular diseases and risk factors: A cross-sectional study in 6,282 primary care patients

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2007-972385 ◽

2007 ◽

Vol 115 (S 1) ◽

Author(s):

HJ Schneider ◽

J Klotsche ◽

H Lehnert ◽

C Sievers ◽

HU Wittchen ◽

...

Keyword(s):

Risk Factors ◽

Primary Care ◽

Standard Deviation ◽

Cardiovascular Diseases ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Age Dependent ◽

Primary Care Patients

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Association of Age, Gender, Deprivation, Urbanicity, Ethnicity, and Smoking with a Positive Test for COVID-19 in an English Primary Care Surveillance Network: Cross Sectional Study of the First 500 Cases

SSRN Electronic Journal ◽

10.2139/ssrn.3578782 ◽

2020 ◽

Author(s):

Simon de Lusignan ◽

Jienchi Dorward ◽

Ana Correa ◽

Nicholas Jones ◽

Oluwafunmi Akinyemi ◽

...

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Positive Test ◽

Sectional Study ◽

Surveillance Network ◽

Cross Sectional

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Portuguese Patient Dignity Question: A cross-sectional study of palliative patients cared for in primary care

Palliative & Supportive Care ◽

10.1017/s1478951520000164 ◽

2020 ◽

Vol 18 (6) ◽

pp. 658-661

Author(s):

Mafalda Lemos Caldas ◽

Miguel Julião ◽

Ana João Santos ◽

Harvey Max Chochinov

Keyword(s):

Primary Care ◽

Health Care Providers ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Clinical Tool ◽

Cross Sectional ◽

Old Patients ◽

Promising Tool ◽

Palliative Patients

AbstractIntroductionThe Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.ObjectiveTo study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).MethodA cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.ResultsTwenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.Significance of resultsThe PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.

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Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-044372 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044372

Author(s):

Mat Nawi Zanaridah ◽

Mohd Noor Norhayati ◽

Zakaria Rosnani

Keyword(s):

Primary Care ◽

Evidence Based Medicine ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Evidence Based ◽

Sectional Study ◽

Primary Care Practitioner ◽

Cross Sectional ◽

Primary Care Practitioners ◽

Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

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