scholarly journals PID5: MOXIFLOXACIN VS AMOXICILLIN/CLAVULANATE IN THE TREATMENT OF ACUTE MAXILLARY SINUSITIS (AMS): EFFICACY, SAFETY AND PATIENT-REPORTED OUTCOMES IN PRIMARY CARE

2001 ◽  
Vol 4 (2) ◽  
pp. 129-130
Author(s):  
S Rakkar
Keyword(s):  
Primary Care ◽  
Patient Reported Outcomes ◽  
Maxillary Sinusitis ◽  
Patient Reported ◽  
Amoxicillin Clavulanate

scholarly journals Quality of life and mental health in breast cancer survivors compared with non-cancer controls: a study of patient-reported outcomes in the United Kingdom

2020 ◽  
Author(s):  
Helena Carreira ◽  
Rachael Williams ◽  
Harley Dempsey ◽  
Susannah Stanway ◽  
Liam Smeeth ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Primary Care ◽  
Cancer Survivors ◽  
Patient Reported Outcomes ◽  
Breast Cancer Survivors ◽  
Patient Reported ◽  
History Of ◽  
History Of Cancer

Abstract Purpose There is limited high-quality evidence on quality of life, anxiety, and depressive symptoms in breast cancer survivors and women with no history of cancer. We aimed to address this by comparing patient-reported outcomes between breast cancer survivors and women with no history of breast cancer. Methods Breast cancer survivors and women with no prior cancer were selected from the UK Clinical Practice Research Datalink GOLD primary care database, which includes population-based primary care electronic health record data. Breast cancer survivors and controls were frequency matched by age and primary care practice. Outcomes were assessed with validated instruments via postal questionnaire. Linear and logistic regression models were fitted to estimate adjusted associations between breast cancer survivorship and outcomes. Results A total of 356 breast cancer survivors (8.1 years post diagnosis) and 252 women with no prior cancer participated in the study. Compared with non-cancer controls, breast cancer survivors had poorer QoL in the domains of cognitive problems (adjusted β (aβ) = 1.4, p = 0.01), sexual function (aβ = 1.7, p = 0.02) and fatigue (aβ = 1.3, p = 0.01), but no difference in negative feelings, positive feelings, pain, or social avoidance. Breast cancer survivors had higher odds of borderline-probable anxiety (score ≥ 8) (adjusted OR = 1.47, 95%CI:1.15–1.87), but no differences in depression. Advanced stage at diagnosis and chemotherapy treatment were associated with poorer QoL. Conclusions Compared with women with no history of cancer, breast cancer survivors report more problems with cognition, sexual function, fatigue, and anxiety, particularly where their cancer was advanced and/or treated with chemotherapy. Implications for Cancer Survivors Breast cancer survivors with more advanced disease and/or treated with chemotherapy should be closely monitored and, when possible, offered evidence-based intervention for fatigue, cognitive dysfunction, and sexual problems.

Primary care physician’s (PCP) perceived value of patient-reported outcomes (PROs) in clinical practice: a mixed methods study

2021 ◽  
pp. bmjqs-2020-012206
Author(s):  
Danny Mou ◽  
Daniel M Horn ◽  
Marilyn Heng ◽  
Manuel Castillo-Angeles ◽  
Keren Ladin ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Mixed Methods ◽  
Clinical Setting ◽  
Patient Reported Outcomes ◽  
Mixed Methods Study ◽  
Clinic Efficiency ◽  
Wide Range ◽  
Patient Reported ◽  
Semistructured Interviews

BackgroundPatient-reported outcomes (PROs) can promote patient engagement, shared-decision making and improve the overall experience of care. However, PRO integration in the primary care clinical setting is limited. Exploring the perspectives of primary care physicians (PCPs) on PROs is key to understanding how they are being used in the clinical setting. We sought to elucidate this clinical perspective at one of the largest US health systems that has integrated a wide range of PROs into routine primary care.MethodsMixed methods study with both anonymous online surveys and in-person qualitative semistructured interviews conducted with PCPs to understand their clinical perspectives on the applications of the existing PROs. PCPs from the 19 affiliated clinics were prompted to complete the survey. Interviewed PCPs were selected via a combination of random and purposive selection from the PCP directory.ResultsOf 172 PCPs, 117 (68%) completed the online survey and 28 completed semistructured interviews. Most PCPs (77%) reviewed PRO responses with their patients. PCPs endorsed that PROs improve clinic efficiency and clinical management. However, PCPs have heterogeneous perspectives on the relevance of PROs in clinical practice, likely due to variations in clinic practice. For specific PRO instruments, PCPs reported anxiety and depression screening PROs to be most helpful. PCPs felt that PROs assisted with completing screening questions that are required by regulatory bodies. Barriers to using PROs include poor user-interface for both clinicians and patients and inadequate training.ConclusionsMost PCPs regularly use PRO data though there are mixed opinions about their clinical relevance. An adaptable, user-friendly PRO system has the potential to have meaningful clinical applications in primary care.

scholarly journals Strategies to reduce the use of low-value medical tests in primary care: a systematic review

2020 ◽  
Vol 70 (701) ◽  
pp. e858-e865
Author(s):  
Toshihiko Takada ◽  
Pauline Heus ◽  
Sander van Doorn ◽  
Christiana A Naaktgeboren ◽  
Jan-Willem Weenink ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Adverse Events ◽  
Patient Reported Outcomes ◽  
Targeted Interventions ◽  
Primary Care Settings ◽  
Medical Tests ◽  
Patient Reported ◽  
Randomised Controlled

BackgroundIt is recognised that medical tests are overused in primary care; however, it is unclear how best to reduce their use.AimTo identify which strategies are effective in reducing the use of low-value medical tests in primary care settings.Design and settingSystematic review.MethodThe databases MEDLINE, EMBASE, and Rx for Change were searched (January 1990 to November 2019) for randomised controlled trials (RCTs) that evaluated strategies to reduce the use of low-value medical tests in primary care settings. Two reviewers selected eligible RCTs, extracted data, and assessed their risk of bias.ResultsOf the 16 RCTs included in the review, 11 reported a statistically significant reduction in the use of low-value medical tests. The median of the differences between the relative reductions in the intervention and control arms was 17% (interquartile range 12% to 24%). Strategies using reminders or audit/feedback showed larger reduction than those without these components (22% versus 14%, and 22% versus 13%, respectively) and patient-targeted strategies showed larger reductions than those not targeted at patients (51% versus 17%). Very few studies investigated the sustainability of the effect, adverse events, cost-effectiveness, or patient-reported outcomes related to reducing the use of low-value tests.ConclusionThis review indicates that it is possible to reduce the use of low-value medical tests in primary care, especially by using multiple components including reminders, audit/feedback, and patient-targeted interventions. To implement these strategies widely in primary care settings, more research is needed not only to investigate their effectiveness, but also to examine adverse events, cost-effectiveness, and patient-reported outcomes.

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