130Improving the implementation of anti-coagulation therapy in AF patients at risk of stroke in a primary care setting

AbstractObjectives: To determine the extent to which general practitioners are currently active in the screening, assessment, diagnosis and management of eating disorders. To identify current deficits in service delivery for eating disordered patients, as identified by general practitioners.Method: A postal questionnaire was circulated to 360 general practitioners within the greater Dublin area and North Eastern Health Service Executive.Results: Response rate was 25%. Respondents had lower case-loads of eating disordered patients than would be expected given the epidemiology of anorexia and bulimia nervosa. Most do not routinely screen for eating disorders, even in at-risk populations and are unaware of the current evidence-based data for guidance. GPs do not feel confident at managing eating disorders within the primary care setting and see their chief role as that of referral to psychiatric services. Treatment outcomes are typically poor. Concern was expressed at the lack of access to specialist treatment in the public sector. Specific deficits in service provision were highlighted including delays in assessment, lack of services appropriate to the adolescent population, poor service transition, and poor availability of psychotherapy at primary care level.Conclusions: Eating disorders are currently underdiagnosed in the primary care setting. Use of simple screening tools might aid detection of pathological eating patterns, particularly in at-risk groups. General practitioners feel under-equipped to manage these complex disorders, given that the resources required to provide high quality care are not widely available. Better integration of primary and secondary services, coupled with training for GPs in the area of screening, assessment and diagnosis, may lead to earlier intervention and improved outcomes.

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Detection of foot at risk of ulceration using a new version of the sisped software in type 2 diabetes patients in a primary care setting

Diabetology & Metabolic Syndrome ◽

10.1186/1758-5996-7-s1-a256 ◽

2015 ◽

Vol 7 (S1) ◽

Author(s):

Karla Freire Rezende ◽

Naira Horta Melo ◽

Thaisa de Fátima Almeida Rocha ◽

Leila Maciel de Almeida e Silva ◽

Helenalda Ferreira

Keyword(s):

Type 2 Diabetes ◽

Primary Care ◽

At Risk ◽

Care Setting ◽

Primary Care Setting ◽

Diabetes Patients

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Elder abuse

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738016647415 ◽

2016 ◽

Vol 10 (2) ◽

pp. 105-111

Author(s):

Eleanor Midgley

Keyword(s):

Primary Care ◽

At Risk ◽

Care Setting ◽

Primary Care Setting ◽

Elder Abuse ◽

Early Recognition

Elder abuse is prevalent and, as the population ages, it is likely to be a growing problem. It frequently goes unrecognised, but is often devastating and sometimes fatal to the victim. It is considered to be both under-funded and under-researched, but early recognition of those at risk and intervention in the primary care setting can reduce harm and sometimes prevent elder abuse occurring entirely.

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Prevalence and Determinants of Sexually Transmitted Infections in Women at Risk Undergoing Abortion in a Swiss Primary Care Setting

Praxis ◽

10.1024/1661-8157/a001724 ◽

2014 ◽

Vol 103 (15) ◽

pp. 875-882 ◽

Cited By ~ 1

Author(s):

Jana Wesbonk ◽

Corinne Chmiel ◽

Thomas Rosemann ◽

André Seidenberg ◽

Oliver Senn

Keyword(s):

Primary Care ◽

At Risk ◽

Chlamydia Trachomatis ◽

Neisseria Gonorrhoeae ◽

Sexually Transmitted Infections ◽

Care Setting ◽

Primary Care Setting ◽

Mycoplasma Genitalium ◽

Sexually Transmitted ◽

Swiss Primary Care

Hintergrund: Schwangerschaftsabbrüche können in der Schweiz auch ambulant in der Hausarztpraxis durchgeführt werden. Daten zur Prävalenz von sexuell übertragbaren Infektionen (STI) bei dieser Patientenpopulation sind nur spärlich vorhanden. Unser Ziel war die Erhebung der Prävalenz und der prädisponierenden Faktoren für sexuell übertragbare Infektion bei Frauen mit erhöhtem Risiko (pathologischer Zervixabstrich), die sich in einer Schweizer Hausarztpraxis einer Abruptio unterzogen. Methode: Querschnittsstudie bei 620 Frauen, die sich in einer Hausarztpraxis in Zürich für eine Abruptio Beratung vorstellten. Im Falle eines pathologischen Zervixabstriches erfolgte zur Abschätzung der STI Prävalenz ein PCR-basierendes Screening bezüglich Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) und Neisseria gonorrhoeae (NG). Resultate: Bei 585 der 620 Frauen resultierte eine Abruptio. Verfügbar waren 581 (93,7%) Zervixabstriche wovon 272 (46,8%) pathologische Zeichen aufwiesen und demnach als eine Risikokonstellation für STI betrachtet wurden. Unter 192 gescreenten Proben fanden sich 28 STI (14,6%) (95% CI: 10,3–20,3%), vorherrschend waren CT-Infektionen (17 Fälle) gefolgt von MG (9 Fälle) und NG (2 Fälle). Frauen mit Migrationshintergrund waren häufiger von einer STI betroffen (OR 2,63; p=0,037 im Vergleich zu Schweizerinnen). Fazit: Frauen, die sich einer Abruptio in der Praxis unterzogen, zeigten hohe STI-Prävalenz. Patientinnen mit einem Migrationshintergrund scheinen eine vulnerable Untergruppe darzustellen. Bemühungen sind notwendig, damit diese Risikogruppe mit kosteneffizientem Screening und Behandlungskonzepten erreicht werden können.

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