Management of hypertension in the elderly: attitudes of general practitioners and hospital physicians.

BACKGROUND Healthcare for older patients is a worldwide challenge for public health system. A new medical Internet system in healthcare which is a new model of telegeriatrics system has been established. The key innovation is the new telegeriatrics system was conducted jointly by general practitioners in the Community Health Service Center and specialists in university teaching hospital. Unlike the typical telemedicine that has been practiced in other countries, the new model provides a solution for the key issues in telemedicine where a doctor is unable to conduct a direct physical examination and the associated potential diagnostic error. OBJECTIVE This study is to introduce the operation mechanism of the new Telegeriatrics system and analyze healthcare demands of older patients in different age groups applying the new Telegeriatrics system. METHODS 472 older patients (aged≥60) were enrolled and divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged≥90) according to the age stratification of World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. RESULTS The process of older patients’ diagnosis and treatment made by specialist and general practitioners formed a closed loop. It ensures the timeliness and effectiveness of diagnosis and treatment of older patients. The treatment effect can be observed by general practitioners and specialist can adjust the treatment plan in time. In this study, it was found that older patients in different age groups have different healthcare demands. Coronary heart disease and type 2 diabetes mellitus were found to be the main diseases of the older patients and the young older patients as well as the old older patients applying Telegeriatrics. CONCLUSIONS The new telegeriatrics system can provide convenient and efficient healthcare services for older patients and overcome the disadvantage of currently used models of telegeriatrics. Older patients in different age groups have different medical care demands. Cardiovascular diseases and metabolic diseases have become the main diseases of the elderly applying the new Telegeriatrics system. Healthcare policy makers should invest more medical resources to the prevention of cardiovascular diseases and metabolic diseases in the elderly.

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French patterns of psychotropic drug use

Psychiatry and Psychobiology ◽

10.1017/s0767399x00003801 ◽

1990 ◽

Vol 5 (5) ◽

pp. 301-308

Author(s):

V Kovess ◽

M Ortun

Keyword(s):

Drug Use ◽

General Practitioners ◽

Psychotropic Drug ◽

Psychotropic Drugs ◽

Elderly Population ◽

The Elderly ◽

Population Surveys ◽

Minor Tranquilizers ◽

French People ◽

Few Data

SummaryFrench publications on psychotropics are curiously few. Data are available and French consumption of psychotropics, at least minor tranquilizers has been consistently reported as being higher than that found in other countries. The authors attempt to answer three questions: is French consuption of psychotropics really higher than other countries? Who is consuming those drugs? In which context? After having reviewed comparative data on sales, data from population surveys are analysed together with samples of prescriptions by different categories of physicians. It seems likely that French people consume more anxiolytics but this does not apply to other psychotropic drugs. Given the fact that drugs are almost free of charge in France, it is always difficult to discriminate between what has been prescribed and what has been taken. Overconsumption of anxiolytics is due to the overconsumption of the elderly population (over 60). Minor tranquilizers are mainly prescribed by general practitioners for psychological reasons.

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Appropriateness of Proton Pump Inhibitor prescription in patients admitted to hospital: Attitudes of general practitioners and hospital physicians in Italy

European Journal of Internal Medicine ◽

10.1016/j.ejim.2016.01.025 ◽

2016 ◽

Vol 30 ◽

pp. 31-36 ◽

Cited By ~ 14

Author(s):

Francesca Lodato ◽

Elisabetta Poluzzi ◽

Emanuel Raschi ◽

Carlo Piccinni ◽

Ariola Koci ◽

...

Keyword(s):

Proton Pump Inhibitor ◽

General Practitioners ◽

Proton Pump ◽

Hospital Physicians

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Spatial Variation in General Medical Services Income in Dublin General Practitioners

International Journal of Family Medicine ◽

10.1155/2011/971231 ◽

2011 ◽

Vol 2011 ◽

pp. 1-5

Author(s):

Conor Teljeur ◽

Alan Kelly ◽

Tom O'Dowd

Keyword(s):

General Practitioners ◽

Catchment Area ◽

The Elderly ◽

Medical Services ◽

Practice Characteristics ◽

Capitation Rate ◽

Point Of Use ◽

Economically Deprived ◽

Almost All ◽

Deprived Areas

The general medical services (GMS) scheme provides care free at the point of use for the 30% most economically deprived section of the population and the elderly. Almost all people of over-70-year olds are eligible for the GMS scheme potentially directing resources away from those most in need. The aim of this study is to analyse the relationship between practice GMS income and deprivation amongst Dublin-based general practitioners (GPs). The practice GMS income in Dublin was analysed in relation to practice characteristics including the number of GPs, catchment area population, proportion of over-70-year olds in the catchment area, catchment deprivation, number of GMS GPs within 2 km, and average GMS practice income within 2 km. Practice GMS income was highest in deprived areas but is also a valuable source of income in the least deprived areas. The capitation rate for over-70-year olds provides an incentive for GPs to locate in affluent areas and potentially directs resources away from those in greater need.

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Háziorvosok és idősellátás egy kérdőíves kutatás tükrében

Orvosi Hetilap ◽

10.1556/650.2018.30959 ◽

2018 ◽

Vol 159 (8) ◽

pp. 312-319

Author(s):

Anett Mária Tróbert ◽

Zsuzsanna Széman

Keyword(s):

Health Care ◽

General Practitioners ◽

Social Care ◽

The Elderly ◽

Care Process ◽

Efficient Operation ◽

Health And Social Care ◽

Care Systems ◽

Care System

Abstract: According to statistical data, the number of healthy life years is not increasing in proportion with the longer average life expectancy. In the ageing societies, the long-term care systems are increasingly overburdened; cost-efficient operation and the related coordination of services is one of the key questions for their sustainability. The present separation of the health care and social care systems causes numerous difficulties. One aim of the online research by questionnaire was to survey the attitude of general practitioners – who play a very important part in care for the elderly – towards their elder patients, the patients’ family members, and social workers providing eldercare. The other aim was to gather information on shortcomings experienced by doctors in the care system and on what possibilities general practitioners see for the improvement of eldercare. Semi-structured questionnaires were applied and analysed by descriptive and content methodology. The questionnaires were sent out to 5060 addresses around the country: a total of 145 were returned filled in. The respondents made many recommendations for the improvement of eldercare in the categories of development of social services, family support, development of health services, and societal cooperation. The areas in need of development named by the general practitioners are closely interrelated: the reform of social care would support the health care system and vice versa. More effective operation of the health and social care systems would ease the burdens of families, and at the same time encourage more active participation of families in the care process. And the systematic education of society and communities is a long-term investment that would strengthen a positive attitude towards old age and a value-oriented view of the ageing process that is one of the basic conditions for successful social integration of the elderly. Orv Hetil. 2018; 159(8): 312–319.

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A rude awakening: post-take ward round in the department of medicine for the elderly

Journal of the Royal Society of Medicine ◽

10.1177/014107689809100905 ◽

1998 ◽

Vol 91 (9) ◽

pp. 471-474 ◽

Cited By ~ 1

Author(s):

Nicholas Coni

Keyword(s):

Internal Medicine ◽

General Practitioners ◽

General Internal Medicine ◽

Teaching Hospital ◽

The Elderly ◽

Ward Round ◽

Younger Patients ◽

General Internal ◽

Ward Rounds ◽

The Uk

This paper describes the post-take ward round of a department of medicine for the elderly (DME), to portray the nature of the medical admissions and their immediate management. The data concern the patients seen by one consultant in 28 such ward rounds during the last four months of 1997, in a teaching hospital where the DME is separate from the department of general internal medicine. 254 patients were seen, 107 men and 147 women, with an average age of 82.4 years (range 73–102). The decisions taken included diagnosis, further investigations, treatment, referral, discharge, and resuscitation status. Very few admissions were judged inappropriate, particularly among the majority referred by general practitioners. 101 patients were thought suitable for transfer to the department of general internal medicine, 109 definitely unsuitable. These findings support the view that, if medical beds are to be freed, the initiative must come from facilitating discharge rather than curtailing admission. Generalists are needed to sort and manage these patients. In the UK, these will often be general internal medicine consultant geriatricians, while the younger patients are seen by consultants practising general internal medicine in addition to one of the specialties. Sizeable numbers of these consultants are needed if the post-take ward round is to be efficient and not conflict with their fixed commitments.

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Hungarian general practitioners’ attitude and the role of education in dementia care

Primary Health Care Research & Development ◽

10.1017/s1463423619000203 ◽

2019 ◽

Vol 20 ◽

Cited By ~ 1

Author(s):

Szilvia Heim ◽

Csilla Busa ◽

Éva Pozsgai ◽

Ágnes Csikós ◽

Edina Papp ◽

...

Keyword(s):

General Practitioners ◽

The Elderly ◽

Likert Scale ◽

Dementia Care ◽

Testing Methods ◽

The Past ◽

Large Survey ◽

Self Administered Questionnaire ◽

Descriptive Statistical Analysis

Abstract Background: Dementia in the elderly constitutes a growing challenge in healthcare worldwide, including Hungary. There is no previous report on the role of general practitioners in the management of dementia. Aim: The purpose of the present study was to investigate the Hungarian general practitioners’ attitude toward their patients living with dementia as well as dementia care. Our goal was also to assess their willingness and habits in assessing dementia. Additionally we wanted to explore the role of education about dementia, and its impact on their attitude in dementia management. Methods: As part of a large survey, a self-administered questionnaire was filled out voluntarily by 402 of general practitioners. According to our preset criteria, 277 surveys were selected for evaluation. Descriptive statistical analysis and Likert-scale analysis were performed. Findings: Half of the doctors (49.8%) indicated that they conducted a test to assess cognitive functions in case of suspicion. Among the respondents who did not assess, 50.0% of physicians cited lack of time as the main reason for not doing so and 14.4% of them had not proper knowledge of testing methods. The respondents most often mentioned feelings toward their patients with dementia, were regret (Likert-scale mean: 3.33), helplessness (3.28) and sadness (3.07). The majority of physicians thought the treatment of dementia was difficult (4.46). Most of the respondents (81.2%) indicated that in the past 2 years they had not participated in any training about dementia. Those practitioners who had participated in some form of education were less likely to feel helpless facing a patient with dementia, and education also determined their approach to dementia care.

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General Practitioners' and Hospital Physicians' Preference for Morphine or Oxycodone as First-Time Choice for a Strong Opioid: A National Register-Based Study

Basic & Clinical Pharmacology & Toxicology ◽

10.1111/j.1742-7843.2012.00927.x ◽

2012 ◽

Vol 112 (2) ◽

pp. 110-115 ◽

Cited By ~ 6

Author(s):

Karen K. Poulsen ◽

Stig E. Andersen ◽

Søren I. Moreno ◽

Dorte Glintborg ◽

Steffen Thirstrup ◽

...

Keyword(s):

General Practitioners ◽

National Register ◽

Strong Opioid ◽

Hospital Physicians ◽

First Time

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The PEN & PAD Medical Record Model: Development of a Nursing Record for Hospital-based Care of the Elderly

Methods of Information in Medicine ◽

10.1055/s-0038-1635061 ◽

1994 ◽

Vol 33 (05) ◽

pp. 464-472 ◽

Cited By ~ 11

Author(s):

N. Hardiker ◽

J. Kirby ◽

R. Tallis ◽

M. Gonsalkarale ◽

H. A. Heathfield

Keyword(s):

Medical Record ◽

Electronic Medical Record ◽

General Practitioners ◽

Model Development ◽

The Elderly ◽

Nursing Profession ◽

Record System ◽

Professional Background ◽

Nursing Record ◽

Computer Based

Abstract:The PEN & PAD Medical Record model describes a framework for an information model, designed to meet the requirements of an electronic medical record. This model has been successfully tested in a computer-based record system for General Practitioners as part of the PEN & PAD (GP) Project.Experiences of using the model for developing computer-based nursing records are reported. Results show that there are some problems with directly applying the model to the nursing domain. Whilst the main purpose of the nursing record is to document and communicate a patient’s care, it has several other, possibly incompatible, roles. Furthermore, the structure and content of the information contained within the nursing record is heavily influenced by the need for the nursing profession to visibly demonstrate the philosophical frameworks underlying their work. By providing new insights into the professional background of nursing records, this work has highlighted the need for nurses to clarify and make explicit their uses of information, and also provided them with some tools to assist in this task.

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Case finding in the elderly: do general practitioners really know enough?

BMJ ◽

10.1136/bmj.298.6668.254-c ◽

1989 ◽

Vol 298 (6668) ◽

pp. 254-254

Author(s):

A. Cartwright ◽

C. Smith

Keyword(s):

General Practitioners ◽

The Elderly ◽

Case Finding

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