scholarly journals Incidence of Obesity at 1 and 3 Years Among Community Dwelling Adults: A Population-Based Study

2022 ◽  
Vol 13 ◽  
pp. 215013192110686
Author(s):  
Ramona S. DeJesus ◽  
Ivana T. Croghan ◽  
Debra J. Jacobson ◽  
Chun Fan ◽  
Jennifer St. Sauver
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Population Based ◽  
Incidence Rates ◽  
Overweight And Obesity ◽  
Community Dwelling ◽  
Care Practice ◽  
Weight Category ◽  
Study Results

Objective: This study determined the incidence rates for obesity among adult patients ages 20 and older empaneled in primary care practice in Midwest United States to potentially identify an optimum timeframe for initiating intervention. Background: Primary care practice patients are likely to reflect underlying community trends in overweight and obesity; however, data on overweight and obesity in primary care patients is limited. While childhood incidence rates of obesity have been well reported, there is still a paucity of data on the incidence of obesity among adult population; literature has mainly focused on its prevalence. Methods: Medical record review of identified cohort with BMI data was conducted. Population was stratified by age and sex and overweight category was subdivided into tertiles. Results: Majority of 40 390 individuals who comprised the final population and had follow-up data, consisted of adults ages 40 to 69 years (47.5%), female (59.8%) of non-Hispanic ethnicity (95.9%) with 21 379 (52.8%) falling in weight category of overweight. Incidence of obesity was 7% at 1 year and 16% at 3 years follow-up. Highest percentages of individuals who became obese at 1 and 3 years were in age category of 40 to 69 years among men and 20 to 39 years among women. In Cox regression analysis, there was statistically significant association to developing obesity among all tertile groups in the overweight category. Age and particularly gender appeared to be modifying factors to likelihood of developing obesity. Conclusion: Study results suggest that while obesity incidence is higher among certain age groups in both genders, middle-aged women, and men in all tertiles of overweight category are at highest risk and may be the optimum population to target for weight loss interventions. Findings support the initiation of population-based interventions before onset of obesity.

Follow-up of 100 dogs with acute diarrhoea in a primary care practice

2014 ◽  
Vol 199 (1) ◽  
pp. 188-190 ◽  
Author(s):  
C.M. Berset-Istratescu ◽  
O.J. Glardon ◽  
I. Magouras ◽  
C.F. Frey ◽  
S. Gobeli ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Acute Diarrhoea ◽  
Care Practice

A retrospective, population-based analysis of persistence with antihypertensive drug therapy in primary care practice in Italy

2002 ◽  
Vol 24 (8) ◽  
pp. 1347-1357 ◽  
Author(s):  
Luca Degli Esposti ◽  
Ezio Degli Esposti ◽  
Giorgia Valpiani ◽  
Mirko Di Martino ◽  
Stefania Saragoni ◽  
...  
Keyword(s):  
Primary Care ◽  
Drug Therapy ◽  
Antihypertensive Drug ◽  
Primary Care Practice ◽  
Population Based ◽  
Antihypertensive Drug Therapy ◽  
Care Practice

scholarly journals Sepsis Recording in Primary Care Electronic Health Records, Linked Hospital Episodes and Mortality Records: Population-based Cohort Study in England

2020 ◽  
Author(s):  
Emma Rezel-Potts ◽  
Martin C. Gulliford ◽  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Population Based ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Recent Period ◽  
General Practices ◽  
Different Sources

AbstractObjectivesSepsis is a growing concern for health systems, but the epidemiology of sepsis is poorly characterised. We evaluated sepsis recording across primary care electronic records, hospital episodes and mortality registrations.Methods and FindingsCohort study including 378 general practices in England from Clinical Practice Research Datalink (CPRD) GOLD database from 2002 to 2017 with 36,209,676 patient-years of follow-up with linked Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality registrations. Incident sepsis episodes were identified for each source. Concurrent records from different sources were identified and age-standardised and age-specific incidence rates compared. Logistic regression analysis evaluated associations of gender, age-group, fifth of deprivation and period of diagnosis with concurrent sepsis recording.There were 20,206 first episodes of sepsis from primary care, 20,278 from HES and 13,972 from ONS. There were 4,117 (20%) first HES sepsis events and 2,438 (17%) mortality records concurrent with incident primary care sepsis records within 30 days. Concurrent HES and primary care records of sepsis within 30 days before or after first diagnosis were higher at younger or older ages and for patients with the most recent period of diagnosis with those diagnosed during 2007:2011 less likely to have a concurrent HES record given CPRD compared to those diagnosed during 2012 to 2017 (odd ratio 0.65, 95% confidence interval 0.60 to 0.70). At age 85 and older, primary care incidence was 5.22 per 1,000 patient years (95% CI 1.75 to 11.97) in men and 3.55 (0.87 to 9.58) in women which increased to 10.09 (4.86 to 18.51) for men and 7.22 (2.96 to 14.72) for women after inclusion of all three sources.ConclusionExplicit recording of sepsis is inconsistent across healthcare sectors with a high proportion of non-concurrent records. Incidence estimates are higher when linked data are analysed.

scholarly journals Sepsis recording in primary care electronic health records, linked hospital episodes and mortality records: Population-based cohort study in England

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244764
Author(s):  
Emma Rezel-Potts ◽  
Martin C. Gulliford ◽  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Population Based ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Recent Period ◽  
General Practices ◽  
Different Sources

Background Sepsis is a growing concern for health systems, but the epidemiology of sepsis is poorly characterised. We evaluated sepsis recording across primary care electronic records, hospital episodes and mortality registrations. Methods and findings Cohort study including 378 general practices in England from Clinical Practice Research Datalink (CPRD) GOLD database from 2002–2017 with 36,209,676 patient-years of follow-up with linked Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality registrations. Incident sepsis episodes were identified for each source. Concurrent records from different sources were identified and age-standardised and age-specific incidence rates compared. Logistic regression analysis evaluated associations of gender, age-group, fifth of deprivation and period of diagnosis with concurrent sepsis recording. There were 20,206 first episodes of sepsis from primary care, 20,278 from HES and 13,972 from ONS. There were 4,117 (20%) first HES sepsis events and 2,438 (17%) mortality records concurrent with incident primary care sepsis records within 30 days. Concurrent HES and primary care records of sepsis within 30 days before or after first diagnosis were higher at younger or older ages and for patients with the most recent period of diagnosis. Those diagnosed during 2007:2011 were less likely to have a concurrent HES record given CPRD compared to those diagnosed during 2012–2017 (odd ratio 0.65, 95% confidence interval 0.60–0.70). At age 85 and older, primary care incidence was 5.22 per 1,000 patient years (95% CI 1.75–11.97) in men and 3.55 (0.87–9.58) in women which increased to 10.09 (4.86–18.51) for men and 7.22 (2.96–14.72) for women after inclusion of all three sources. Conclusion Explicit recording of ‘sepsis’ is inconsistent across healthcare sectors with a high proportion of non-concurrent records. Incidence estimates are higher when linked data are analysed.

scholarly journals Call your doctor: prospective description study of telemedicine during the first COVID-19 outbreak in a Swiss primary care practice

2020 ◽  
Author(s):  
Joëlle Suillot ◽  
Sophie Zuercher ◽  
Lydie Zufferey ◽  
Julien Sagez
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Practice ◽  
Emergency Services ◽  
Phone Call ◽  
Categorical Variables ◽  
Care Practice ◽  
Or Groups ◽  
Swiss Primary Care

Abstract Background: Telemedicine is a healthcare assistance method which has been promoted during the COVID-19 pandemic for the management of patients. The aim of this study is to quantify the type of request that primary care physicians are experiencing, as well as the healthcare assistance modalities and ultimately, how many physical consultations are necessary.Methods: We conducted a prospective, descriptive study in a primary care practice in Switzerland on telephone consultations related to COVID-19. The data collected included the reasons for the call, symptoms, healthcare assistance modalities and follow-up. The categorical variables are expressed as percentages of the total cases or groups.Results: We included 200 calls corresponding to 113 patients. The majority of patients (76.1%) were taken care of solely through telemedicine. The physical consultations were due to the need: for a swab test (12.4%), for a somatic assessment at the practice (9.7%) and for an emergency services consultation (1.8%). In 64.6% of cases, patient assistance required only one phone call. Calls lasted 7.85 minutes on average and were more frequent on Mondays (24%) and Fridays (18.5%). Calls led to the prescription of medication in 12.5% of cases, of a bronchodilator in 3% of cases and of an antibiotic in 0.5% of cases.Conclusion: A rigorous telephone follow-up strategy carried out by primary care physicians requires few physical consultations in patients showing symptoms of COVID-19.

Improving quality in general practice using the Primary Care Practice Improvement Tool (PC-PIT) with Primary Health Network support

2020 ◽  
Vol 26 (6) ◽  
pp. 484
Author(s):  
Samantha J. Borg ◽  
Maria Donald ◽  
Koula Totsidis ◽  
Narelle Quinn ◽  
Claire L. Jackson
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Care Home ◽  
Care Practice ◽  
Organisational Performance ◽  
Health Network ◽  
Practice Improvement ◽  
Primary Health ◽  
Primary Care Sector

Optimal primary care sector performance is vital for ensuring the delivery of quality health services and effective clinical management of populations. The Primary Care Practice Improvement Tool (PC-PIT) incorporates subjective staff input and objective indicators to measure 13 elements of organisational performance. This study aimed to measure change in organisational performance for general practices using the PC-PIT with Primary Health Network (PHN) support. A pre-post design was used for changes in PC-PIT subjective and objective scores. Practices used results with PHN support to complete two Plan Do Study Act initiatives and were reassessed 9-months later. PC-PIT scales were dichotomised into lower and higher scores, with odds ratios used to determine effect size. Staff survey response rates were 55.4% at baseline and 50.1% at follow up. There were modest increases in the likelihood of staff rating several elements higher at follow up. When implemented with PHN support staff, the PC-PIT has the potential for effective, focussed and sustained quality improvement, with capacity to support Health Care Home model transition and implementation.

Whose role is it? Primary care and the provision of emotional support for women experiencing miscarriage: a pilot qualitative Australian study

2020 ◽  
Vol 26 (5) ◽  
pp. 388
Author(s):  
Vellyna Sumarno ◽  
Meredith J. Temple-Smith ◽  
Jade E. Bilardi
Keyword(s):  
Primary Care ◽  
Emotional Support ◽  
Primary Care Practice ◽  
Care Practice ◽  
Health Issues ◽  
Structured Interviews ◽  
Self Blame ◽  
Physical Care

Miscarriage can cause significant psychological morbidity. Women frequently report dissatisfaction with healthcare professionals’ support following miscarriage. This pilot study aimed to explore the views and practices of GPs in providing emotional support to women experiencing miscarriage. Eight GPs participated in semi-structured interviews. GPs considered women’s physical care their top priority at the time of miscarriage; however, acknowledged miscarriage could result in significant emotional sequelae. Most GPs felt it was their role to provide emotional support, including expressing empathy, listening and normalising miscarriage to mitigate guilt and self-blame. GPs preferred an individualised approach to emotional support and mostly offered follow-up appointments if a patient requested it or was considered ‘high risk’ for mental health issues. Some GPs believed miscarriage support was within the scope of primary care practice; however, others felt it was the role of social networks and pregnancy loss support organisations. GPs identified several structural and external barriers that precluded enhanced emotional support. Further tools and resources to enhance support care may be of benefit to some GPs. The feasibility of GPs providing follow-up support remains uncertain. Further research is required to determine whether support is best placed within primary care or better served through external organisations.

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