Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial

IntroductionThe control rate of hypertension is low in China, especially in rural, western and minority areas. This is related to poor medical skills among physicians in primary care institutions and low levels of trust among patients. However, primary healthcare institutions are the main battleground for the prevention and treatment of hypertension. It is worth exploring how to most effectively integrate patients, primary care physicians and cardiologists in tertiary hospitals, to build a long-term mechanism for the prevention and treatment of hypertension. In this study, we aim to evaluate the clinical effectiveness and conduct a health economic evaluation of an internet-based patient–primary care physician–cardiologist integrated management model of hypertension in areas of China with different socioeconomic levels.Methods and analysisThis is a 12-month, multicentre, randomised controlled trial involving patients with hypertension in urban communities and rural areas of Sichuan Province, China. Each primary healthcare institution will cooperate with their tertiary hospital through the Red Shine Chronic Disease Management System (RSCDMS). Patients will be randomly assigned 1:1 to two groups: (1) a traditional care group; (2) an intervention group in which primary care physicians and cardiologists can share patient data and manage patients together through the RSCDMS. Patients can upload their blood pressure (BP) values and communicate with physicians using the system. The primary outcome is the change in systolic BP over a 12-month period. Secondary outcomes are changes in diastolic BP, BP control rate, values of 24-hour ambulatory BP monitoring, difference in cost-effectiveness between the groups, patient satisfaction, medication adherence and home BP monitoring compliance. All data will be recorded and stored in the RSCDMS and analysed using IBM SPSS V.26.0.Ethics and disseminationThis study has been approved by the Biomedical Research Ethics Committee of the West China Hospital of Sichuan University in Sichuan, China (No. 2020-148). Written informed consent will be obtained from all participants. The results of this study will be disseminated to the public through academic conferences and peer-reviewed journals.Trial registration numberChiCTR2000030677.

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Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial

Trials ◽

10.1186/s13063-017-1889-4 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Hanna Sandelowsky ◽

Ingvar Krakau ◽

Sonja Modin ◽

Björn Ställberg ◽

Anna Nager

Keyword(s):

Primary Care ◽

Randomised Controlled Trial ◽

Study Protocol ◽

Primary Care Physicians ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Case Method ◽

Cluster Randomised ◽

Randomised Controlled

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Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.112.122663 ◽

2014 ◽

Vol 204 (2) ◽

pp. 144-150 ◽

Cited By ~ 23

Author(s):

Marco Menchetti ◽

Paola Rucci ◽

Biancamaria Bortolotti ◽

Annarosa Bombi ◽

Paolo Scocco ◽

...

Keyword(s):

Primary Care ◽

Treatment Outcome ◽

Randomised Controlled Trial ◽

Social Adjustment ◽

Primary Care Physicians ◽

Selective Serotonin Reuptake Inhibitors ◽

Controlled Trial ◽

Smoking Habit ◽

Randomised Controlled ◽

Depressive Episodes

BackgroundDespite depressive disorders being very common there has been little research to guide primary care physicians on the choice of treatment for patients with mild to moderate depression.AimsTo evaluate the efficacy of interpersonal counselling compared with selective serotonin reuptake inhibitors (SSRIs), in primary care attenders with major depression and to identify moderators of treatment outcome.MethodA randomised controlled trial in nine centres (DEPICS, Australian New Zealand Clinical Trials Registry number: ACTRN12608000479303). The primary outcome was remission of the depressive episode (defined as a Hamilton Rating Scale for Depression score 7 at 2 months). Daily functioning was assessed using the Work and Social Adjustment Scale. Logistic regression models were used to identify moderators of treatment outcome.ResultsThe percentage of patients who achieved remission at 2 months was significantly higher in the interpersonal counselling group compared with the SSRI group (58.7% v. 45.1%, P = 0.021). Five moderators of treatment outcome were found: depression severity, functional impairment, anxiety comorbidity, previous depressive episodes and smoking habit.ConclusionsWe identified some patient characteristics predicting a differential outcome with pharmacological and psychological interventions. Should our results be confirmed in future studies, these characteristics will help clinicians to define criteria for first-line treatment of depression targeted to patients' characteristics.

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