Preschool children in Danish out-of-hours primary care: a one-year descriptive study of face-to-face consultations

Context: Despite evidence demonstrating the benefits of understanding patients, there is a paucity of information about how physicians address psychological and social concerns of patients. No one study has been published about the incidence of crying in General/Family Practice. Objective: To know the incidence of crying in primary care/general practice, and the patients’ characteristics, their reasons for encounter and their health problems. Design: A descriptive, prospective study, of one year, of three general practitioners/family physicians in Madrid, Spain. Setting: primary care (doctors’ office and patients’ home). Subjects: Face to face encounters with crying patients. Main outcome measure: At least one rolling tear. Results: Patients cried in 157 encounters out of a total of 18,627 giving an incidence rate of 8.4 per thousand. More frequent reasons for encounters were: feeling depressed (12.7%), social handicap (mainly social isolation/living alone) (6.4%), relationship problem with partner (5.1%) and feeling anxious (3.2%). More frequent health problems were: depressive disorder (23.6%), anxiety disorder (8.3%), cerebrovascular disease (5.1%) and loss/death of partner (3.8%). Conclusions: Crying in primary care is not uncommon. Reasons for crying cover the whole range of human problems, mainly social and psychological problems.

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Local implementation of AMS initiatives: a mixed-methods study

British Journal of General Practice ◽

10.3399/bjgp18x697025 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697025 ◽

Cited By ~ 2

Author(s):

Rosalie Allison ◽

Donna Lecky ◽

Elizabeth Beech ◽

Ceire Costelloe ◽

Diane Ashiru-Oredope ◽

...

Keyword(s):

Primary Care ◽

Qualitative Interviews ◽

Antibiotic Prescribing ◽

Out Of Hours ◽

Face To Face ◽

E Learning ◽

General Practices ◽

Primary Care Practitioners ◽

Future Work ◽

Common Infections

BackgroundThe NHS English Quality Premium recommends that inappropriate antibiotic prescribing is reduced; there are a range of national antimicrobial stewardship (AMS) initiatives to support this.AimThe aim of this study is to assess AMS activities in primary care across England. The findings will be used to inform how the RCGP, PHE and NHS can help optimise stewardship activities.MethodQualitative interviews: with AMS leads within Clinical Commissioning Groups’ (CCGs) and Commissioning Support Units’ (CSUs) medicines management teams. Questionnaire: informed by the qualitative data, sent to all 209 CCGs in England in 2017.ResultsIn total, 89% (187/209) of CCGs returned a questionnaire; 82% of AMS leads reported spending only 0.1 whole-time equivalent on AMS activities, as it was only one role within a wider remit, so dedicating time is challenging. 99% (167/169) of CCGs had delivered AMS education in the last 2 years: 140 face-to-face; 121 via e-learning. 99% (184/186) actively promoted the TARGET Antibiotics Toolkit; 94% (175/187) actively promoted TARGET patient leaflets: 92% The Treating Your Infection (TYI) leaflet. 90% (166/185) used the PHE managing common infections guidance: 81% (149/185) modify or localise; 41/185 (22%) signpost directly to it. Eighty-six CCGs reported using CCG audit tools and 82 CCGs reported using TARGET’s audit tools. 85% (142/168) fed back antimicrobial prescribing data to the CCG/CSU board; 100% (169/169) to general practices and 33% (56/169) to out-of-hours providers.ConclusionAlthough CCGs reported promoting these AMS activities, there was little evaluation of uptake by primary care practitioners. Future work should focus on measuring AMS uptake; having staff dedicated solely to AMS could facilitate this.

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Out-of-hours primary care use at the end of life: a descriptive study

British Journal of General Practice ◽

10.3399/bjgp16x686137 ◽

2016 ◽

Vol 66 (650) ◽

pp. e654-e660 ◽

Cited By ~ 4

Author(s):

Rebecca FR Fisher ◽

Daniel Lasserson ◽

Gail Hayward

Keyword(s):

Primary Care ◽

End Of Life ◽

Descriptive Study ◽

Out Of Hours

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Do Telemedicine Wound Care Specialist Consults Meet the Needs of the Referring Physician? A Survey of Primary Care Providers

International Journal of Telemedicine and Applications ◽

10.1155/2011/321376 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Marek K. Dobke ◽

Dhaval Bhavsar ◽

Fernando Herrera

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Wound Care ◽

Care Program ◽

Primary Care Providers ◽

Care Providers ◽

Face To Face ◽

Telemedicine Consultation ◽

Number Of Patients ◽

One Year

The purpose of our study was to determine the factors that influence the use of telemedicine consultation by primary care physicians (PCPs) in the management of patients with problem wounds. A short questionnaire was administered to thirty-six PCPs who referred to our Wound Care Program within one year. Participants were asked to rate the importance of specific concerns and benefits regarding the role of wound care surgical specialist (WCSS) and the use of telemedicine consults prior to possible face-to-face consultation. Sixty percent of respondents felt comfortable with telemedicine consultation based on recommendations alone. The total number of patients referred for telemedicine consult was 230, and face-to-face consultation with a WCSS was offered and arranged for 30% of patients. The perception of shared decision making, streamlining patient care, and an opportunity for followup were all highly ranked benefits. The majority of PCPs (93%) agreed that telemedicine wound care consult is a useful tool in their practice and would continue to use the telemedicine consult service.

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From Doctor to Nurse Triage in the Danish Out-of-Hours Primary Care Service: Simulated Effects on Costs

International Journal of Family Medicine ◽

10.1155/2013/987834 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 7

Author(s):

Grete Moth ◽

Linda Huibers ◽

Peter Vedsted

Keyword(s):

Primary Care ◽

Cost Effectiveness ◽

Care Service ◽

Primary Care Service ◽

Nurse Training ◽

Out Of Hours ◽

Face To Face ◽

Administrative Costs ◽

The Cost ◽

Nurse Triage

Introduction. General practitioners (GP) answer calls to the Danish out-of-hours primary care service (OOH) in Denmark, and this is a subject of discussions about quality and cost-effectiveness. The aim of this study was to estimate changes in fee costs if nurses substituted the GPs. Methods. We applied experiences from The Netherlands on nurse performance in the OOH triage concerning the number of calls per hour. Using the 2011 number of calls in one region, we examined three hypothetical scenarios with nurse triage and calculated the differences in fee costs. Results. A new organisation with 97 employed nurses would be needed. Fewer telephone consultations may result in an increase of face-to-face contacts, resulting in an increase of 23.6% in costs fees. Under optimal circumstances (e.g., a lower demand for OOH services, a high telephone termination rate, and unchanged GP fees) the costs could be reduced by 26.2% though excluding administrative costs of a new organisation. Conclusion. Substituting GPs with nurses in OOH primary care may increase the cost in fees compared to a model with only GPs. Further research is needed involving more influencing factors, such as costs due to nurse training and running the organisation.

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Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105280 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5280

Author(s):

Luis Miguel Azogil-López ◽

Valle Coronado-Vázquez ◽

Juan José Pérez-Lázaro ◽

Juan Gómez-Salgado ◽

Esther María Medrano-Sánchez

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Descriptive Study ◽

Mobile Telephone ◽

Structured Interviews ◽

Face To Face ◽

Healthcare Burden ◽

Qualitative Descriptive ◽

Attending Physicians ◽

The Relationship

The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried out through six semi-structured interviews and two focus groups in a sample of eleven PCPs and five HAPs. Interviews were carried out from September 2019 to February 2020. Data were analysed by creating the initial categories, recording the sessions, transcribing the information, by doing a comprehensive reading of the texts obtained, and analysing the contents. The results show that DETELPROG gives the PCP greater prominence as a patient’s health coordinator by improving their relationship and patient safety; it also improves the relationship between PCP and HAP, avoiding unnecessary face-to-face referrals and providing safety to the PCP when making decisions. The barriers for DETELPROG to be used by PCP were defensive medicine, patients’ skepticism in DETELPROG, healthcare burden, and inability to focus on the patient or interpret a sign, symptom, or diagnostic test. For HAP, the barriers were lack of confidence in the PCP and complexity of the patient. As a conclusion, DETELPROG referral model provides a lot of advantages and does not pose any new barrier to face-to-face referral or other non-face-to-face referral models, so it should be implemented in primary care.

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Preschool children in out-of-hours primary care – a questionnaire-based cross-sectional study of factors related to the medical relevance of health problems

BMC Family Practice ◽

10.1186/s12875-017-0702-5 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Grete Moth ◽

Linda Huibers ◽

Astrid Ovesen ◽

Morten Bondo Christensen ◽

Peter Vedsted

Keyword(s):

Primary Care ◽

Preschool Children ◽

Cross Sectional Study ◽

Health Problems ◽

Sectional Study ◽

Cross Sectional ◽

Out Of Hours ◽

Medical Relevance

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Primary care consultations for respiratory tract symptoms during the COVID-19 pandemic: a cohort study including 70,000 people in South West England

Family Practice ◽

10.1093/fampra/cmab127 ◽

2021 ◽

Author(s):

Hajira Dambha-Miller ◽

Hilda O Hounkpatin ◽

Jeffrey Morgan-Harrisskitt ◽

Beth Stuart ◽

Simon D S Fraser ◽

...

Keyword(s):

Primary Care ◽

Respiratory Tract ◽

Cohort Analysis ◽

Home Visits ◽

Descriptive Statistics ◽

Out Of Hours ◽

Face To Face ◽

South West ◽

Retrospective Cohort Analysis ◽

South West England

Abstract Background Primary care consultations for respiratory tract symptoms including identifying and managing COVID-19 during the pandemic have not been characterized. Methods A retrospective cohort analysis using routinely collected records from 70,431 adults aged 18+ in South England within the Electronic Care and Health Information Analytics (CHIA) database. Total volume and type of consultations (face-to-face, home visits, telephone, email/video, or out of hours) for respiratory tract symptoms between 1 January and 31 July 2020 (during the first wave of the pandemic) were compared with the equivalent period in 2019 for the same cohort. Descriptive statistics were used to summarize consultations by sociodemographic and clinical characteristics, and by COVID-19 diagnosis and outcomes (death, hospitalization, and pneumonia). Results Overall consultations for respiratory tract symptoms increased by 229% during the pandemic compared with the preceding year. This included significant increases in telephone consultations by 250%, a 1,574% increase in video/email consultations, 105% increase in home visits, and 92% increase in face-to-face consultations. Nearly 60% of people who presented with respiratory symptoms were tested for COVID-19 and 16% confirmed or clinically suspected to have the virus. Those with complications including pneumonia, requiring hospitalization, and who died were more likely to be seen in-person. Conclusion During the pandemic, primary care substantially increased consultations for respiratory tract symptoms to identify and manage people with COVID-19. These findings should be balanced against national reports of reduced GP workload for non-COVID care.

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