scholarly journals Audit of a psychiatric liaison service – the value of general practice casenotes

1990 ◽  
Vol 14 (12) ◽  
pp. 727-729 ◽  
Author(s):  
Sheila M. Curran ◽  
Ian M. Pullen
Keyword(s):  
Primary Care ◽  
General Practice ◽  
General Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Number Of Patients

The practice of out-patient psychiatry has undergone a number of significant developments in recent years: the number of patients referred by general practitioners has steadily increased: a large number of psychiatrists are now seeing patients in the primary care setting and more patients are being seen on one occasion only.

Providing Mental Health Services in the Primary Care Setting: the Experiences and Perceptions of General Practitioners at a New York City Clinic

2018 ◽  
Vol 89 (4) ◽  
pp. 897-908 ◽  
Author(s):  
Issa Papiss Bagayogo ◽  
Katharina Turcios-Wiswe ◽  
Kanako Taku ◽  
Lauren Peccoralo ◽  
Craig L. Katz
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
New York ◽  
New York City ◽  
Mental Health Services ◽  
Health Services ◽  
General Practitioners ◽  
York City ◽  
Care Setting ◽  
Primary Care Setting

General practice

2021 ◽  
pp. 223-244
Author(s):  
Philippa Edwards
Keyword(s):  
Primary Care ◽  
Risk Management ◽  
General Practice ◽  
Patient Compliance ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diagnostic Skills ◽  
The Common

This chapter contains 34 questions that encompass all of the important areas of primary care, with detailed explanations. They will assess your knowledge in the common areas that present, testing diagnostic skills and reasoning. They also test negotiating skills to ensure patient compliance, teamworking within the primary care setting, and risk management. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.

How general practitioners treat migraine patients—evaluation of a headache guideline

Cephalalgia ◽  
2012 ◽  
Vol 32 (12) ◽  
pp. 908-915 ◽  
Author(s):  
R Zielman ◽  
PJL Veenstra ◽  
EW van Zwet ◽  
JSP van den Berg
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Pharmacological Treatment ◽  
Care Setting ◽  
Primary Care Setting ◽  
Referral Letter ◽  
Hospital Record ◽  
Specific Medication ◽  
History Of ◽  
First Time

Aim: The aim of the study was to evaluate the pharmacological treatment of migraine patients by general practitioners before referral to a neurologist. First, was the pharmacological treatment in accordance with the Dutch College of General Practitioners headache guideline? Second, which migraine characteristics were associated with receiving migraine-specific medication? Methods: Migraine patients (age ≥18 years) who visited the neurology outpatient clinic for the first time were included. Migraine characteristics and pharmacological status were collected retrospectively for each patient from the general practitioner’s referral letter, hospital record and a headache characteristics questionnaire. Results: A total of 420 migraine patients were included. Only 18.3% of the patients with two or more migraine attacks per month were using prophylactic medication. Furthermore, only 11.7% of patients with symptoms of nausea and/or vomiting were using anti-emetic medication. More than half of patients (51.7%) were using triptans and were likely to have typical migraine symptoms and a long history of migraine. Conclusions: Migraine prophylactic medication and anti-emetics are underutilized in the primary care setting for migraine patients in the Netherlands, when compared to the general practitioners guideline. It is important to enhance the knowledge of general practitioners regarding the diagnosis of migraine, and to increase awareness of the headache guideline.

scholarly journals Barriers to End-of-life Discussions in the Primary Care Setting

2020 ◽  
pp. 12-15
Author(s):  
Devon Boydstun ◽  
Shandra Basil ◽  
JIll Porter ◽  
Anand Gupta
Keyword(s):  
Primary Care ◽  
End Of Life ◽  
Primary Care Physicians ◽  
Care Setting ◽  
Primary Care Setting ◽  
Age Difference ◽  
Advanced Directives ◽  
Healthcare Facilities ◽  
Number Of Patients ◽  
Study Population

Background: The Patient Self Determination Act was passed in 1991 and requires healthcare facilities to present patients with information regarding advanced directives. Since that time, there has been no improvement in the number of patients reported to have had such discussions. Numerous barriers to these discussions exist both on the patient and provider side. This study aims to identify barriers to end of life discussions among providers in the primary care setting. Methods: The study population included practicing primary care physicians in the OhioHealth system. They were administered an anonymous questionnaire addressing demographic information and questions specific to end of life discussions and what barriers exist. Results: A majority of primary care physicians reported engaging in end of life discussions with their patients. A majority of physicians cited lack of time as a barrier to having these discussions. There was a statistically significant age difference among primary care physicians who reported they have end of life discussions with their patients and among these physicians there was a statistically significant increase in their level of comfort having these discussions. Conclusion: Primary care physicians further into their career reported having end of life discussions more frequently and felt more comfortable doing so. Additionally, physicians cite lack of time as the most common barrier to holding end of life discussions.

scholarly journals Work-Related Psychosocial Demands and Resources in General Practice Teams in Germany. A Team-Based Ethnography

2020 ◽  
Vol 17 (19) ◽  
pp. 7114
Author(s):  
Elena Tsarouha ◽  
Christine Preiser ◽  
Birgitta Weltermann ◽  
Florian Junne ◽  
Tanja Seifried-Dübon ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Care Setting ◽  
Primary Care Setting ◽  
Group Discussion ◽  
Working Environment ◽  
Theory Approach ◽  
Work Intensity ◽  
Work Related ◽  
General Practices

General practices are established microenterprises in Germany providing a variety of preventive and therapeutic health care services and procedures in a challenging working environment. For example, general practice teams are confronted increasingly with work-related demands, which have been associated with poor psychological and physical outcomes. It is therefore important to gain a better understanding of issues related to occupational health and safety for personnel working in the primary care setting. This study aims to gain an in-depth understanding of psychosocial demands and resources in the primary care setting. We applied an ethnographic design, comprising a combination of participating observations, individual interviews with general practitioners (GPs) (N = 6), and focus group discussion with practice assistants and administrative staff (N = 19) in five general practices in Germany. A grounded theory approach was applied to analyze all data. Our results identified psychosocial demands and resources exemplified mainly along two typical tasks in GP practices: the issuing of medical prescriptions and blood sampling. Main psychosocial demands included factors related to work content and tasks, organization of work, and the working environment. For example, daily routines across all practices were characterized by a very high work intensity including disturbances, interruptions, delegation, and the division of labor between GPs and practice staff. Work-related resources comprised the staff’s influence on aspects related to work organization and social support. The triangulation of methods and data formats allowed the disclosure of interconnectedness between these factors. Although work processes in general practices are complex and required to comply with legal regulations, there are opportunities for practice owners and practice teams to establish working procedures in ways that reduce psychosocial risks and strengthen work-related resources.

Detection, assessment and management of eating disorders; how involved are GPs?

2006 ◽  
Vol 23 (3) ◽  
pp. 96-99 ◽  
Author(s):  
Claire Flahavan
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Eating Disorders ◽  
General Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Screening Tools ◽  
Current Evidence ◽  
Eating Disordered ◽  
Screening Assessment

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.

Identity, Contract and Enterprise in a Primary Care Setting: An English General Practice Case Study

Organization ◽  
2008 ◽  
Vol 15 (3) ◽  
pp. 355-370 ◽  
Author(s):  
Ruth McDonald ◽  
Stephen Harrison ◽  
Kath Checkland
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Care Setting ◽  
Primary Care Setting

scholarly journals What is the significance of guidelines in the primary care setting?

2021 ◽  
Author(s):  
Julian Wangler ◽  
Michael Jansky
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Care Setting ◽  
Primary Care Setting ◽  
Evidence Based ◽  
Online Questionnaire ◽  
Positive Effects ◽  
Ability To Act ◽  
Wide Range

SummaryMedical guidelines aim to ensure that care processes take place in an evidence-based and structured manner. They are especially relevant in outpatient primary care due to the wide range of symptoms and clinical pictures. In German-speaking countries, there is a lack of current findings documenting general practitioners’ opinions and experiences regarding guidelines, their expectations and their views on what improvements could be made to increase the use of this type of evidence-based instrument in the primary care setting. Between April and August 2020, a total of 3098 general practitioners were surveyed in the states of Baden–Württemberg, Hesse and Rhineland–Palatinate via an online questionnaire. Alongside the descriptive evaluation, t‑testing was used to determine significant differences between two independent sampling groups. A factor analysis was also used to cluster the expectations of those surveyed regarding the fulfilment of requirements relating to guidelines. A total of 52% of those surveyed have a positive view of guidelines. Overall, guidelines are associated with an increased evidence-based approach (69%), standardisation of diagnosis and treatment (62%) and a reduction in overprovision or underprovision of care (57%). In all, 62% of the physicians who implemented guidelines observed positive effects on the quality of care provided, and 67% reported that the implementation of guidelines improved the quality of their diagnostic or therapeutic skills. However, implementation is often seen as being complicated (43%) and restricting the physician’s ability to act independently (63%). Survey participants suggested that guidelines could be optimised by giving greater consideration to nondrug alternatives (46%), focusing on issues related to quality of life (42%) and offering a comparative assessment of various treatment options (39%). In order to further promote the attractiveness of guidelines for primary care the design of guidelines should be oriented more towards their application; they should be well-presented to make them easier to implement. The scope of action available to the physician should be stressed. The guidelines should provide recommendations on opportunities for the delegation of tasks within practice teams.

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