Initial Steps Taken by Nine Primary Care Practices to Implement Alcohol Screening Guidelines with Hypertensive Patients

2006 ◽  
Vol 27 (1-2) ◽  
pp. 61-70 ◽  
Author(s):  
Peter M. Miller ◽  
Ruth Stockdell ◽  
Lynne Nemeth ◽  
Chris Feifer ◽  
Ruth G. Jenkins ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Screening ◽  
Hypertensive Patients ◽  
Screening Guidelines ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Blood Pressure Control in Hypertensive Patients in Irish Primary Care Practices

2009 ◽  
Vol 11 (8) ◽  
pp. 432-440 ◽  
Author(s):  
Brendan Buckley ◽  
Eamonn Shanahan ◽  
Niall Colwell ◽  
Eva Turgonyi ◽  
Peter Bramlage ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Hypertensive Patients ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review Protocol

2018 ◽  
Vol 31 (1) ◽  
pp. 45 ◽  
Author(s):  
Frederico Rosário ◽  
Maria Inês Santos ◽  
Kathryn Angus ◽  
Leo Pas ◽  
Niamh Fitzgerald
Keyword(s):  
Primary Care ◽  
Brief Intervention ◽  
Behavioural Change ◽  
Family Physicians ◽  
Alcohol Screening ◽  
Brief Interventions ◽  
Barriers And Facilitators ◽  
Screening And Brief Intervention ◽  
Care Practices ◽  
Primary Care Practices

Introduction: Alcohol is a leading risk factor contributing to the global burden of disease. National and international agencies recommend evidence-based screening and brief interventions in primary care settings in order to reduce alcohol consumption. However, the majority of primary care professionals do not routinely deliver such interventions.Objective: To identify factors influencing general practitioners/family physicians’ and primary care nurses’ routine delivery of alcohol screening and brief intervention in adults.Material and Methods: A systematic literature search will be carried out in the following electronic databases: Medline, CINAHL, CENTRAL, and PsycINFO. Two authors will independently abstract data and assess study quality using the NIH National Heart, Lung, and Blood Institute quality assessment tools for quantitative studies, and the CASP checklist for qualitative studies. A narrative synthesis of the findings will be provided, structured around the barriers and facilitators identified. Identified barriers and facilitators will be further analysed using the Behavioural Change Wheel/Theoretical Domains Framework.Discussion: This review will describe the barriers to, and facilitators for, the implementation of alcohol screening and brief interventions by general practitioners/family physicians and nurses at primary care practices. By mapping the barriers and facilitators to the domains of the Behavioural Change Wheel/Theoretical Domains Framework, this review will also provide implementation researchers with a useful tool for selecting promising practitioner-oriented behavioural interventions for improving alcohol screening and brief intervention delivery in primary care.Conclusion: This review will provide important information for implementing alcohol screening and brief intervention in primary health care.Systematic Review Registration: PROSPERO CRD42016052681 

scholarly journals Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e042052
Author(s):  
Jean-Baptiste Woods ◽  
Geva Greenfield ◽  
Azeem Majeed ◽  
Benedict Hayhoe
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cost Effectiveness ◽  
Health Worker ◽  
Health Workers ◽  
Risk Of Bias ◽  
Mental Health Workers ◽  
Mental Health Worker ◽  
Care Practices ◽  
Primary Care Practices

ObjectivesMental health disorders contribute significantly to the global burden of disease and lead to extensive strain on health systems. The integration of mental health workers into primary care has been proposed as one possible solution, but evidence of clinical and cost effectiveness of this approach is unclear. We reviewed the clinical and cost effectiveness of mental health workers colocated within primary care practices.DesignSystematic literature review.Data sourcesWe searched the Medline, Embase, PsycINFO, Healthcare Management Information Consortium (HMIC) and Global Health databases.Eligibility criteriaAll quantitative studies published before July 2019 were eligible for the review; participants of any age and gender were included. Studies did not need to report a certain outcome measure or comparator in order to be eligible.Data extraction and synthesisData were extracted using a standardised table; however, pooled analysis proved unfeasible. Studies were assessed for risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane collaboration’s tool for assessing risk of bias in randomised trials.ResultsFifteen studies from four countries were included. Mental health worker integration was associated with mental health benefits to varied populations, including minority groups and those with comorbid chronic diseases. Furthermore, the interventions were correlated with high patient satisfaction and increases in specialist mental health referrals among minority populations. However, there was insufficient evidence to suggest clinical outcomes were significantly different from usual general practitioner care.ConclusionsWhile there appear to be some benefits associated with mental health worker integration in primary care practices, we found insufficient evidence to conclude that an onsite primary care mental health worker is significantly more clinically or cost effective when compared with usual general practitioner care. There should therefore be an increased emphasis on generating new evidence from clinical trials to better understand the benefits and effectiveness of mental health workers colocated within primary care practices.

scholarly journals Do statins reduce mortality in older people? Findings from a longitudinal study using primary care records

2021 ◽  
Vol 9 (2) ◽  
pp. e000780
Author(s):  
Lisanne Andra Gitsels ◽  
Ilyas Bakbergenuly ◽  
Nicholas Steel ◽  
Elena Kulinskaya
Keyword(s):  
Primary Care ◽  
Older People ◽  
Clinical Information ◽  
Cardiac Risk ◽  
Health Improvement ◽  
Network Database ◽  
Statin Prescription ◽  
The Health Improvement Network ◽  
Care Practices ◽  
Primary Care Practices

ObjectiveAssess whether statins reduce mortality in the general population aged 60 years and above.DesignRetrospective cohort study.SettingPrimary care practices contributing to The Health Improvement Network database, England and Wales, 1990–2017.ParticipantsCohort who turned age 60 between 1990 and 2000 with no previous cardiovascular disease or statin prescription and followed up until 2017.ResultsCurrent statin prescription was associated with a significant reduction in all-cause mortality from age 65 years onward, with greater reductions seen at older ages. The adjusted HRs of mortality associated with statin prescription at ages 65, 70, 75, 80 and 85 years were 0.76 (95% CI 0.71 to 0.81), 0.71 (95% CI 0.68 to 0.75), 0.68 (95% CI 0.65 to 0.72), 0.63 (95% CI 0.53 to 0.73) and 0.54 (95% CI 0.33 to 0.92), respectively. The adjusted HRs did not vary by sex or cardiac risk.ConclusionsUsing regularly updated clinical information on sequential treatment decisions in older people, mortality predictions were updated every 6 months until age 85 years in a combined primary and secondary prevention population. The consistent mortality reduction of statins from age 65 years onward supports their use where clinically indicated at age 75 and older, where there has been particular uncertainty of the benefits.

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