scholarly journals Characteristics of Dutch and Swiss primary care COPD patients - baseline data of the ICE COLD ERIC study

2011 ◽  
pp. 273 ◽  
Author(s):  
Lara Siebeling ◽  
Puhan ◽  
Muggensturm ◽  
Zoller ◽  
ter Riet
Keyword(s):  
Primary Care ◽  
Baseline Data ◽  
Copd Patients ◽  
Swiss Primary Care

scholarly journals COPD patients need more information about self-management: a cross-sectional study in Swedish primary care

2019 ◽  
Vol 37 (4) ◽  
pp. 459-467 ◽  
Author(s):  
Hanna Sandelowsky ◽  
Ingvar Krakau ◽  
Sonja Modin ◽  
Björn Ställberg ◽  
Anna Nager
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Self Management ◽  
Sectional Study ◽  
Cross Sectional ◽  
Copd Patients

scholarly journals Understanding usual care for patients with multimorbidity: baseline data from a cluster-randomised trial of the 3D intervention in primary care

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e019845 ◽  
Author(s):  
Katherine Chaplin ◽  
Peter Bower ◽  
Mei-See Man ◽  
Sara T Brookes ◽  
Daisy Gaunt ◽  
...  
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
External Validity ◽  
Randomised Trial ◽  
Baseline Data ◽  
Secondary Outcome ◽  
Treatment Burden ◽  
Practice Staff ◽  
Illness Burden ◽  
Cluster Randomised

ObjectivesRecent evidence has highlighted the high prevalence and impact of multimorbidity, but the evidence base for improving management is limited. We have tested a new complex intervention for multimorbidity (the 3D model). The paper describes the baseline characteristics of practices and patients in order to establish the external validity of trial participants. It also explores current ‘usual primary care’ for multimorbidity, against which the 3D intervention was tested.DesignAnalysis of baseline data from patients in a cluster-randomised controlled trial and additional data from practice staff.SettingPrimary care in the UK.ParticipantsPatients with multimorbidity (n=5253) and 154 practice staff.Primary and secondary outcome measuresUsing surveys and routinely available data, we compared the characteristics of participating and non-participating practices and participating and non-participating eligible patients.Baseline questionnaire data from patient participants was used to examine participant illness burden, treatment burden and perceptions of receiving patient-centred care. We obtained data about usual care preintervention from practice staff using questionnaires and a structured pro forma.ResultsParticipating practices were slightly larger, in less deprived areas, and with slightly higher scores for patient satisfaction compared with non-participating practices. Patients with dementia or learning difficulties were likely to be excluded by their general practitioners, but comparison of participants with non-participants identified only minor differences in characteristics, suggesting that the sample was otherwise representative. Patients reported substantial illness burden, and an important minority reported high treatment burden. Although patients reported relatively high levels of satisfaction with care, many reported not having received potentially important components of care.ConclusionThis trial achieved good levels of external validity. Although patients were generally satisfied with primary care services, there was significant room for improvement in important aspects of care for multimorbidity that are targeted by the 3D intervention.Trial registration numberISRCTN06180958; Post-results.

scholarly journals Advanced practice nurses in primary care in Switzerland: an analysis of interprofessional collaboration

2019 ◽  
Author(s):  
Renata Josi ◽  
Monica Bianchi ◽  
Sophie Brandt
Keyword(s):  
Primary Care ◽  
Medical Practice ◽  
Health Professionals ◽  
Interprofessional Collaboration ◽  
Advanced Practice Nurses ◽  
Advanced Practice ◽  
Practice Nurses ◽  
Care Models ◽  
Team Functioning ◽  
Swiss Primary Care

Abstract Background: The increase in the number of chronically ill patients due to ageing is calling existing models of primary care into question. New care models have recently been implemented in Swiss primary care and involve interprofessional teams. This paper aimed to analyze the practice of interprofessional collaboration between advanced practice nurses, registered nurses, and medical practice assistants within new models of primary care in Switzerland using the National Interprofessional Competency Framework (NICF). Methods: An ethnographic design comprising semi-structured interviews and non-participant observations was conducted. Sixteen interviews were conducted with care providers at their primary care practice. Interviewees included four advanced practice nurses, two registered nurses, six medical practice assistants, and four general practitioners. Nine other health professionals were subsequently observed in their practice. Interviews and observations were conducted by the first author from February to April 2019. Results: Our analysis confirmed that role clarification, team functioning, collaborative leadership, interprofessional conflict resolution, patient-centered care, and interprofessional communication have a significant influence on the interprofessional collaboration among health professionals in Swiss primary care. Among these domains, role clarification and team functioning were the most frequently raised issues. Both were found to have the potential to negatively influence and, therefore, hinder efficient interprofessional collaboration within primary care. The observation of APNs and MPAs working in practice confirmed these results. Conclusion: From the analysis, it emerged that role clarification is crucial for effective interprofessional collaboration within new care delivery models in the Swiss primary care context. Our study results may inform international health policymakers and practitioners about six important domains of interprofessional care when implementing new care models. Practical experience with new models of care involving advanced practice nurses and medical practice assistants may also influence the regulation of the scope of practice of these health professionals in Switzerland.

scholarly journals Time Trends and Factors Associated with Antibiotic Prescribing in Swiss Primary Care (2008 to 2020)

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 837
Author(s):  
Nahara Anani Martínez-González ◽  
Stefania Di Gangi ◽  
Giuseppe Pichierri ◽  
Stefan Neuner-Jehle ◽  
Oliver Senn ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Trends ◽  
Antibiotic Consumption ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
Antibiotic Prescribing ◽  
Employment Level ◽  
Cross Sectional ◽  
Factors Associated ◽  
Swiss Primary Care

Antibiotic resistance (ABR) is a major threat to public health, and the majority of antibiotics are prescribed in the outpatient setting, especially in primary care. Monitoring antibiotic consumption is one key measure in containing ABR, but Swiss national surveillance data are limited. We conducted a retrospective cross-sectional study to characterise the patterns of antibiotic prescriptions, assess the time trends, and identify the factors associated with antibiotic prescribing in Swiss primary care. Using electronic medical records data, we analysed 206,599 antibiotic prescriptions from 112,378 patients. Based on 27,829 patient records, respiratory (52.1%), urinary (27.9%), and skin (4.8%) infections were the commonest clinical indications for antibiotic prescribing. The most frequently prescribed antibiotics were broad-spectrum penicillins (BSP) (36.5%), fluoroquinolones (16.4%), and macrolides/lincosamides (13.8%). Based on the WHO AWaRe classification, antibiotics were 57.9% Core-Access and 41.7% Watch, 69% of which were fluoroquinolones and macrolides. Between 2008 and 2020, fluoroquinolones and macrolides/lincosamides prescriptions significantly declined by 53% and 51%; BSP prescriptions significantly increased by 54%. Increasing patients’ age, volume, and employment level were significantly associated with antibiotic prescribing. Our results may inform future antibiotic stewardship interventions to improve antibiotic prescribing.

scholarly journals Advanced practice nurses, registered nurses and medical practice assistants in new care models in Swiss primary care: a focused ethnography of their professional roles

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033929
Author(s):  
Renata Josi ◽  
Monica Bianchi
Keyword(s):  
Primary Care ◽  
Health Professionals ◽  
Chronic Care ◽  
Advanced Practice Nurses ◽  
Models Of Care ◽  
Advanced Practice ◽  
Practice Nurses ◽  
New Models ◽  
Care Models ◽  
Swiss Primary Care

ObjectivesWe aimed to analyse roles and tasks of advanced practice nurses (APNs), registered nurses (RNs) without advanced practice education and medical practice assistants (MPAs) with regard to chronic care in Swiss primary care (PC). The objective of this study was to explore the potential of new care models, involving these health professionals, which could meet changing future healthcare needs.DesignAn ethnographic design comprising semi-structured interviews and non-participant observations was conducted.SettingHealth professionals who worked in 10 primary care practices in the German-speaking part of Switzerland were included in the study.ParticipantsIn total, 16 interviews were conducted with four APNs, six MPAs, two RNs and four general practitioners (GPs). Nine of the health professionals were subsequently observed in their primary care practice.ResultsAPNs and MPAs were both involved in chronic care in the PC practice. While APNs cared for older, multimorbid patients with more complex needs, MPAs were involved in counselling of younger patients with chronic disease such as type 2 diabetes. Additionally, APNs were involved in many home visits and visits in elderly peoples — and nursing homes. APNs worked with a high degree of autonomy while MPAs had worked mostly in delegation. Task division between GPs and APNs or MPAs was not clear in every case yet.ConclusionsAPNs and MPAs have a high potential to contribute to optimal care in new care models, which address needs of the elderly population. The experience from our sample may inform international health policymakers and practitioners about the tasks and responsibilities those health professionals can take over in PC when implementing new models of care. The practical experience with new models of care involving APNs and MPAs may also influence the future regulation with regard to the scope of practice of these health professionals in Switzerland.

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