scholarly journals The role of health technologies in multicomponent primary care interventions: A systematic review (Preprint)

10.2196/20195 ◽  
2020 ◽  
Author(s):  
Geronimo Jimenez ◽  
David Matchar ◽  
Gerald Koh Choon Huat ◽  
MJJ Rianne van der Kleij ◽  
Niels H. Chavannes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Technologies

scholarly journals The role of health technologies in primary care interventions: A systematic review (Preprint)

2020 ◽  
Author(s):  
Geronimo Jimenez ◽  
David Matchar ◽  
Gerald Koh Choon Huat ◽  
MJJ Rianne van der Kleij ◽  
Niels H. Chavannes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Digital Health ◽  
Grey Literature ◽  
Chronically Ill ◽  
Prescribing Practices ◽  
Health Technologies ◽  
Monitoring Technologies ◽  
Multicomponent Interventions

BACKGROUND Several countries around the world have implemented multicomponent interventions to enhance primary care (PC), as a way of strengthening their health systems to cope with an ageing, chronically ill population, and rising costs. Some of these efforts have included technology-based enhancements as one of their features to support the overall intervention, but their details and impact have not been explored. OBJECTIVE To identify the role of digital/health technologies within wider, multi-feature interventions aimed at enhancing PC, and to describe the type of technologies used, aim and stakeholder, and potential impacts. METHODS A systematic review was performed, following Cochrane guidelines. An electronic search, supplemented with manual and grey literature searches, was conducted to identify multicomponent interventions which included at least one technology-based enhancement. After title/abstract and full text screening, selected articles were assessed for quality based on their study design. A descriptive, narrative synthesis was used for analysis and presentation of results. RESULTS Fourteen out of 37 articles (38%) described the inclusion of a technology-based innovation, as part of their multicomponent interventions to enhance PC. The most common identified technologies were the use of electronic health records, data monitoring technologies and online portals with messaging platforms. The most common aim of these technologies was to improve continuity of care and comprehensiveness, which resulted in increased patient satisfaction, increased PC visits compared to specialist visits, and the provision of more health prevention education and improved prescribing practices. Technologies seem also to increase costs and utilization for some parameters, such as increased consultation costs and increased number of drugs prescribed. CONCLUSIONS Technologies and digital health have not played a major role within comprehensive innovation efforts aimed at enhancing PC, reflecting that these technologies have not yet reached maturity or wider acceptance as a means for improving PC. Stronger policy and financial support is needed, as well as the advocacy of key stakeholders, to encourage the introduction of efficient technological innovations, backed by evidence-based research, so that digital technologies can fulfill the promise of supporting a strong, sustainable primary care.

scholarly journals What is the role of the Practice Nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)? : A systematic review.

2020 ◽  
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Dimity Pond
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Care Management ◽  
Practice Nurse ◽  
Early Recognition ◽  
Dementia Care ◽  
Support Person ◽  
Practice Nurses

Abstract Background The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged. Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published literature to identify existing and potential roles of Practice Nurse’s in the delivery of care to people affected by dementia and to describe the characteristics and effectiveness of nurse interventions in dementia models of care. Methods The PRISMA statement was used as a guide to systematically review the evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search of seven electronic databases and Google scholar identified relevant original research published in English between January 2000 and January 2019. Thirteen articles met the inclusion criteria and were extracted into the Covidence software for analysis.Results The heterogeneity of the included studies purpose, design and outcomes measures and the diversity in health systems and primary care nurses scope of practice made it difficult to synthesise the findings and draw conclusions. The heterogeneity did, however, provide important insights into the characteristics of roles undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person. These included patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions Embedding an evidence-based model that describes the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia.Systematic Review registration numberPROSPERO 2018 CRD42018088191

scholarly journals Role of the GP in the management of patients with self-harm behaviour: a systematic review

2020 ◽  
Vol 70 (694) ◽  
pp. e364-e373 ◽  
Author(s):  
Faraz Mughal ◽  
M Isabela Troya ◽  
Lisa Dikomitis ◽  
Carolyn A Chew-Graham ◽  
Nadia Corp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Risk Factor ◽  
Service Provision ◽  
Data Extraction ◽  
Health Concern ◽  
Specialist Care ◽  
Eligibility Criteria ◽  
Self Harm

BackgroundSelf-harm is a serious risk factor for suicide, a major public health concern, and a significant burden on the NHS. Rates of self-harm presentation in primary care are rising and GPs interact with patients both before and after they have self-harmed. There is significant public and political interest in reducing rates of self-harm, but there has been no robust synthesis of the existing literature on the role of GPs in the management of patients who self-harm.AimThis study aimed to explore the role of the GP in the management of patients with self-harm behaviour.Design and settingA systematic review and narrative synthesis of primary care literature.MethodThis systematic review was conducted and is reported in line with PRISMA guidance. Electronic databases systematically searched were MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and AMED. Two independent reviewers conducted study screening and selection, data extraction, and quality appraisal of all included studies. Thematic analysis was conducted.ResultsFrom 6976 unique citations, 12 studies met eligibility criteria and were included. These 12 studies, published from 1997–2016, of 789 GPs/family medicine physicians from Europe, the US, and Australia were of good methodological quality. Five themes were identified for facilitating GP management of self-harm: GP training, improved communication, service provision, clinical guidelines, and young people. Four barriers for GP management of self-harm were identified: assessment, service provision, local, and systemic factors.ConclusionGPs recognise self-harm as a serious risk factor for suicide, but some feel unprepared for managing self-harm. The role of the GP is multidimensional and includes frontline assessment and treatment, referral to specialist care, and the provision of ongoing support.

scholarly journals The Role of Physician and Practice Characteristics in the Quality of Diabetes Management in Primary Care: Systematic Review and Meta-analysis

2020 ◽  
Vol 35 (6) ◽  
pp. 1836-1848
Author(s):  
F. Riordan ◽  
S. M. McHugh ◽  
Clodagh O’Donovan ◽  
Mavis N. Mtshede ◽  
P. M. Kearney
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Practice Characteristics

scholarly journals Young People and the Management of Chronic Illness by Primary Care Pharmacists: A Systematic Review

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 89
Author(s):  
Mohammed Almunef ◽  
Julie Mason ◽  
Chris Curtis ◽  
Zahraa Jalal
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Illness ◽  
Young People ◽  
Community Pharmacists ◽  
Chronic Illnesses ◽  
Original Research ◽  
Subject Headings

Recent evidence has shown that the incidence of long-term illnesses in young people aged 10–24 years is increasing. It is essential to highlight the importance of long-term health conditions in this age group and understand young people’s health needs to be able to improve current support for young people. Pharmacists, as medicine experts, are in a unique position to promote young people’s health. The role of primary care pharmacists in the management of chronic illnesses in young people has not been widely researched. The aim of this review was to explore the current role of primary care pharmacists in the management of chronic illnesses in young people aged 10–24 years. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using Medical Subject Headings (MeSH) and Embase subject headings (Emtree) terms, covering three main themes: Pharmacists, young people and chronic illnesses. Articles were critically appraised using Critical Appraisal Skills Programme (CASP) tools. Eight articles were included in this review. Seven articles included original research studies (one observational study, two surveys, two qualitative interview studies and two interventions). The remaining article was a literature review. All of the articles made reference to community pharmacists, while there was no information about GP pharmacists. Roles that community pharmacists identified as high-priority in their practice when dealing with young people included supporting young people to develop generic healthcare skills, counselling and building trusted relationships directly with young people, helping young people to find credible health information and the provision of specialist services. Community pharmacists feel that they have a role to play in supporting young people with chronic illness and have identified many areas where they can provide services and support.

scholarly journals Understanding the role of GPs’ gut feelings in diagnosing cancer in primary care: a systematic review and meta-analysis of existing evidence

2020 ◽  
Vol 70 (698) ◽  
pp. e612-e621 ◽  
Author(s):  
Claire Friedemann Smith ◽  
Sarah Drew ◽  
Sue Ziebland ◽  
Brian D Nicholson
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Clinical Experience ◽  
Cancer Diagnosis ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Verbal Cues ◽  
Gut Feelings ◽  
Referral Letters

BackgroundGrowing evidence for the role of GPs’ gut feelings in cancer diagnosis raises questions about their origin and role in clinical practice.AimTo explore the origins of GPs’ gut feelings for cancer, their use, and their diagnostic utility.Design and settingSystematic review and meta-analysis of international research on GPs’ gut feelings in primary care.MethodSix databases were searched from inception to July 2019, and internet searches were conducted. A segregated method was used to analyse, then combine, quantitative and qualitative findings.ResultsTwelve articles and four online resources were included that described varied conceptualisations of gut feelings. Gut feelings were often initially associated with patients being unwell, rather than with a suspicion of cancer, and were commonly experienced in response to symptoms and non-verbal cues. The pooled odds of a cancer diagnosis were four times higher when gut feelings were recorded (OR 4.24, 95% confidence interval = 2.26 to 7.94); they became more predictive of cancer as clinical experience and familiarity with the patient increased. Despite being included in some clinical guidelines, GPs had varying experiences of acting on gut feelings as some specialists questioned their diagnostic value. Consequently, some GPs ignored or omitted gut feelings from referral letters, or chose investigations that did not require specialist approval.ConclusionGPs’ gut feelings for cancer were conceptualised as a rapid summing up of multiple verbal and non-verbal patient cues in the context of the GPs’ clinical knowledge and experience. Triggers of gut feelings not included in referral guidance deserve further investigation as predictors of cancer. Non-verbal cues that trigger gut feelings appear to be reliant on continuity of care and clinical experience; they tend to remain poorly recorded and are, therefore, inaccessible to researchers.

scholarly journals A systematic review of the role of community pharmacies in improving the transition from secondary to primary care

2015 ◽  
Vol 80 (5) ◽  
pp. 936-948 ◽  
Author(s):  
Hamde Nazar ◽  
Zachariah Nazar ◽  
Jane Portlock ◽  
Adam Todd ◽  
Sarah P. Slight
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Community Pharmacies

scholarly journals Follow-up care for men with prostate cancer and the role of primary care: a systematic review of international guidelines

2009 ◽  
Vol 100 (12) ◽  
pp. 1852-1860 ◽  
Author(s):  
H M McIntosh ◽  
◽  
R D Neal ◽  
P Rose ◽  
E Watson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Primary Care ◽  
International Guidelines ◽  
Follow Up Care
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