scholarly journals Patients’ evaluations of patient safety in English general practices: a cross-sectional study

2017 ◽  
Vol 67 (660) ◽  
pp. e474-e482 ◽  
Author(s):  
Ignacio Ricci-Cabello ◽  
Kate S Marsden ◽  
Anthony J Avery ◽  
Brian G Bell ◽  
Umesh T Kadam ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Healthcare Delivery ◽  
Patient Activation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The North ◽  
Patient Reported ◽  
General Practices

BackgroundDescription of safety problems and harm in general practices has previously relied on information from health professionals, with scarce attention paid to experiences of patients.AimTo examine patient-reported experiences and outcomes of patient safety in primary care.Design and settingCross-sectional study in 45 general practices across five regions in the north, centre, and south of England.MethodA version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire was sent to a random sample of 6736 patients. Main outcome measures included ‘practice activation’ (what a practice does to create a safe environment); ‘patient activation’ (how proactive are patients in ensuring safe healthcare delivery); ‘experiences of safety events’ (safety errors); ‘outcomes of safety’ (harm); and ‘overall perception of safety’ (how safe patients rate their practice).ResultsQuestionnaires were returned by 1244 patients (18.4%). Scores were high for ‘practice activation’ (mean [standard error] = 80.4 out of 100 [2.0]) and low for ‘patient activation’ (26.3 out of 100 [2.6]). Of the patients, 45% reported experiencing at least one safety problem in the previous 12 months, mostly related to appointments (33%), diagnosis (17%), patient provider communication (15%), and coordination between providers (14%). Twenty-three per cent of the responders reported some degree of harm in the previous 12 months. The overall assessment of level of safety of practices was generally high (86.0 out of 100 [16.8]).ConclusionPriority areas for patient safety improvement in general practices in England include appointments, diagnosis, communication, coordination, and patient activation.

scholarly journals Primary care bonus payments and patient-reported access in urban Ontario: a cross-sectional study

CMAJ Open ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. E1080-E1096
Author(s):  
Kamila Premji ◽  
Ewa Sucha ◽  
Richard H. Glazier ◽  
Michael E. Green ◽  
Walter P. Wodchis ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Reported ◽  
Bonus Payments

scholarly journals Gambling problems among patients in primary care: a cross-sectional study of general practices

2017 ◽  
Vol 67 (657) ◽  
pp. e274-e279 ◽  
Author(s):  
Sean Cowlishaw ◽  
Lone Gale ◽  
Alison Gregory ◽  
Jim McCambridge ◽  
David Kessler
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Problem Gambling ◽  
Family Members ◽  
Cross Sectional Study ◽  
Gambling Problems ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risky Alcohol ◽  
General Practices

BackgroundPrimary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems.AimTo indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability.Design and settingCross-sectional study of patients attending 11 general practices in Bristol, South West England.MethodAdult patients (n= 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced.ResultsThere were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1–4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression.ConclusionThere is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention.

scholarly journals Multimorbidity and patient-reported diagnostic errors in the primary care setting: multicentre cross-sectional study in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039040
Author(s):  
Takuya Aoki ◽  
Satoshi Watanuki
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diagnostic Errors ◽  
Cross Sectional Study ◽  
Research Network ◽  
Diagnostic Process ◽  
Sectional Study ◽  
Cross Sectional ◽  
Patient Reported

ObjectivesThere is lack of evidence for the association between multimorbidity and diagnostic errors. Information on diagnostic errors from patients’ perspectives is crucial to improve the diagnostic process. In this study, we aimed to investigate patient-reported diagnostic errors and to examine the relationship between multimorbidity and patient-reported diagnostic errors in the primary care setting.DesignMulticentre cross-sectional study.SettingA primary care practice-based research network in Japan (25 primary care facilities).ParticipantsAdult outpatients filled out a standardised questionnaire.Primary outcome measurePatient-reported diagnostic errors.ResultsData collected from 1474 primary care outpatients were analysed. The number of participants who reported diagnostic errors was 57 (3.9%). Most of the missed diagnoses were common conditions in primary care, such as cancer, dermatitis and hypertension. After adjustment for possible confounders and clustering within facilities, multimorbidity was positively associated with patient-reported diagnostic errors (adjusted OR=1.83, 95% CI 1.01 to 3.31). The results of the sensitivity analysis were consistent with those of the primary analysis.ConclusionsThe present study showed a lower proportion of patients reporting experiences of diagnostic errors in primary care than those reported in previous studies in other countries. However, patients with multimorbidity are more likely to report diagnostic errors in primary care; thus, further research is necessary to improve the diagnostic process for patients with multimorbidity.

scholarly journals Management of depression in primary care - A cross-sectional study in the North-East of England, UK

2021 ◽  
Vol 19 (2) ◽  
Author(s):  
Reshma Hegde ◽  
Prinul Gunputh ◽  
Baxi Sinha
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Secondary Care ◽  
Cross Sectional Study ◽  
Free Text ◽  
Sectional Study ◽  
Cross Sectional ◽  
North East ◽  
The North

Background: Depression is a common and serious disorder that impairs quality of life. Since general practitioners (GP) are considered gatekeepers to secondary care, the choice of interventions offered in primary care can have a significant impact not only on patients’ quality of life, but also on health service demands. Objective: To evaluate the confidence of GPs in diagnosing and managing depression; and, to assess the factors influencing their strategy in treating depression. Methods: A cross-sectional study was carried out among GPs working in the North-East of England, UK. The survey questionnaire consisted of mostly close-ended questions with some allowing for free-text comments (see Appendix 1). The responses obtained were analysed using Microsoft Excel. Results: Among the total of 63 respondents, most GPs were comfortable diagnosing depression. Most would consider combining talking therapies with antidepressants (68.3%) at presentation, followed by referral to talking therapies alone (41.2%). In only 14.3% of cases would antidepressant therapy alone be considered. For those patients non-responsive to initial treatment, 25.4% considered offering a different antidepressant or adjunct medication (such as a sedative, anxiolytic, or beta-blocker), and another 25.4% of GPs considered a combination with another antidepressant. 46.0% of participants were not comfortable prescribing dual antidepressants due to concerns about side effects, lack of experience, paucity of guidelines, and lack of timely access and guidance from the local mental team. Nearly all (98.4%) GP participants would agree to prescribe dual antidepressants on advice of the mental health team with telephone advice being the preferred means of communication in 65.1% of cases. Conclusion: The results of this study can help to develop closer co-operation between primary and secondary care by not only upskilling GPs through various means (educational events, training posts, etc.), but by also creating better communication channels at the interface between those two services. Key words: antidepressants, combination therapy, depression, primary care, primary-secondary care interface

scholarly journals Relationship between prescribing of antibiotics and other medicines in primary care: a cross-sectional study

2018 ◽  
Vol 69 (678) ◽  
pp. e42-e51 ◽  
Author(s):  
Yan Li ◽  
Anna Mölter ◽  
Andrew White ◽  
William Welfare ◽  
Victoria Palin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
General Practices ◽  
The Uk

BackgroundHigh levels of antibiotic prescribing are a major concern as they drive antimicrobial resistance. It is currently unknown whether practices that prescribe higher levels of antibiotics also prescribe more medicines in general.AimTo evaluate the relationship between antibiotic and general prescribing levels in primary care.Design and settingCross-sectional study in 2014–2015 of 6517 general practices in England using NHS digital practice prescribing data (NHS-DPPD) for the main study, and of 587 general practices in the UK using the Clinical Practice Research Datalink for a replication study.MethodLinear regression to assess determinants of antibiotic prescribing.ResultsNHS-DPPD practices prescribed an average of 576.1 antibiotics per 1000 patients per year (329.9 at the 5th percentile and 808.7 at the 95th percentile). The levels of prescribing of antibiotics and other medicines were strongly correlated. Practices with high levels of prescribing of other medicines (a rate of 27 159.8 at the 95th percentile) prescribed 80% more antibiotics than low-prescribing practices (rate of 8815.9 at the 5th percentile). After adjustment, NHS-DPPD practices with high prescribing of other medicines gave 60% more antibiotic prescriptions than low-prescribing practices (corresponding to higher prescribing of 276.3 antibiotics per 1000 patients per year). Prescribing of non-opioid painkillers and benzodiazepines were also strong indicators of the level of antibiotic prescribing. General prescribing levels were a much stronger driver for antibiotic prescribing than other risk factors, such as deprivation.ConclusionThe propensity of GPs to prescribe medications generally is an important driver for antibiotic prescribing. Interventions that aim to optimise antibiotic prescribing will need to target general prescribing behaviours, in addition to specifically targeting antibiotics.

scholarly journals Patient Activation in Type 2 Diabetes: Does It Differ between Men and Women?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Steven H. Hendriks ◽  
Laura C. Hartog ◽  
Klaas H. Groenier ◽  
Angela H. E. M. Maas ◽  
Kornelis J. J. van Hateren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Patient Activation ◽  
Well Being ◽  
Cross Sectional Study ◽  
Macrovascular Complications ◽  
Sectional Study ◽  
Cross Sectional ◽  
Men And Women ◽  
General Practices

Background.Aim was to investigate whether the degree of patient activation of patients with type 2 diabetes (T2D) is different between men and women. Furthermore, we investigated which factors are associated with patient activation in men and women.Methods.This cross-sectional study included 1615 patients with T2D from general practices. Patient activation was measured with the Patient Activation Measure (PAM) questionnaire. Multivariate linear regression analyses were used to investigate the association between gender and patient activation. Stratified analyses according to gender were performed to investigate which factors are associated with patient activation.Results.No association between gender and PAM score was found after adjustment for all selected confounders (p=0.094). In men, lower age (p=0.001), a higher WHO-5 score (p<0.001), and a lower BMI (p=0.013) were associated with a higher PAM score. In women, a higher WHO-5 score (p<0.017) and the absence of macrovascular complications (p<0.031) were associated with a higher PAM score.Conclusion.There is no difference in the degree of patient activation of men and women with T2D. Age, well-being, and BMI were found to be associated with patient activation in men, whereas well-being and macrovascular complications were found to be associated with patient activation in women.

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