A scoping review of the role of GPs in the management of obesity

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697289
Author(s):  
Nicholas Elmitt ◽  
Elizabeth Sturgiss ◽  
Emily Haesler ◽  
Chris van Weel ◽  
Kirsty Douglas

BackgroundGPs are caring for more adults with obesity. Research in primary health care has provided insight on the components of effective interventions. However, the most appropriate and effective role for GPs in these interventions remains unclear.AimA scoping review was undertaken to examine the literature for descriptions of the role of the GP in managing adults who are overweight or have obesity in: primary research interventions, guidelines, and the role expectations expressed by opinion leaders.MethodBlack and grey literature were searched based on the terms ‘obesity’, ‘doctor’ and ‘primary care’. A customised data extraction tool was used to identify the specific role of GPs and the explicit use of general practice values, including whole person care and person-centred care.Results282 articles were reviewed in full, with a majority of the interventions originating in the US. Poor description of the involvement of healthcare professionals made it difficult to determine if GPs had been involved. When described, GPs were rarely actively involved. Most guidelines explicitly name GPs in obesity management and suggest wide ranging roles for them. Opinions from experts on GP involvement have become more positive in recent years.ConclusionGPs are minimally involved in obesity interventions in primary care research, but are promoted in obesity guidelines as essential to patient care. There is a need for an international standard on how to accurately describe which healthcare professionals were involved in intervention delivery and their specific role.

2019 ◽  
Vol 27 (4) ◽  
pp. 340-347 ◽  
Author(s):  
Rebecca L. Hartley ◽  
Anna R. Todd ◽  
Alan R. Harrop ◽  
Frankie O. G. Fraulin

Background: Pediatric hand fractures are common, but few require surgery; therefore, these fractures are often perceived to be overreferred. Our objective is to systematically identify and describe pediatric hand fracture referring practices. Method: A scoping review was performed, searching electronic databases and grey literature up to January 2018 to identify referring practices for children (17 years and younger) with hand fractures (defined as radiographically confirmed fractures distal to the carpus) to hand surgeons. All study designs were included, and study selection and data extraction were independently performed in duplicate by 2 reviewers. Outcomes included referring rates, necessity of referral, referring criteria, and management of fractures. Results: Twenty (10 cross-sectional, 7 prospective cohorts, and 3 narrative reviews) studies reporting on referring practices or management of 21,624 pediatric hand fractures were included. Proportion of pediatric hand fractures referred to hand surgeons ranged from 6.5% to 100%. Unnecessary referral, defined as those fractures within the scope of primary care management, ranged from 27% to 78.1%. Ten studies reported referring criteria, with 14 unique criteria identified. The most common referring criteria were displacement (36.4%), loss of joint congruity (36.4%), and instability (36.4%). The most common justification for these criteria was increased likelihood of requiring surgery. The most common initial management was immobilization (66%-100%). Final management was provided by orthopedic or plastic hand surgeons with 0% to 32.9% of fractures requiring surgery. Conclusion: Referring practices vary widely in the literature. Major gaps in the literature include objective measures and justification for referring criteria and primary care education on hand fracture referring practices.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052414
Author(s):  
Lorena Jorge Lorenzi ◽  
Letícia Fernanda Belo ◽  
David Mark Frohlich ◽  
Victor Zuniga Dourado ◽  
Paula Costa Castro ◽  
...  

IntroductionAgeing is a natural process marked by physiological changes and declines in functional capacity. One strategy to encourage healthy habits in older people is the use of applications on mobile devices to promote physical activity (PA). An immediate challenge is for these applications to be accessible to older people themselves, while a second challenge is to retain their interest and engagement in connection with PA itself. Therefore, the purpose of this review is to map the factors related to the adoption and adherence of PA mobile applications by older people.Methods and analysisFive databases will be searched where articles and reviews, available between 2010 and present, in English, Portuguese or Spanish, at full text, will be included. In addition, two additional strategies will be performed, including grey literature. The search terms adoption, adherence, factors, mobile application, PA, older people and other terms related to them will be used in the search strategy. This review will include studies that identify factors related to the adoption and adherence to PA mobile applications by people over 60 years. The selection of studies will be carried out by two reviewers in five stages: identification of studies and duplicate removal; pilot test; selection by reading abstracts; inclusion by reading the full text and search in additional sources. Disagreements will be resolved by a third reviewer. Data will be extracted using a data extraction tool. Quantitative data will be described in a narrative manner and qualitative data will be categorised through inductive thematic analysis.Ethics and disseminationEthical approval is not required for this scoping review. Plans for the dissemination of the review include the presentation of the results at relevant scientific conferences and the submission and publication in significant journals.


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019367 ◽  
Author(s):  
Elizabeth A Sturgiss ◽  
Nicholas Elmitt ◽  
Emily Haelser ◽  
Chris van Weel ◽  
Kirsty A Douglas

ObjectivesObesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology.SettingPrimary care. Adult patients.Included papersPeer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review.Primary and secondary outcome measuresData were extracted on the family doctors’ involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned.Results110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations.ConclusionsThere is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation of how the pillars of primary care are used in intervention development.


2021 ◽  
Vol 4 ◽  
pp. 27
Author(s):  
Trish O'Sullivan ◽  
Tony Foley ◽  
Joseph G. McVeigh ◽  
Suzanne Timmons

Background: The care of people with dementia is of global concern. Physiotherapeutic intervention can be of benefit to patients with dementia. Physiotherapists can play a role in assessment, falls prevention, pain management and gait re-education. Dementia care forms a significant part of the workload of a physiotherapist. However, there is a paucity of evidence on what constitutes effective education and training for physiotherapists working in dementia care. Objective: This scoping review aims to explore and map the evidence on education and training for physiotherapists working in dementia care. Inclusion criteria: Studies that explore dementia training and/or education for physiotherapists or for multidisciplinary teams, in which physiotherapists have been included. Studies that explore student physiotherapy training will also be considered. Qualitative, quantitative, mixed methods studies, case studies and observational studies will be included. Methods: This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews. Databases to be searched as part of this review include: Medline, SocINDEX, CINAHL and, PsycINFO, with no limitation on publication date. Google Scholar and Open-Grey will be searched for grey literature, limited to the first 100 searches. Titles and abstracts will be screened for inclusion and identified full texts reviewed independently by two reviewers. Data will be extracted using a draft data extraction tool based on the JBI data extraction tool. A chronological narrative synthesis of the data will outline how the results relate to the aims and objective of this scoping review.


2019 ◽  
Vol 31 (10) ◽  
pp. G146-G157 ◽  
Author(s):  
Samantha Machen ◽  
Yogini Jani ◽  
Simon Turner ◽  
Martin Marshall ◽  
Naomi J Fulop

ABSTRACT Purpose This scoping review explores what is known about the role of organizational and professional cultures in medication safety. The aim is to increase our understanding of ‘cultures’ within medication safety and provide an evidence base to shape governance arrangements. Data sources Databases searched are ASSIA, CINAHL, EMBASE, HMIC, IPA, MEDLINE, PsycINFO and SCOPUS. Study selection Inclusion criteria were original research and grey literature articles written in English and reporting the role of culture in medication safety on either organizational or professional levels, with a focus on nursing, medical and pharmacy professions. Articles were excluded if they did not conceptualize what was meant by ‘culture’ or its impact was not discussed. Data extraction Data were extracted for the following characteristics: author(s), title, location, methods, medication safety focus, professional group and role of culture in medication safety. Results of data synthesis A total of 1272 citations were reviewed, of which, 42 full-text articles were included in the synthesis. Four key themes were identified which influenced medication safety: professional identity, fear of litigation and punishment, hierarchy and pressure to conform to established culture. At times, the term ‘culture’ was used in a non-specific and arbitrary way, for example, as a metaphor for improving medication safety, but with little focus on what this meant in practice. Conclusions Organizational and professional cultures influence aspects of medication safety. Understanding the role these cultures play can help shape both local governance arrangements and the development of interventions which take into account the impact of these aspects of culture.


2021 ◽  
Author(s):  
Shannon Marion Aylward ◽  
Alison Farrell ◽  
Anna Walsh ◽  
Marshall Godwin ◽  
Roger Chafe ◽  
...  

BACKGROUND A strong primary care system is vital to overall health. Research on the primary care of people with autism spectrum disorder (ASD) has mostly focused on children. A synthesis of the existing literature related to the quality of primary care for the adult population with ASD would elucidate what is known about the topic as well as inform future research and clinical practice. OBJECTIVE The purpose of our scoping review is to describe what is known about the quality of primary care for adults with ASD and identify knowledge gaps. METHODS Prior to beginning the literature search, we reviewed literature related to defining both primary care and primary care quality to establish the context and concept of the research question. The search strategy was designed and executed by a research librarian. The MEDLINE, CINAHL, EMBASE, PsycINFO, and ProQuest Dissertations and Theses databases were searched for relevant literature. Grey literature will include relevant reports from government websites and associations with a focus on ASD. Two members of the research team will independently screen the academic and grey literature. Quantitative, qualitative, or mixed methods study designs involving the quality of primary care services or patient-centered care for adults with ASD are eligible for inclusion in our scoping review. Studies that make it past the full-text review will undergo data extraction and quality appraisal by 2 independent reviewers. The data extraction results will be presented in a tabular format to clearly present what is known about the quality of primary care for adults with ASD; this table will be accompanied by a narrative synthesis. Literature selected for extraction will be coded for themes, which will form the basis of a thematic synthesis. The scoping review will follow the guidance proposed by the Joanna Briggs Institute. RESULTS The search of electronic databases was conducted in October 2020, and it returned 2820 results. This research is still in progress. The results from our scoping review are expected to be available by fall 2021. CONCLUSIONS The results from our scoping review will be useful for guiding future research on the quality of primary care for adults with ASD. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/28196


10.2196/28196 ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. e28196
Author(s):  
Shannon Marion Aylward ◽  
Alison Farrell ◽  
Anna Walsh ◽  
Marshall Godwin ◽  
Roger Chafe ◽  
...  

Background A strong primary care system is vital to overall health. Research on the primary care of people with autism spectrum disorder (ASD) has mostly focused on children. A synthesis of the existing literature related to the quality of primary care for the adult population with ASD would elucidate what is known about the topic as well as inform future research and clinical practice. Objective The purpose of our scoping review is to describe what is known about the quality of primary care for adults with ASD and identify knowledge gaps. Methods Prior to beginning the literature search, we reviewed literature related to defining both primary care and primary care quality to establish the context and concept of the research question. The search strategy was designed and executed by a research librarian. The MEDLINE, CINAHL, EMBASE, PsycINFO, and ProQuest Dissertations and Theses databases were searched for relevant literature. Grey literature will include relevant reports from government websites and associations with a focus on ASD. Two members of the research team will independently screen the academic and grey literature. Quantitative, qualitative, or mixed methods study designs involving the quality of primary care services or patient-centered care for adults with ASD are eligible for inclusion in our scoping review. Studies that make it past the full-text review will undergo data extraction and quality appraisal by 2 independent reviewers. The data extraction results will be presented in a tabular format to clearly present what is known about the quality of primary care for adults with ASD; this table will be accompanied by a narrative synthesis. Literature selected for extraction will be coded for themes, which will form the basis of a thematic synthesis. The scoping review will follow the guidance proposed by the Joanna Briggs Institute. Results The search of electronic databases was conducted in October 2020, and it returned 2820 results. This research is still in progress. The results from our scoping review are expected to be available by fall 2021. Conclusions The results from our scoping review will be useful for guiding future research on the quality of primary care for adults with ASD. International Registered Report Identifier (IRRID) PRR1-10.2196/28196


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yasamin Veziari ◽  
Saravana Kumar ◽  
Matthew Leach

Abstract Background Over the past few decades, the popularity of complementary and alternative medicine (CAM) has grown considerably and along with it, scrutiny regarding its evidence base. While this is to be expected, and is in line with other health disciplines, research in CAM is confronted by numerous obstacles. This scoping review aims to identify and report the strategies implemented to address barriers to the conduct and application of research in CAM. Methods The scoping review was undertaken using the Arksey and O’Malley framework. The search was conducted using MEDLINE, EMBASE, EMCARE, ERIC, Scopus, Web of Science, The Cochrane Library, JBI and the grey literature. Two reviewers independently screened the records, following which data extraction was completed for the included studies. Descriptive synthesis was used to summarise the data. Results Of the 7945 records identified, 15 studies met the inclusion criteria. Using the oBSTACLES instrument as a framework, the included studies reported diverse strategies to address barriers to the conduct and application of research in CAM. All included studies reported the use of educational strategies and collaborative initiatives with CAM stakeholders, including targeted funding, to address a range of barriers. Conclusions While the importance of addressing barriers to the conduct and application of research in CAM has been recognised, to date, much of the focus has been limited to initiatives originating from a handful of jurisdictions, for a small group of CAM disciplines, and addressing few barriers. Myriad barriers continue to persist, which will require concerted effort and collaboration across a range of CAM stakeholders and across multiple sectors. Further research can contribute to the evidence base on how best to address these barriers to promote the conduct and application of research in CAM.


2021 ◽  
Author(s):  
Nachiket Gudi ◽  
Prashanthi Kamath ◽  
Trishnika Chakraborty ◽  
Anil G. Jacob ◽  
Shradha Parsekar ◽  
...  

BACKGROUND Data sharing from clinical trials is well recognized and has widely gained recognition amid the COVID-19 pandemic. The competing interests of powerful stakeholders expressed through data exclusivity practices make clinical trial data sharing a complex phenomenon. The wider acceptance of data sharing practices in the absence of mandated policy creates uncertainty among trial investigators to count for risks vs benefit from sharing trial data. Data sharing becomes further complex as the trial data sharing is governed by the regional policies. This drew our attention to explore policies for informed data sharing. OBJECTIVE This scoping review aimed to map the existing literature around the regulatory documents that guide trial investigators to share clinical trial data. METHODS We followed a Joanna Briggs Institute scoping review approach and have reported the article according to the PRISMA extension for Scoping reviews (PRISMA-ScR). In addition to the use of the electronic databases, a targeted website search was performed to access relevant grey literature. The articles were screened at the title-abstract and the full text stages based on the selection criteria. All the included articles for data extraction were in English language. Data extraction was done independently using a pre-tested data extraction sheet. Included literature focused on clinical trial data sharing policies, guidelines, or SOPs. A narrative synthesis approach was used to summarize the findings. RESULTS This scoping review identified four articles and 13 policy documents from the grey literature. A majority of the clinical trial agencies require an agreement for data sharing between the data requestor/organization and trial agency. None of the policy documents mandates informed consent for data sharing. The time interval to share data underlying results, varies from six to 18 months from the time of trial publication. Depending upon trial data, policies follow both controlled and open access models. Regulatory documents identified in both scientific and grey literature emphasized on good research principles of protection of privacy of participant data and data anonymization through data sharing agreement between the data requester and trial agency. Need for an informed consent and cost of data sharing, timeline to share data, incentives, or reward to promote data sharing and capacity building for data sharing have remained grey areas in these policy documents. CONCLUSIONS This paper acknowledges the vital role of clinical data sharing from a public health perspective. We found that given the challenges around clinical trial data sharing, developing a feasible mechanism for data sharing is important. We suggest that standardizing data sharing processes by framing a concise policy with key elements of data sharing mechanisms could be easier to practice rather than a rigid and comprehensive data sharing policy. CLINICALTRIAL This scoping review protocol has not been registered and published.


BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032662 ◽  
Author(s):  
Amélie Frégeau ◽  
Alexis Cournoyer ◽  
Marc-André Maheu-Cadotte ◽  
Massimiliano Iseppon ◽  
Nathalie Soucy ◽  
...  

IntroductionThere is a growing interest in developing interprofessional education (IPE) in the community of healthcare educators. Tabletop exercises (TTX) have been proposed as a mean to cultivate collaborative practice. A TTX simulates an emergent situation in an informal environment. Healthcare professionals need to take charge of this situation as a team through a discussion-based approach. As TTX are gaining in popularity, performing a review about their uses could guide educators and researchers. The aim of this scoping review is to map the uses of TTX in healthcare.Methods and analysisA search of the literature will be conducted using medical subject heading terms and keywords in PubMed, Medline, EBM Reviews (Evidence-Based Medicine Reviews), CINAHL (Cumulative Index of Nursing and Allied Health Literature), Embase and ERIC (Education Resources Information Center), along with a search of the grey literature. The search will be performed after the publication of this protocol (estimated to be January 1st 2020) and will be repeated 1 month prior to the submission for publication of the final review (estimated to be June 1st 2020). Studies reporting on TTX in healthcare and published in English or French will be included. Two reviewers will screen the articles and extract the data. The quality of the included articles will be assessed by two reviewers. To better map their uses, the varying TTX activities will be classified as performed in the context of disaster health or not, for IPE or not and using a board game or not. Moreover, following the same mapping objective, outcomes of TTX will be reported according to the Kirkpatrick model of outcomes of educational programs.Ethics and disseminationNo institutional review board approval is required for this review. Results will be submitted for publication in a peer-reviewed journal. The findings of this review will inform future efforts to TTX into the training of healthcare professionals.


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