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Integrating Preconception Risk Assessment and Counseling with Primary Health Care: A Feasibility Assessment medRxiv. Prim. Care Res. Pub Date : 2024-04-19 Anne L. Dunlop, Susana Alfonso, Nora Hansen, Dionne Williams, Ariela L. Marshall, Victoria M. Anderson
Background Professional association recommendations call for integrating preconception health promotion with primary care, yet there are scarce tools and implementation research to support practices in doing so.
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Monitoring Report: GLP-1 RA Prescribing Trends - March 2024 Data medRxiv. Prim. Care Res. Pub Date : 2024-04-18 Samuel Gratzl, Patricia J Rodriguez, Brianna M Goodwin Cartwright, Charlotte Baker, Duy Do, Nicholas L Stucky
Background Limited recent data exist on prescribing patterns and patient characteristics for glucagon-like peptide 1 receptor agonists (GLP-1 RAs), an important drug class used as anti-diabetic medication (ADM) for patients with type 2 diabetes mellitus (T2D) and/or anti-obesity medication (AOM) in patients with overweight or obesity.
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Effects of the Covid-19 pandemic on the continuity of sexual and reproductive health care in the maternity ward of a health and social promotion centre in Burkina Faso: a qualitative study medRxiv. Prim. Care Res. Pub Date : 2024-04-15 Patrice Ngangue, Mariam Ahmat Mahamat, Danièle Sandra Yopa, Gbètogo Maxime Kiki, Nestor Bationo, Douglas Mbang Massom, Josiane Seu, Birama Apho Ly
Background The COVID-19 pandemic has significantly impacted the continuity of maternity care in Burkina Faso. This study aimed to compare the volumes of in-person visits and to explore the experiences of healthcare providers and users regarding the continuity of healthcare in the maternity ward of a Health and Social Promotion Center (HSPC) before, during and after the lockdown during the COVID-19
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Judgements about carer assessments for carers of people with dementia: case vignette study medRxiv. Prim. Care Res. Pub Date : 2024-04-13 Paul Clarkson, Lucie Mills, Asif Butt, Baber Malik, Ruth Eley, Cecilia Toole, Caroline Sanders, Ian Sheriff
Objectives UK carer assessments, in primary and social care, intend to discover what carers need in their caring roles and more widely. Evidence points to these not being configured sufficiently around carers of people with dementia, with potentially their breadth of needs not being recognised. We evaluated the extent of agreement, between carers of people with dementia, primary care, and social care
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Telehealth versus face-to-face delivery of speech language pathology services: a systematic review and meta-analysis medRxiv. Prim. Care Res. Pub Date : 2024-04-10 Anna Mae Scott, Justin Clark, Magnolia Cardona, Tiffany Atkins, Ruwani Peiris, Hannah Greenwood, Rachel Wenke, Elizabeth Cardell, Paul Glasziou
Background There is an increasing demand for the provision of speech language pathology (SLP) services via telehealth. Therefore, we systematically reviewed randomized controlled trials comparing telehealth to face-to-face provision of SLP services.
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Reach and effectiveness of a HEARTS hypertension control pilot project in Guatemala medRxiv. Prim. Care Res. Pub Date : 2024-04-05 Irmgardt Alicia Wellmann, José Javier Rodríguez, Benilda Batzin, Guillermo Hegel, Luis Fernando Ayala, Kim Ozano, Meredith P. Fort, Walter Flores, Lesly Ramirez, Eduardo Palacios, Mayron Martínez, Manuel Ramirez-Zea, David Flood
The World Health Organization’s HEARTS Technical Package aims to improve the primary care management of hypertension and other cardiovascular risk disease factors at the population level. This study describes the first HEARTS implementation project in the Ministry of Health primary care system in Guatemala. This pilot project was implemented from April to December 2022 in 6 primary health facilities
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A Novel Intervention to Increase Postpartum Primary Care Engagement: A Randomized Clinical Trial medRxiv. Prim. Care Res. Pub Date : 2024-04-04 Mark A. Clapp, Alaka Ray, Pichliya Liang, Kaitlyn E. James, Ishani Ganguli, Jessica Cohen
Importance Over 30% of pregnant people have at least one chronic medical condition, and nearly 20% develop gestational diabetes or pregnancy-related hypertension, increasing the risk of future chronic disease. While these individuals are often monitored closely during pregnancy, they face significant barriers when transitioning to primary care following delivery, due in part to a lack of health care
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A grounded theory study of beliefs underlying use of ancestral spirits for healing among Baganda traditional spiritual healers in Central Uganda medRxiv. Prim. Care Res. Pub Date : 2024-04-03 Yahaya H. K. Sekagya, Charles Muchunguzi, Payyappallimana Unnikrishnan, Edgar M. Mulogo
The increasing global sensitivity to spirituality in medicine and sociology has elevated the relevance of beliefs in ancestral spirits as an integral element in Africa’s multi-ethnic society and biocultural diversity for health management. However, ancestral spirituality in healthcare in the local context, remains sparse and elusive since most literature relates spirituality with religion and religious
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Perspectives on health, illness, disease and management approaches among Baganda traditional spiritual healers in Central Uganda medRxiv. Prim. Care Res. Pub Date : 2024-04-02 Yahaya H. K. Sekagya, Charles Muchunguzi, Payyappallimana Unnikrishnan, Edgar M. Mulogo
In Uganda, spirituality is closely associated with traditional healthcare; however, though prevalent, it is considered controversial, mystical, less-documented and often misunderstood. There is a paucity of literature on the description of health, illness, disease, and management approaches among traditional spiritual healers. This article examines perspectives on health, illness, disease and management
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Facilitators and barriers in the use of the electronic consultation register for Integrated Management of Childhood Illness in the health district of Toma, Burkina Faso: Perspectives of health care providers medRxiv. Prim. Care Res. Pub Date : 2024-04-01 Ngangue Patrice, Saouadogo Issaka, Kaboré Soutongnoma Safiata, Mbang Massom Douglas, Bationo Nestor, Josiane Seu, Birama Apho Ly
Background In collaboration with the Ministry of Health and Public Hygiene (MHPH) of Burkina Faso (BF), the Foundation Terre des Hommes (Tdh) has developed the Integrated e-Diagnostic Approach (IeDA) project in BF since 2010 to strengthen the health system by digitalizing medical protocols, improving the quality of services and using data. We sought to identify and analyze the barriers and facilitators
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Ethnic inequalities in primary care for people with multiple long-term conditions: evidence from the General Practice Patient Survey medRxiv. Prim. Care Res. Pub Date : 2024-04-01 Brenda Hayanga, Mai Stafford, Laia Bécares
Objective To examine the relationship between ethnicity and experiences of primary care for people with multiple long-term conditions (MLTCs) and assess the relative importance of demographic, practice, and area-level factors as influences on primary care experiences across ethnic groups.
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Design of a Clinical Balance Tool for Fall Risk Assessments: A Development and Usability Study medRxiv. Prim. Care Res. Pub Date : 2024-03-30 Jennifer Hornung Garvin, Virginia M. Yazzie, Natalie A. Katsuyama, Truman Rudloff, Lise C. Worthen-Chaudhari, Ajit M.W. Chaudhari
Background Falls are a significant source of early morbidity and mortality in the aging population, yet clinical changes that lead to increased fall risks often escape early identification and intervention. A device to measure postural control would facilitate evidence-based fall risk assessment.
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Educational interventions to combat burnout: Are General Practitioners interested? A Qualitative Study medRxiv. Prim. Care Res. Pub Date : 2024-03-28 Darius Benedict Williams
Background Rising burnout in General Practitioners has been noted as a major issue worldwide that is contributing to many leaving the profession earlier than anticipated or reducing their hours of clinical work. Educational interventions as part of continuing professional development (CPD) have been shown to be effective in reducing burnout and improving overall wellbeing amongst GPs. There is no published
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Health outcome priorities of people with multiple long-term conditions before and during the COVID-19 pandemic: Survey data from the UK medRxiv. Prim. Care Res. Pub Date : 2024-03-26 Harini Sathanapally, Yogini Chudasama, Francesco Zaccardi, Alessando Rizzi, Samuel Seidu, Kamlesh Khunti
Background The outcome prioritisation tool (OPT) is a simple tool to ascertain the health outcome priorities of people with MLTC. Use of this tool in people aged under 65 years with MLTC has not previously been investigated. This study investigated the feasibility of using the OPT in people with MLTC aged 45 years or above, in a multi-ethnic primary-care setting, to describe the health outcome priorities
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Navigating primary health care challenges: Insights from older people with multimorbidity in Malawi. medRxiv. Prim. Care Res. Pub Date : 2024-03-24 Duncan Pagwansuko Kwaitana, Maya Jane Bates, Esnath Msowoya, Dorothee Van Breevoort, Thomas Mildestvedt, Eivind Meland, Eric Umar
The global population is undergoing a significant surge in aging leading to increased susceptibility to various forms of progressive illnesses. This phenomenon significantly impacts both individual health and healthcare systems. Low and Middle Income Countries face particular challenges, as their Primary Health Care (PHC) settings often lack the necessary human and material resources to effectively
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Persistence of S1 Spike Protein in CD16+ Monocytes up to 245 Days in SARS-CoV-2 Negative Post COVID-19 Vaccination Individuals with Post-Acute Sequalae of COVID-19 (PASC)-Like Symptoms medRxiv. Prim. Care Res. Pub Date : 2024-03-24 Ram Yogendra, Bruce K Patterson, Brian Francisco, Emily Long, Amruta Pise, Eric Osgood, John Bream, Mark Kreimer, Devin Jeffers, Christopher Beaty, Richard Vander Heide, Jose Guevara, Rodrigo Mora-Rodriguez
There have been concerning reports about people experiencing new onset persistent complications (greater than 30 days) following approved SARS-CoV-2 vaccines (BNT162b2 (Pfizer), mRNA-1273 (Moderna), Janssen (Johnson and Johnson), and ChAdOx1 nCoV-19 (AstraZeneca)). We sought to determine the immunologic abnormalities in these patients and to investigate whether the potential etiology was similar to
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A Wearable In-pad Diagnostic for the Detection of Disease Biomarkers in Menstruation Blood medRxiv. Prim. Care Res. Pub Date : 2024-03-24 Lucas Dosnon, Thomas Rduch, Charlotte Meyer, Inge K. Herrmann
The pain-free regular monitoring of blood-based biomarkers is a highly appealing yet difficult-to-realize approach for the early detection of pathological changes, including cancers, infections, or metabolic diseases, such as diabetes. While a major focus of the research community lies on the investigation of pain-free blood sampling and devices for venous blood analysis, menstruation blood remains
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Interventions to reduce opioid use for patients with chronic non-cancer pain in primary care settings: a systematic review and meta-analysis medRxiv. Prim. Care Res. Pub Date : 2024-03-18 Qian Cai, Christos Grigoroglou, Thomas Allen, Teng-Chou Chen, Li-Chia Chen, Evangelos Kontopantelis
Abstract Objective: This systematic review and meta-analysis aimed to assess interventions to reduce opioid use for patients with chronic non-cancer pain (CNCP) versus usual care or active controls in primary care settings. Methods: In this registered study (PROSPERO: CRD42022338458), we searched MEDLINE, Embase PsycInfo, CINAHL, and Cochrane Library from inception to December 28th 2021, and updated
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Comparative safety and effectiveness of Pfizer BA.4-5 versus Sanofi during the spring 2023 COVID-19 booster vaccination programme in England: a matched cohort study in OpenSAFELY-TPP medRxiv. Prim. Care Res. Pub Date : 2024-03-16 The OpenSAFELY Collaborative, Colm D Andrews, Em Prestige, Edward P K Parker, Venexia Walker, Tom Palmer, Andrea L Schaffer, Amelia CA Green, Helen J Curtis, Alex J Walker, Rebecca M Smith, Christopher Wood, Christopher Bates, Amir Mehrkar, Brian MacKenna, Sebastian CJ Bacon, Ben Goldacre, Miguel A Hernan, Jonathan AC Sterne, William J Hulme
Introduction The spring 2023 COVID-19 booster vaccination programme in England used both Pfizer BA.4-5 and Sanofi vaccines. All people aged 75 years or over and the clinically vulnerable were eligible to receive a booster dose. Direct comparisons of the effectiveness of these two vaccines in boosting protection against severe COVID-19 events have not been made in trials or observational data. Methods
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Discontinuity of care and trust in usual physician among patients with systemic lupus erythematosus medRxiv. Prim. Care Res. Pub Date : 2024-03-15 Yu Katayama, Yoshia Miyawaki, Kenta Shidahara, Shoichi Nawachi, Yosuke Asano, Eri Katsuyama, Takayuki Katsuyama, Mariko Takano-Narazaki, Yoshinori Matsumoto, Nao Oguro, Nobuyuki Yajima, Yuichi Ishikawa, Natsuki Sakurai, Chiharu Hidekawa, Ryusuke Yoshimi, Shigeru Ohno, Takanori Ichikawa, Dai Kishida, Yasuhiro Shimojima, Ken-ei Sada, Jun Wada, David Thom, Noriaki Kurita
Importance: Patient trust plays a central role in the patient-physician relationship; however, the impact of outpatient visits with a covering physician (covered visits) on the level of trust in usual physician among patients with chronic conditions is unknown. Objective: To determine whether the number of outpatient visits with a covering rheumatologist is associated with patient trust in the usual
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Comparison of telephone and in-person interview modalities: duration, richness, and costs in the context of exploring determinants of equitable access to community health services in Meru, Kenya medRxiv. Prim. Care Res. Pub Date : 2024-03-15 Luke N. Allen, Sarah Karanja, John Tlhakanelo, David Macleod, Malebogo Tlhajoane, Andrew Bastawrous
Background: Our research team is conducting phenomenological interviews in Kenya with people who have not been able to access community eye health services, aiming to explore the barriers and ideas for potential service modifications. We conducted an embedded study that compared in-person and telephone interview modalities in terms of time requirements, costs, and data richness. Methods: A team of
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Molecular hydrogen for outpatients with Covid-19 (Hydro-Covid): a phase 3, randomised, triple-blinded, adaptive, placebo-controlled, multicentre trial medRxiv. Prim. Care Res. Pub Date : 2024-03-05 Yoann GABOREAU, Aleksandra Milovancev, Carole Rolland, Claire Eychenne, Jean-pierre Alcaraz, Cordelia Ihl, Roseline Mazet, Francois Boucher, Celine Vermorel, Sergej M Ostojic, Jean Christian Borel, Philippe Cinquin, Jean-Luc Bosson
Background Due to its antioxidative, anti-inflammatory, anti-apoptosis, and antifatigue properties, molecular hydrogen (H2) is potentially a novel therapeutic gas for acute coronavirus disease 2019 (COVID-19) patients. Aim To determine the efficacy and safety profile of hydrogen rich water (HRW) to reduce the risk of progression of COVID-19. Design and settings We conducted a phase 3, triple-blind
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Implementing remote monitoring for COVID-19 patients in primary care medRxiv. Prim. Care Res. Pub Date : 2024-02-29 Susanne M. Koehler, Svea Holtz, Peter Jan Chabiera, Nurlan Dauletbaev, Kim Deutsch, Zoe S. Oftring, Dennis Lawin, Lukas Niekrenz, Teresa Euler, Rainer Gloeckl, Rembert Koczulla, Gernot Rohde, Michael Dreher, Claus F. Vogelmeier, Sebastian Kuhn, Beate Sigrid Mueller
Background In Germany, most patients with coronavirus disease 2019 (COVID-19) are treated in an outpatient setting. To improve assessments of the health status of COVID-19 outpatients, various remote monitoring models have been developed. However, little information exists on experiences acquired with remote monitoring in an outpatient setting, particularly from a patient perspective. The aim of our
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Effectiveness of DiabeText, a mHealth intervention to support diabetes self-management: randomized controlled trial in primary care medRxiv. Prim. Care Res. Pub Date : 2024-02-29 Rocio Zamanillo-Campos, Maria Antonia Fiol-deRoque, Maria Jesus Serrano-Ripoll, Joan Llobera-Canaves, Joana Maria Taltavull-Aparicio, Alfonso Leiva-Rus, Joana Ripoll-Amengual, Escarlata Angullo-Martinez, Isabel Maria Socias-Buades, Luis Masmiquel-Comas, Jadwiga Konieczna, Maria Zaforteza-Dezcallar, Maria Asuncion Boronat-Moreiro, Sofia Mira-Martinez, Elena Gervilla-Garcia, Ignacio Ricci-Cabello
Background: Complications arising from uncontrolled Type 2 Diabetes (T2D) poses a significant burden on individuals' well-being and healthcare resources. Digital interventions may play a key role in mitigating such complications by supporting patients to adequately self-manage their condition. Aim: To assess the impact of DiabeText, a new theory-based, patient-centered, mobile health intervention integrated
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Investigating a structured diagnostic approach for chronic breathlessness in primary care: a mixed-methods feasibility cluster Randomised Controlled Trial medRxiv. Prim. Care Res. Pub Date : 2024-02-23 Gillian Doe, Jill Clanchy, Simon Wathall, Shaun Barber, Sarah Edwards, Helen Evans, Darren Jackson, Natalie Armstrong, Michael Steiner, Rachael A Evans
Background There is need to reduce delays to diagnosis for chronic breathlessness to improve patient outcomes.
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Could behaviour change techniques be used to address under-recognition of work-related asthma in primary care? A systematic review medRxiv. Prim. Care Res. Pub Date : 2024-02-23 GI Walters, H Foley, CC Huntley, A Naveed, K Nettleton, C Reilly, M Thomas, C Walker, K Wheeler
Introduction Work-related asthma (WRA) is prevalent yet under-recognized in UK primary care. The aim of this systematic review was to identify behaviour change interventions (BCI) intended for use in a primary care setting to identify any chronic disease, that may be used in the context of WRA. The study was registered on the PROPSPERO database (19/04/2023; CRD42023418316) and received no funding.
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Additional Roles Reimbursement Scheme commissioning 2020-2023: associations with patient experience and QOF medRxiv. Prim. Care Res. Pub Date : 2024-02-23 Chris Penfold, Jialan Hong, Peter J Edwards, Mavin Kashyap, Chris Salisbury, Ben Bennett, John Macleod, Maria Theresa Redaniel
Background The Additional Roles Reimbursement Scheme (ARRS) was introduced by NHS England in 2020 alongside Primary Care Networks (PCNs) with aims of increasing the workforce and improving patient outcomes.
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Automated visual acuity estimation by optokinetic nystagmus using a stepped sweep stimulus. medRxiv. Prim. Care Res. Pub Date : 2024-02-20 Jason Turuwhenua, Mohammad Norouzifard, Zaw LinTun, Misty Edmonds, Rebecca Findlay, Joanna Black, Benjamin Thompson
Purpose: Measuring visual acuity (VA) can be challenging in adults with cognitive impairment and young children. We developed an automatic system for measuring VA using Optokinetic Nystagmus (OKN). Methods: VA-OKN and VA by ETDRS (VA-ETDRS) were measured monocularly in healthy participants (n=23, age 30±12). VA was classified as reduced (n=22, >0.2 logMAR) or not (n=24, ≤0.2 logMAR) in each eye. VA-OKN
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Predicting intentions towards long-term antidepressant use in the management of people with depression in primary care: A longitudinal survey study medRxiv. Prim. Care Res. Pub Date : 2024-02-20 Rachel Dewar-Haggart, Ingrid Muller, Felicity Bishop, Adam Geraghty, Beth Stuart, Tony Kendrick
Background Over the last two decades, antidepressant prescribing in the UK has increased considerably, due to an increased number of people staying on antidepressants for longer. Even when treatment is no longer clinically indicated, qualitative research suggests many people continue due to a fear of depressive relapse or antidepressant withdrawal symptoms. The quantitative effects of peoples’ beliefs
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Screening Accuracy and Age-based Scoring Procedures of the Polish Version of Communication and Symbolic Behavior Scales-Developmental Profile Infant-Toddler Checklist medRxiv. Prim. Care Res. Pub Date : 2024-02-17 Mateusz Sobieski, Anna Kopszak, Sylwia Wrona, Maria Magdalena Bujnowska-Fedak
Background The first stage of diagnosing autism spectrum disorders usually involves population screening to detect children at risk. The aim of this study was to develop cut-off points and assess diagnostic properties for the Polish version of the Communication and Symbolic Behavior Scales-Developmental Profile – Infant-Toddler Checklist for the possibility of using this questionnaire in population
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The association between time-weighted remnant cholesterol and cardiovascular and non-cardiovascular mortality: A population-based cohort study medRxiv. Prim. Care Res. Pub Date : 2024-02-09 Lifang Li, Vanessa Chou, Oscar Hou In Chou, Sakshi Roy, Jeffrey Shi Kai Chan, Wing Tak Wong, Tong Liu, Gregory Y.H. Lip, Bernard M.Y. Cheung, Gary Tse, Jiandong Zhou
Background: Remnant cholesterol (RC) have been suggested as a significant mediator of atherosclerotic cardiovascular diseases. However, the relationship between RC with cause-specific mortality in long-term remained uncertain. This study aimed to investigate the association between time-weighted RC and cause-specific mortality outcomes. Methods: This retrospective population-based study enrolled patients
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Telephone training to improve ECG quality in remote screening for atrial fibrillation medRxiv. Prim. Care Res. Pub Date : 2024-02-08 Kethaki Prathivadi Bhayankaram, Jonathan Mant, James Brimicombe, Andrew Dymond, Kate Williams, Peter H. Charlton, SAFER authorship group
Background and Aims Self-recorded, single-lead ECGs are increasingly used to diagnose arrhythmias. However, they can be of variable quality, which can affect the reliability of interpretation. In this analysis of ECGs collected in atrial fibrillation screening studies, our aims were to: (i) determine the quality of ECGs when recorded unsupervised (at home); and (ii) investigate whether telephone training
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Effects of intervention stage completion in an integrated behavioral health and primary care randomized pragmatic intervention trial medRxiv. Prim. Care Res. Pub Date : 2024-02-08 Kari A. Stephens, Constance van Eeghen, Zihan Zheng, Tracy Anastas, Kris Pui Kwan Ma, Maria G. Prado, Jessica Clifton, Gail Rose, Daniel Mullin, Kwun C. G. Chan, Rodger Kessler
Purpose A pragmatic, cluster-randomized controlled trial of a comprehensive practice-level, multi-staged practice transformation intervention aimed to increase behavioral health integration in primary care practices and improve patient outcomes. We examined association between the completion of intervention stages and patient outcomes across a heterogenous national sample of primary care practices
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Impact of a team-based versus individual clinician-focused training approach on primary healthcare professionals’ intention to have serious illness conversations with patients: a theory informed process evaluation of a cluster randomized trial medRxiv. Prim. Care Res. Pub Date : 2024-02-07 Lucas Gomes Souza, Patrick Archambault, Dalil Asmaou Bouba, Suélène Georgina Dofara, Sabrina Guay-Bélanger, Sergio Cortez Ghio, Souleymane Gadio, LeAnn Michaels, Jean-Sébastien Paquette, Shigeko (Seiko) Izumi, Annette M. Totten, France Légaré, The Meta-LARC ACP Cluster Randomized Trial team
Background Cluster Randomized Trials (cRTs) conducted in real-world settings face complex challenges due to diverse practices and populations. Process evaluations alongside cRTs can help explain their results by exploring possible causal mechanisms as the trial proceeds.
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Renal Profile of Herbal Medicine Users versus Non-users: an Exploratory Cross-sectional Study in a Family Medicine Clinic in Nigeria medRxiv. Prim. Care Res. Pub Date : 2024-02-03 Afisulahi Abiodun Maiyegun, Mark Divine Akangoziri, Bukar Alhaji Grema, Yahkub Babatunde Mutalub, Farida Buhari Ibrahim
ABSTRACT Background A major risk of herbal medicine is the potential for toxicity and serious side effects. Unlike orthodox medicine, herbs are usually consumed without prior safety assessment via clinical studies. This means the clinical effects of herbs may be detected only through an assessment of health parameters of consumers. Objective: To evaluate participants' renal profile, comparing that
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Patterns of Herbal Medicine Use in a General Outpatient Clinic in Nigeria- A Cross-sectional Study medRxiv. Prim. Care Res. Pub Date : 2024-01-31 Afisulahi Abiodun Maiyegun, Mark D Akangoziri, Bukar A Grema, Yahkub B Mutalub, Farida B Ibrahim, AbdulRauf S Ibraheem
Background: Herbal medicine use remains an important part of primary care and the World Health Organization has mandated member countries to conduct research into this and other forms of traditional medicine. However, research into traditional medicine remains scanty, even in the developing where it is often a major health option. Objective: to determine the prevalence, types and sources of herbal
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Characteristics of Walk-In Clinic Physicians and Patients in Ontario, Canada: A Cross-Sectional Study medRxiv. Prim. Care Res. Pub Date : 2024-01-17 Lauren Lapointe-Shaw, Christine Salahub, Peter C. Austin, Li Bai, Sundeep Banwatt, Simon Berthelot, R. Sacha Bhatia, Cherryl Bird, Laura Desveaux, Tara Kiran, Aisha Lofters, Malcolm Maclure, Danielle Martin, Kerry A. McBrien, Rita K. McCracken, J. Michael Paterson, Bahram Rahman, Jennifer Shuldiner, Mina Tadrous, Braeden A. Terpou, Niels Thakkar, Ruoxi Wang, Noah M. Ivers
Objective We aimed to describe family physicians who primarily practice in a walk-in clinic setting and compare them to family physicians who provide longitudinal care.
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Primary care access and feasibility of Spatial Accessibility Index (SAI) in assessing primary care in rural Sri Lanka medRxiv. Prim. Care Res. Pub Date : 2024-01-12 Parami Abeyrathna, Suneth Buddhika Agampodi, Manjula Weerasinghe, Shyamalee Samaranayake, Pahala Hangidi Gedara Janaka Pushpakumara
Despite decades of global health efforts and policies, inequitable access to primary care in low and middle-income countries remains an ongoing challenge. This study assessed accessibility to curative sector-primary healthcare services in the Anuradhapura district of Sri Lanka in 2020 and 2021. In this study, we included both private and state-owned primary care facilities (PCF) and their corresponding
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Patient and family engagement interventions on patients’ safety in primary care: a systematic review and meta-analysis medRxiv. Prim. Care Res. Pub Date : 2024-01-11 Yan Pang, Anna Szücs, Ignacio Ricci Cabello, Jaheeda Gangannagaripalli, Lay Hoon Goh, Foon Leng Leong, Li Fan Zhou, Jose M. Valderas
Background Engaging patients and their families has been proposed and promoted as key strategy in patient safety. However, little is known about the translation of such an approach in primary care. This systematic review and meta-analysis sought to assess the effectiveness of interventions promoting patient and family engagement for patient safety in primary care based on randomised controlled trials
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Multimorbidity in Older Adults with Depression Study (MODS) (Behavioural Activation to improve physical and mental functioning among older people with multiple long-term conditions): Protocol for a fully powered randomised controlled trial medRxiv. Prim. Care Res. Pub Date : 2024-01-11 Eloise Ryde, Kelly Hollingsworth, Elizabeth Littlewood, Lucy Atha, Della Bailey, Heather Baker, Katharine Bosanquet, Leanne Shearsmith, Carolyn A. Chew-Graham, Dean McMillan, Kalpita Baird, Peter Coventry, Suzanne Crosland, Caroline Fairhurst, Han-I Wang, Lauren Burke, Janine Heeley, Catherine Hewitt, Andrew Clegg, Tom Gentry, Andrew Hill, Karina Lovell, Sarah Dexter-Smith, Gemma Traviss-Turner, Judith
Introduction Older adults (65 years or over) and those with long-term health conditions (LTCs), represent a ‘high risk’ group for depression, with a risk two-to-three times the general population. This can lead to poorer quality of life and be costly to health and social care services. In the Multimorbidity in Older Adults with Depression Study (MODS) we will test whether a brief psychological intervention
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Determining the feasibility of calculating pancreatic cancer risk scores for people with new-onset diabetes in primary care (DEFEND PRIME): study protocol medRxiv. Prim. Care Res. Pub Date : 2024-01-05 Hugh Claridge, Claire A. Price, Rofique Ali, Elizabeth A. Cooke, Simon de Lusignan, Adam Harvey-Sullivan, Catherine Hodges, Natalia Khalaf, Dean O’Callaghan, Ali Stunt, Spencer A. Thomas, Joanna Thomson, Agnieszka Lemanska
Introduction Worldwide, pancreatic cancer has a poor prognosis. Early diagnosis may improve survival by enabling curative treatment. Statistical and machine learning diagnostic prediction models using risk factors such as patient demographics and blood tests are being developed for clinical use to improve early diagnosis. One example is the Enriching New-onset Diabetes for Pancreatic Cancer (ENDPAC)
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The Sensation and Pain Rating Scale: easy to use, clear to interpret, and responsive to clinical change medRxiv. Prim. Care Res. Pub Date : 2024-01-09 Victoria J Madden, Peter Kamerman, Hayley B Leake, Mark J Catley, Lauren C Heathcote, Lorimer G Moseley
Background: The Sensation and Pain Rating Scale (SPARS) allows rating of non-painful as well as painful percepts. While it performs well in the experimental context, its clinical utility is untested. This prospective, repeated-measures study mixed qualitative and quantitative methods to examine the utility and performance of the SPARS in a clinical context, and to compare it with the widely used 11-point
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A Human Factors Approach to Childhood Pneumonia A qualitative study in Malawian primary care medRxiv. Prim. Care Res. Pub Date : 2024-01-03 Balwani Mbakaya, Master R.O. Chisale, Tsung-Shu Joseph Wu, Mark T Ledwidge, Billy Nyambalo, Chris Watson, Joe Gallagher
Introduction Pneumonia is one of the major causes of childhood mortality worldwide. Most of these deaths are readily preventable or treatable with proven cost effective interventions. The aim of this study is to investigate the assessment and management of childhood pneumonia in primary care in Malawi.
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Comparative Analysis of Three Surveys on Primary Care Providers’ Experiences with Interoperability and Electronic Health Records medRxiv. Prim. Care Res. Pub Date : 2024-01-03 Nathaniel Hendrix, Natalya Maisel, Jordan Everson, Vaishali Patel, Andrew Bazemore, Lisa S. Rotenstein, A Jay Holmgren, Alex H. Krist, Julia Adler-Milstein, Robert L. Phillips
Objective This study compared primary care physicians’ self-reported experiences with Electronic Health Records’ (EHR) interoperability, as reported across three surveys: the 2022 Continuous Certification Questionnaire (CCQ) from the American Board of Family Medicine, the 2022 University of California San Francisco’s (UCSF) Physician Health IT Survey, and the 2021 National Electronic Health Records
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Profiling an integrated network of cellular senescence and immune resilience measures in natural aging: a prospective multi-cohort study medRxiv. Prim. Care Res. Pub Date : 2023-12-28 Natalia Mitin, Amy Entwistle, Anne Knecht, Susan L. Strum, Allison Ross, Kirsten Nyrop, Hyman B. Muss, Denis Tsygankov, Joseph M. Raffaele
Background Biological aging begins decades before the onset of age-related clinical conditions and is mediated by both cellular senescence and declining adaptive immune function. These processes are functionally related with the rate of senescent cell accumulation dependent upon a balance between induction and immune clearance. We previously showed that biomarkers in these domains can identify patients
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Beyond the medical file: a scoping review on patients’ perspectives on guideline-oriented depression treatment in primary care medRxiv. Prim. Care Res. Pub Date : 2023-12-27 Katharina Biersack, Heribert Sattel, Petra Schönweger, Lea Kaspar, Nadine Lehnen, Jochen Gensichen, Peter Henningsen, the POKAL group
Objectives Depressive disorders are common in the primary care setting. Primary care practitioners must deal with different disorders and keep up with evidence-based treatment. Clinical practice guidelines (CPG) offer accessible information about up-to-date care but are poorly implemented. Research on the implementation of CPGs has focused on the practitioners’ perspective but has neglected the patients’
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Implementation of Evidence-Based Medicine in Primary Care Through the Use of Encounter Shared Decision Making Tools: The ShareEBM Pragmatic Trial medRxiv. Prim. Care Res. Pub Date : 2023-12-21 Annie LeBlanc, Megan E Branda, Jason Egginton, Jonathan Inselman, Sara Dick, Janet Schuerman, Jill Kemper, Nilay Shah, Victor Montori
BACKGROUND: While decision aids have been proven effective to facilitate patient-centered discussion about evidence-based health information in practice and enable shared decision making (SDM), a chasm remains between the promise and the use of these SDM tools in practice. AIMS: To promote evidence-based patient-centered care in primary care by using encounter SDM tools for medication management of
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Assessing the usability of the new automated medication dispensation device for patients and the adherence dashboard for real-time medication monitoring for healthcare providers: a study protocol medRxiv. Prim. Care Res. Pub Date : 2023-12-17 Tejal Patel, Christoph Laeer, Hamed Darabi, Maxime Lachance, Michelle Anawati, Marie-Hélène Chomienne
Background Non-adherence to prescribed medication regimens can lead to suboptimal control of chronic health conditions and increased hospitalizations. Older adults may find it particularly challenging to self-manage medications due to physical and cognitive limitations resulting in medication non-adherence. While automated medication dispensing technologies may offer a solution for medication self-management
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A Clinical Audit on Longer-Term Stroke Management as A Specific Service in A Primary Care Setting: Assessing Adherence of Service and Clinical Parameters medRxiv. Prim. Care Res. Pub Date : 2023-12-14 Gadaffi Mostapha, Noor Azah Abd Aziz, Mohd Fairuz Ali
Background Primary-care long-term stroke care service offers comprehensive management at the community level. A clinical audit was carried out to assess the services of this clinic as compared to the established standardized criteria for longer-term stroke care.
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Outcomes of Antiplatelet Therapy Continuation in Older Hypertensive Adults With Peptic Ulcer Disease medRxiv. Prim. Care Res. Pub Date : 2023-12-13 Yi-Tsang Lan, Kar-Chun Lim, Chung-Yu Ho, Ying-Ting Chao, Tsung-Yi Yen, Ming-Feng Shih, Chien-Hsieh Chiang
Background The appropriateness of continuation of antiplatelet therapy in older hypertensive aspirin users with documented peptic ulcer disease (PUD) is uncertain.
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Prevalence, risks and outcomes of frailty in People Experiencing Homelessness: a protocol for secondary analysis of Health Needs Audit data medRxiv. Prim. Care Res. Pub Date : 2023-12-09 Jo Dawes, Kate Walters, Rachael Frost, Emmanouil Bagkeris, Alexandra Burton, Debra Herzberg, Andrew Hayward
Frailty describes a health state related to ageing where people become less resilient to health challenges and more likely to have adverse outcomes if they become unwell. People experiencing homelessness (PEH) are known to have poor health, with research suggesting that many become frail at a younger age than the general population. Previous research using small-scale primary data collection suggests
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WITHDRAWN: Screening for Poverty And Related Social determinants to improve Knowledge of and links to resources (SPARK): development and cognitive testing of a tool for primary care medRxiv. Prim. Care Res. Pub Date : 2023-12-08 Itunuoluwa Adekoya, Alannah Delahunty-Pike, Dana Howse, Leanne Kosowan, Zita Seshie, Eunice Abaga, Jane Cooney, Marjeiry Robinson, Dorothy Senior, Alexander Zsager, Kris Aubrey-Bassler, Frederick Burge, Mandi Irwin, Lois Jackson, Alan Katz, Emily Marshall, Nazeem Muhajarine, Cory Neudorf, Andrew D Pinto
The authors have withdrawn this manuscript owing to one of the authors, Lynn Thompson, no longer standing by her participation in this work. Therefore, the authors do not wish this work to be cited as reference for the project. The remaining authors have since published the work in BMC Primary Care: Adekoya, I., Delahunty-Pike, A., Howse, D. et al. Screening for poverty and related social determinants
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A systematic review of Flotation-Restricted Environmental Stimulation Therapy (REST) medRxiv. Prim. Care Res. Pub Date : 2023-11-30 Elnaz Lashgari, Emma Chen, Jackson Gregory, Uri Maoz
Background Restricted Environmental Stimulation Therapy (REST) is a therapeutic technique that involves immersing an individual in an environment with minimal sensory input or stimulation. The goal of REST is to induce a state of relaxation that is deeper than what can be achieved through other forms of relaxation techniques. Research suggests that REST can help reduce anxiety, alleviate chronic pain
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Barriers and enablers to improving integrated primary healthcare for non-communicable diseases and mental health conditions in Ethiopia: a mixed methods study medRxiv. Prim. Care Res. Pub Date : 2023-11-22 Alemayehu Bekele, Atalay Alem, Nadine Seward, Tigist Eshetu, Tewodros Haile Gebremariam, Yeneneh Getachew, Wondosen Mengiste, Girmay Medhin, Lara Fairall, Nick Sevdalis, Martin Prince, Abebaw Fekadu, Charlotte Hanlon
Background The Ethiopian Primary Healthcare Clinical Guidelines (EPHCG) seek to improve quality for people with Non-Communicable Diseases and Mental Health Conditions (NCDs-MHCs) and provide an integrated approach to multi-morbidity. The aim of this study was to identify barriers and enablers to implementation of the EPHCG with a particular focus on NCDs-MHCs.
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Consistency, completeness and external validity of ethnicity recording in NHS primary care records: a cohort study in 25 million patients’ records at source using OpenSAFELY medRxiv. Prim. Care Res. Pub Date : 2023-11-22 The OpenSAFELY Collaborative, Colm D Andrews, Rohini Mathur, Jon Massey, Robin Park, Lisa Hopcroft, Helen J Curtis, Amir Mehrkar, Seb Bacon, George Hickman, Rebecca Smith, David Evans, Tom Ward, Simon Davy, Peter Inglesby, Iain Dillingham, Steven Maude, Thomas O’Dwyer, Ben Butler-Cole, Lucy Bridges, Chris Bates, John Parry, Frank Hester, Sam Harper, Jonathan Cockburn, Ben Goldacre, Brian MacKenna,
Background Ethnicity is known to be an important correlate of health outcomes, particularly during the COVID-19 pandemic, where some ethnic groups were shown to be at higher risk of infection and adverse outcomes. The recording of patients’ ethnic groups in primary care can support research and efforts to achieve equity in service provision and outcomes; however the coding of ethnicity is known to
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Comparative Effectiveness of Semaglutide and Tirzepatide for Weight Loss in Adults with Overweight and Obesity in the US: A Real-World Evidence Study medRxiv. Prim. Care Res. Pub Date : 2023-11-22 Patricia J Rodriguez, Brianna M Goodwin Cartwright, Samuel Gratzl, Rajdeep Brar, Charlotte Baker, Ty J. Gluckman, Nicholas L Stucky
Background Both tirzepatide and semaglutide have been shown to reduce weight for patients with overweight or obesity in randomized controlled trials (RCTs). While tirzepatide appears to provide greater weight loss than semaglutide in this population, head-to-head RCTs are not yet available. Accordingly, we sought to compare on-treatment weight loss in a real-world setting for adults with overweight
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Management of Antipsychotics in Primary Care: Insights from Healthcare Professionals and Policy Makers in the UK medRxiv. Prim. Care Res. Pub Date : 2023-11-14 Alan A Woodall, A S Abuzour, S A Wilson, Frances S Mair, Iain Buchan, Sally B Sheard, Paul Atkinson, Dan W Joyce, Pyers Symon, Lauren E Walker
Introduction: Antipsychotic medication is increasingly prescribed to patients with serious mental illness. Patients with serious mental illness often have cardiovascular and metabolic comorbidities, and antipsychotics independently increase the risk of cardiometabolic disease. Despite this, many patients prescribed antipsychotics are discharged to primary care without planned psychiatric review. We
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Management of patients with occupational burnout in Switzerland: some insights on the heterogeneity in current practices medRxiv. Prim. Care Res. Pub Date : 2023-11-11 Irina Guseva Canu, Roger Getzmann, Yara Shoman, Fulvia Rota, Stéphane Saillant, Roland von Känel, Christine Cohidon, Catherine Lazor-Blanchet, Lysiane Rochat, Rafaël Weissbrodt, Nadia Droz, Anny Wahlen
We aimed to describe the characteristics and current practices of Swiss health professionals who manage patients with occupational burnout (POB), namely the general practitioners (GP), psychiatrist-psychotherapists (PP), occupational physicians (OP) and psychologists. Among 3216 respondents, 2951 reported to consult POB, and 1130 (713 physicians and 410 psychologists) to treat them. The study showed
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Leadership and governance of mental healthcare and integration at the community level: a mixed methods study in Ghana medRxiv. Prim. Care Res. Pub Date : 2023-11-10 PETER BADIMAK YARO, Emmanuel Asampong, Philip Teg-Nefaah Tabong, Graham Thornicroft, Paulina Tindana
Leadership and governance are key components of health systems, nevertheless research into leadership and governance of mental healthcare at the community level is probably the least well researched and understood part of these systems. As part of assessing the integration of mental health in Primary Health Care in Ghana, the leadership and governance organisation and structures to ensure oversight
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How, why and when are delayed (back-up) antibiotic prescriptions used in primary care? A realist review integrating concepts of uncertainty in healthcare medRxiv. Prim. Care Res. Pub Date : 2023-11-08 Monsey McLeod, Anne Campbell, Benedict Hayhoe, Aleksandra Borek, Sarah Tonkin-Crine, Michael V Moore, Christopher C Butler, Ann Sarah Walker, Alison Holmes, Geoff Wong, STEP-UP study team
Background: Antimicrobial resistance is a global patient safety priority and inappropriate antimicrobial use is a key contributing factor. Trials have shown that delayed (back-up) antibiotic prescriptions (DP) are an effective and safe strategy for reducing unnecessary antibiotic use but its uptake is controversial. Methods: We conducted a realist review (a literature review which goes beyond assessing