Abstract:
BACKGROUND:Inappropriate use of antidepressants (AD), defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy, applies to approximately half of all long term AD users. METHODS/DESIGN:We have designed a cluster randomized controlled clinical trial to assess the (cost-) effectiveness of an antidepressant cessation advice in the absence of a proper indication for maintenance treatment with antidepressants in primary care.We will select all patients using antidepressants for over 9 months from 45 general practices. Patients will be diagnosed using the Composite International Diagnostic Interview (CIDI) version 3.0, extended with questions about the psychiatric history and previous treatment strategies. General practices will be randomized to either the intervention or the control group. In case of overtreatment, defined as the absence of a proper indication according to current guidelines, a cessation advice is given to the general practitioner. In the control groups no specific information is given. The primary outcome measure will be the proportion of patients that successfully discontinue their antidepressants at one-year follow-up. Secondary outcomes are dimensional measures of psychopathology and costs. DISCUSSION:This study protocol provides a detailed overview of the design of the trial. Study results will be of importance for refining current guidelines. If the intervention is effective it can be used in managed care programs. TRIAL REGISTRATION:NTR2032.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Muskens E,Eveleigh R,Lucassen P,van Weel C,Spijker J,Verhaak P,Speckens A,Voshaar ROdoi
10.1186/1471-2296-14-6subject
Has Abstractpub_date
2013-01-08 00:00:00pages
6issn
1471-2296pii
1471-2296-14-6journal_volume
14pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Patients vary widely when making decisions to consult primary care. Some present frequently with trivial illness: others delay with serious disease. Differences in health service provision may play a part in this. We aimed to explore whether and how patients' consulting intentions take account of their perce...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-7-26
更新日期:2006-04-26 00:00:00
abstract:BACKGROUND:Care for overweight children in general practice involves collaboration with parents. Acknowledging the parents' frames of references is a prerequisite for successful management. We therefore aimed to analyse parental beliefs about the presumed causes and consequences of overweight in children and expectatio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-152
更新日期:2013-10-11 00:00:00
abstract:BACKGROUND:The prevalence of coexisting chronic conditions (multimorbidity) is rising. Disease labels, however, give little information about impact on subjective health and personal illness experience. We aim to examine the strength of association of single and multimorbid physical chronic diseases with self-rated hea...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0185-6
更新日期:2014-11-25 00:00:00
abstract:BACKGROUND:The aim of this study is in a general practice trial setting to identify predictive factors for weight loss after 1 year among young adults who are over-weight or obese and who have several psychosocial problems. METHODS:Twenty-eight general practitioners recruited 495 patients aged 20-45 years with psychos...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-016-0437-8
更新日期:2016-04-11 00:00:00
abstract:BACKGROUND:'Ad hoc' help-seeking by trainees from their supervisors during trainee consultations is important for patient safety, and trainee professional development. We explored trainee objectives and activities in seeking supervisor assistance, and trainee perceptions of the outcomes of this help-seeking (including ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1084-7
更新日期:2020-02-07 00:00:00
abstract:BACKGROUND:Hallingdal is a rural region in southern Norway. General practitioners (GPs) refer acutely somatically ill patients to any of three levels of care: municipal nursing homes, the regional community hospital or the local general hospital. The objective of this paper is to describe the patterns of referrals to t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-87
更新日期:2013-06-22 00:00:00
abstract:BACKGROUND:Women presenting with symptoms of acute uncomplicated urinary tract infection (UTI) are often prescribed antibiotics. However, in 25 to 50% of symptomatic women not taking antibiotics, symptoms recover spontaneously within one week. It is not known how many women are prepared to delay antibiotic treatment. W...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-71
更新日期:2013-05-31 00:00:00
abstract:BACKGROUND:The Patient Participation Program (PPP) was a patient satisfaction survey endorsed by the Royal Australian College of General Practitioners and designed to assist general practitioners in continuous quality improvement (CQI). The survey was been undertaken by 3500 practices and over a million patients betwee...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-13
更新日期:2009-02-08 00:00:00
abstract:BACKGROUND:Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians con...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0743-4
更新日期:2018-05-14 00:00:00
abstract:BACKGROUND:The successful implementation of cardiovascular disease (CVD) prevention guidelines relies heavily on primary care physicians (PCPs) providing risk factor evaluation, intervention and patient education. The aim of this study was to ascertain the degree of awareness and implementation of the Spanish adaptatio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-36
更新日期:2013-03-18 00:00:00
abstract:BACKGROUND:There is compelling evidence that there is substantial undetected vision loss amongst older people. Early recognition of undetected vision loss and timely referral for treatment might be possible within general practice, but methods of identifying those with unrecognised vision loss and persuading them to ta...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-99
更新日期:2013-07-16 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the effectiveness of a patient education program developed to facilitate statin adherence. METHODS:A controlled trial was designed to test the effectiveness of a multifaceted patient education program to facilitate statin adherence. The program included a brief, in-...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-48
更新日期:2009-06-30 00:00:00
abstract:BACKGROUND:Multimorbidity poses a challenge for decision-making processes and requires that more attention is paid to patient goals, preferences and needs; however, goal setting is not yet widely recognised as a core aspect of the shared decision-making (SDM) approach. This study aims to analyse clinician perceptions o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0966-z
更新日期:2019-06-06 00:00:00
abstract:BACKGROUND:Registered Sick Children's Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives chi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-57
更新日期:2012-06-14 00:00:00
abstract:BACKGROUND:The benefit of a "diagnosis" of pre-diabetes in very elderly patients is debated. How clinicians manage pre-diabetic blood results in these patients is unknown. This study aims to understand how clinicians are "diagnosing" older patients with pre-diabetic blood parameters. METHODS:Semi-structured interviews...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0981-0
更新日期:2019-06-29 00:00:00
abstract:BACKGROUND:Standardised generic patient-reported outcome measures (PROMs) which measure health status are often unresponsive to change in primary care. Alternative formats, which have been used to increase responsiveness, include individualised PROMs (in which respondents specify the outcomes of interest in their own w...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0850-2
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:The aim here was to explore trends in patient satisfaction with primary health care and its accessibility and continuity, and to explore whether through reforms and improvements some of the essential goals had been achieved over a 14-year period of time in Finland. METHODS:Nine questionnaire surveys were co...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-15-98
更新日期:2014-05-15 00:00:00
abstract:BACKGROUND:The Electronic Health Record (EHR) is now widely used in clinical encounters. Because its use can negatively impact the physician-patient relationship, several recommendations on the "patient-centered" use of the EHR have been published. However, the impact of training to improve EHR use during clinical enco...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0640-2
更新日期:2017-05-26 00:00:00
abstract:BACKGROUND:General practitioners' (GPs') feelings of burnout or dissatisfaction may affect their patient care negatively, but it is unknown if these negative feelings also affect their mental health care. GPs' available time, together with specific communication tools, are important conditions for providing mental heal...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-60
更新日期:2009-08-26 00:00:00
abstract:BACKGROUND:Antibiotics are being overprescribed in ambulant care, especially for respiratory tract infections (RTIs). Gaining insight into the actual reasons for prescribing remains important for the design of effective strategies to optimise antibiotic prescribing. We aimed to determine items of importance for the ant...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-3-16
更新日期:2002-09-09 00:00:00
abstract:BACKGROUND:Evidence-based medicine (EBM) is gradually being recognized worldwide as an important clinical skill and plays an important role in health care. Although the concept has successfully spread in the health care field, EBM still has not been widely incorporated into clinical decisions in primary care due to pot...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1062-0
更新日期:2019-12-06 00:00:00
abstract:BACKGROUND:The benefits of smoking cessation among older people are well documented. Despite this, evidence suggests that older smokers are rarely engaged in smoking cessation efforts, and that existing tobacco dependence treatments require further tailoring to the specific needs of older smokers. This study assesses t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0317-7
更新日期:2015-08-06 00:00:00
abstract:BACKGROUND:Gout is estimated to affect 1.4% of adults in the UK. Appropriate and timely management is essential to reduce the risk of further flares, complications, and to reduce cardiovascular disease risk. The British Society for Rheumatology and British Health Professionals in Rheumatology (BSR/BHPR) and the Europea...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-170
更新日期:2013-11-14 00:00:00
abstract:BACKGROUND:General practitioners (GPs) often lack time and resources to invest in health education; audiovisual messages broadcast in the waiting room may be a useful educational tool. This work was designed to assess the effect of a message inviting patients to ask for a tetanus booster vaccination. METHODS:A quasi e...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-104
更新日期:2011-09-28 00:00:00
abstract:BACKGROUND:Consultations for minor ailments constitute a large part of the workload of general practitioners (GPs). As medical interventions are not always available, specific communication strategies, such as active listening and positive communication, might help GPs to handle these problems adequately. This study ex...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-38
更新日期:2008-06-30 00:00:00
abstract:BACKGROUND:Acceptance to a family practice is key to access and continuity of care. While Canadian patients increasingly report not being able to acquire acceptance to a family practice, little is known about the association between requiring opioids and acceptance. We aim to determine the proportion of family physicia...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1027-3
更新日期:2019-10-23 00:00:00
abstract:BACKGROUND:Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government pol...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-46
更新日期:2010-06-04 00:00:00
abstract:BACKGROUND:The utility of clinical exercise tests depends on their support of treatment decisions. We sought to assess the utility of exercise tests for the selection of primary-care patients for referral to cardiologic care, and to determine whether referral decisions were biased by gender or socioeconomic status. We ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0182-9
更新日期:2014-11-30 00:00:00
abstract:BACKGROUND:There are gaps in knowledge and understanding about the relationships between primary care and community-based health and social services in the context of healthy aging at home and system navigation. This study examined provider perspectives on: a) older adults' health and social needs; b) barriers to acces...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01143-8
更新日期:2020-04-23 00:00:00
abstract:BACKGROUND:Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0884-5
更新日期:2018-12-13 00:00:00