Abstract:
BACKGROUND:In many countries, general practitioner (GP) care of acute low back pain often does not adhere to evidence-based clinical guidelines. There has been little exploration of this deviation from evidence-based care from the patients' perspective, particularly in relation to patients' care expectations. The aim of this study was to explore the care expectations in patients who present to their GP with acute low back pain, influences on expectation development, and congruence of these expectations with clinical guideline recommendations. METHODS:Qualitative study in an inner urban general practice in Brisbane, Australia. Semi-structured interviews were conducted with 11 patients who presented to their GP with acute low back pain. RESULTS:Patients had a biomechanical understanding of back pain, how it should be tested and treated, and a poor understanding of its natural history. Most expected x-rays, believing they were necessary to identify the "cause of the pain" without belief of any downsides to x-rays. Patients' expectations were primarily influenced by the experiences of family and friends, their own previous experiences of low back pain care, and comments from other health professionals they were consulting. The GP-patient relationship was important in influencing patient satisfaction of care provided. Most patient expectations, and some of the care that they reported receiving, were incongruent with guideline recommendations. CONCLUSIONS:A biomechanical approach to management rather than an awareness of empirical evidence was evident in patients' expectations. Communication and education by the GP that includes specifically enquiring about patients' expectations, provides an opportunity to correct misperceptions, explain acute low back pain natural history, and the rationale for test and treatment recommendations.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Hoffmann TC,Del Mar CB,Strong J,Mai Jdoi
10.1186/1471-2296-14-7subject
Has Abstractpub_date
2013-01-08 00:00:00pages
7issn
1471-2296pii
1471-2296-14-7journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Overuse of proton pump inhibitors (PPIs) - frequently used for relieving symptoms of gastroesophageal reflux disease (GORD) - raises long-term safety concerns, warranting evidence-based non-drug interventions. We conducted a systematic review to evaluate the effect of head-of-bed elevation on relieving sympt...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-021-01369-0
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:In the primary health care setting, patients interact directly with their healthcare workers (HCW), which include their primary physicians, nurses and pharmacists. Studies have shown that such interactions, when interrupted by phone calls received by either party, can lead to adverse outcomes and negative ex...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0330-x
更新日期:2015-09-02 00:00:00
abstract:BACKGROUND:Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practice as a first treatmen...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-35
更新日期:2014-02-19 00:00:00
abstract:BACKGROUND:Reform of primary healthcare (PHC) organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations' needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care. METHODS:Populatio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-66
更新日期:2012-07-02 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
abstract:BACKGROUND:Elderly patients with multimorbidity who are treated according to guidelines use a large number of drugs. This number of drugs increases the risk of adverse drug events (ADEs). Stopping medication may relieve these effects, and thereby improve the patient's wellbeing. To facilitate management of polypharmacy...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-56
更新日期:2012-07-09 00:00:00
abstract:BACKGROUND:Chronic meningitis is defined as symptoms and signs of meningeal inflammation and persisting cerebrospinal fluid abnormalities such as elevated protein level and pleocytosis for at least one month. CASE PRESENTATION:A 62-year-old woman, of unremarkable past medical history, was admitted to hospital for inve...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-21
更新日期:2004-10-06 00:00:00
abstract:BACKGROUND:It is common to find a high variability in the accuracy of heart failure (HF) diagnosis in electronic primary care medical records (EMR). Our aims were to ascertain (i) whether the prognosis of HF labelled patients whose ejection fraction (EF) was missing in their EMR differed from those that had it register...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0612-6
更新日期:2017-03-17 00:00:00
abstract:BACKGROUND:A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mo...
journal_title:BMC family practice
pub_type: 杂志文章,meta分析,评审
doi:10.1186/s12875-015-0314-x
更新日期:2015-08-19 00:00:00
abstract:BACKGROUND:During an influenza epidemic prompt diagnosis of influenza is important. This diagnosis however is still essentially based on the interpretation of symptoms and signs by general practitioners. No single symptom is specific enough to be useful in differentiating influenza from other respiratory infections. Ou...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-4
更新日期:2011-02-09 00:00:00
abstract:BACKGROUND:Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. T...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1101-x
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:Multimorbidity is defined as suffering from coexistent chronic conditions. Multimorbid patients demand highly complex patient-centered care which often includes polypharmacy, taking an average of six different drugs per day. Adverse drug reactions, adverse drug events and medication errors are all potential ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-119
更新日期:2013-08-15 00:00:00
abstract:BACKGROUND:The objective of this study is to perform an independent evaluation of the feasibility and effectiveness of an educational programme for the primary prevention of type 2 diabetes (DM2) in high risk populations in primary care settings, implanted within the Basque Health Service - Osakidetza. METHODS/DESIGN:...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-13-109
更新日期:2012-11-16 00:00:00
abstract:BACKGROUND:Very Brief Advice on smoking (VBA) is an evidence-based intervention designed to increase quit attempts among patients who smoke. VBA has been widely disseminated in general practice settings in the United Kingdom, however its transferability to Southern European settings is not well established. This study ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01195-w
更新日期:2020-06-24 00:00:00
abstract:BACKGROUND:Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01152-7
更新日期:2020-05-04 00:00:00
abstract:BACKGROUND:Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0224-y
更新日期:2015-01-29 00:00:00
abstract:BACKGROUND:There are now effective drugs to prevent cardiovascular disease and guidelines recommend their use. Patients do not always choose to accept preventive medication at levels of risk reduction recommended in guidelines. The purpose of the study was to identify and explore the attitudes of patients and general p...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-59
更新日期:2011-06-26 00:00:00
abstract:BACKGROUND:Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim - sulfamethoxazol as empiric first line antimicrobial agents in uncomplicated infections. However, there is evidence that the use o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01201-1
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The family doctor system is a vital part of China's national medical and health system reform. Evidence of the degree of implementation of the family doctor system is required to assist managers and policy makers in Pudong with resource allocation planning. This study analyzed changes in indicators (family d...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01353-0
更新日期:2021-01-08 00:00:00
abstract:BACKGROUND:There is some evidence to support a risk-stratified, multi-disciplinary approach to manage patients with hypertension in primary care. The aim of this study is to evaluate the quality of care (QOC) of a multi-disciplinary Risk Assessment and Management Programme for Hypertension (RAMP-HT) for hypertensive pa...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0291-0
更新日期:2015-06-19 00:00:00
abstract:BACKGROUND:Primary care is a central element of healthcare and addresses the main health problems of the population. While primary care gains in importance due to an aging population, there is an ongoing debate on physician shortages in German rural regions. The study aims on analyzing the population's preferences on p...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0967-y
更新日期:2019-06-11 00:00:00
abstract:BACKGROUND:There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effe...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01166-1
更新日期:2020-06-08 00:00:00
abstract:BACKGROUND:The work of general practitioners (GPs) is increasingly being looked at from the perspective of the strategies and factors shaping it. This reflects the importance given to primary care services in health care system reform. However, the literature provides little insight into the medical decision-making pro...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-12
更新日期:2008-02-19 00:00:00
abstract:BACKGROUND:While increasing attention is being paid to enabling terminal patients to remain at home until death, limited information is available on the circumstances in which people at home actually die. Therefore this study aims to describe patient characteristics, functional and cognitive status and physical and psy...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-4
更新日期:2012-01-19 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:Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. METHODS:We used a novel priority-setting method for i...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0552-6
更新日期:2016-11-16 00:00:00
abstract:BACKGROUND:Disabling fatigue is the main illness related reason for prolonged absence from school. Although there are accepted criteria for diagnosing chronic fatigue in adults, it remains uncertain as to how best to define disabling fatigue and Chronic Fatigue Syndrome (CFS) in children and adolescents. In this popula...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-33
更新日期:2005-08-09 00:00:00
abstract:BACKGROUND:General practitioners (GPs) and patients find it difficult to talk about risk of future disease, especially when patients have asymptomatic conditions, and treatment options are unlikely to cause immediate perceptible improvements in well-being. Further studies in risk communication training are needed. AIM...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-11-70
更新日期:2010-09-22 00:00:00
abstract:BACKGROUND:Chest complaints presented to a general practitioner (GP) are frequently caused by diseases which have advantageous outcomes. However, in some cases, acute coronary syndrome (ACS) is present (1.5-22% of cases). The patient's signs, symptoms and electrocardiography results are insufficient diagnostic tools to...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0203-8
更新日期:2014-12-12 00:00:00
abstract:BACKGROUND:When medically unexplained physical symptoms (MUPS) become persistent, it may have major implications for the patient, the general practitioner (GP) and for society.Early identification of patients with MUPS in electronic medical records (EMRs) might contribute to prevention of persistent MUPS by creating aw...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-109
更新日期:2014-06-05 00:00:00