General practitioners' views on polypharmacy and its consequences for patient health care.

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 consequences of polypharmacy. Our study aims to detect the status quo of the health care situation in Saxony's general practices for multimorbid patients receiving multiple medications. We will identify the most common clinical profiles as well as documented adverse drug events and reactions that occur during the treatment of patients receiving multiple medications. We will focus on exploring the motives of general practitioners for the prescription of selected drugs in individual cases where there is evidence of potential drug-drug-interactions and potentially inappropriate medications in elderly patients. Furthermore, the study will explore general practitioners' opinions on delegation of skills to other health professions to support medical care and monitoring of patients receiving multiple medications. METHODS/DESIGN:This is a retrospective cross sectional study using mixed methods. Socio-demographic data as well as diagnoses, medication regimens and clinically important events will be analyzed retrospectively using general practitioners documentation in patients' records. Based on these data, short vignettes will be generated and discussed by general practitioners in qualitative telephone interviews. DISCUSSION:To be able to improve outpatient health care management for patients receiving multiple medications, the current status quo of care, risk factors for deficient treatment and characteristics of concerned patients must be investigated. Furthermore, it is necessary to understand the physicians' decision making process regarding treatment.

journal_name

BMC Fam Pract

journal_title

BMC family practice

authors

Köberlein J,Gottschall M,Czarnecki K,Thomas A,Bergmann A,Voigt K

doi

10.1186/1471-2296-14-119

subject

Has Abstract

pub_date

2013-08-15 00:00:00

pages

119

issn

1471-2296

pii

1471-2296-14-119

journal_volume

14

pub_type

杂志文章
  • Primary care physician perspectives on barriers to diagnosing axial Spondyloarthritis: a qualitative study.

    abstract:BACKGROUND:The average delay in diagnosis for patients with axial spondyloarthritis (axSpA) is 7 to 10 years. Factors that contribute to this delay are multifactorial and include the lack of diagnostic criteria (although classification criteria exist) for axSpA and the difficulty in distinguishing inflammatory back pai...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01274-y

    authors: Lapane KL,Khan S,Shridharmurthy D,Beccia A,Dubé C,Yi E,Kay J,Liu SH

    更新日期:2020-09-29 00:00:00

  • Swedish Child Health Care nurses conceptions of overweight in children: a qualitative study.

    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

    authors: Isma GE,Bramhagen AC,Ahlstrom G,Ostman M,Dykes AK

    更新日期:2012-06-14 00:00:00

  • Evaluating the scripts and thresholds of general practitioners for diagnosing heart failure in elderly people.

    abstract:BACKGROUND:Multiple diagnostic algorithms for heart failure exist. However, it is unclear whether these algorithms are incorporated in the 'scripts' clinicians use in every day practice. Scripts are networks of organised knowledge that are acquired and accumulated during clinical training and are refined with each clin...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-016-0481-4

    authors: Decaluwe K,Degryse J,Vaes B

    更新日期:2016-07-21 00:00:00

  • Cluster randomized, controlled trial on patient safety improvement in general practice: a study protocol.

    abstract:BACKGROUND:An open, constructive safety culture is key in healthcare since it is seen as a main condition for patient safety. Studies have examined culture improvement strategies in hospitals. In primary care, however, not much is known about effective strategies to improve the safety culture yet. The purpose of this s...

    journal_title:BMC family practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1186/1471-2296-14-127

    authors: Verbakel NJ,Langelaan M,Verheij TJ,Wagner C,Zwart DL

    更新日期:2013-08-29 00:00:00

  • Primary prevention in general practice - views of German general practitioners: a mixed-methods study.

    abstract:BACKGROUND:Policy efforts focus on a reorientation of health care systems towards primary prevention. To guide such efforts, we analyzed the role of primary prevention in general practice and general practitioners' (GPs) attitudes toward primary prevention. METHODS:Mixed-method study including a cross-sectional survey...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-15-103

    authors: Holmberg C,Sarganas G,Mittring N,Braun V,Dini L,Heintze C,Rieckmann N,Muckelbauer R,Müller-Nordhorn J

    更新日期:2014-05-25 00:00:00

  • Physicians' communication skills with patients and legal liability in decided medical malpractice litigation cases in Japan.

    abstract:BACKGROUND:In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical litigation cases includes the issue of a doctor's explanation to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients,...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-9-43

    authors: Hamasaki T,Takehara T,Hagihara A

    更新日期:2008-07-25 00:00:00

  • Decisions on statin therapy by patients' opinions about survival gains: cross sectional survey of general practitioners.

    abstract:BACKGROUND:Guidelines for primary prevention of cardiovascular disease provide little guidance on how patients' preferences should be taken into account. We wanted to explore whether general practitioners (GPs) are sensitive to patient preferences regarding survival gains from statin therapy. METHODS:In a cross sectio...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-015-0288-8

    authors: Halvorsen PA,Aasland OG,Kristiansen IS

    更新日期:2015-07-03 00:00:00

  • Lifetime risk assessment in cholesterol management among hypertensive patients: observational cross-sectional study based on electronic health record data.

    abstract:BACKGROUND:In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (E...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01138-5

    authors: Tahkola A,Korhonen P,Kautiainen H,Niiranen T,Mäntyselkä P

    更新日期:2020-04-14 00:00:00

  • Who is on the primary care team? Professionals' perceptions of the conceptualization of teams and the underlying factors: a mixed-methods study.

    abstract:BACKGROUND:Due to the growing prevalence of elderly patients with multi-morbidity living at home, there is an increasing need for primary care professionals from different disciplinary backgrounds to collaborate as primary care teams. However, it is unclear how primary care professionals conceptualize teams and what un...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-017-0685-2

    authors: Doekhie KD,Buljac-Samardzic M,Strating MMH,Paauwe J

    更新日期:2017-12-28 00:00:00

  • Implementing a fax referral program for quitline smoking cessation services in urban health centers: a qualitative study.

    abstract:BACKGROUND:Fax referral services that connect smokers to state quitlines have been implemented in 49 U.S. states and territories and promoted as a simple solution to improving smoker assistance in medical practice. This study is an in-depth examination of the systems-level changes needed to implement and sustain a fax ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-10-81

    authors: Cantrell J,Shelley D

    更新日期:2009-12-17 00:00:00

  • Antibiotics for coughing in general practice: a questionnaire study to quantify and condense the reasons for prescribing.

    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

    authors: Coenen S,Michiels B,Van Royen P,Van der Auwera JC,Denekens J

    更新日期:2002-09-09 00:00:00

  • Implementing evidence-based medicine in general practice: a focus group based study.

    abstract:BACKGROUND:Over the past years concerns are rising about the use of Evidence-Based Medicine (EBM) in health care. The calls for an increase in the practice of EBM, seem to be obstructed by many barriers preventing the implementation of evidence-based thinking and acting in general practice. This study aims to explore t...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-6-37

    authors: Hannes K,Leys M,Vermeire E,Aertgeerts B,Buntinx F,Depoorter AM

    更新日期:2005-09-09 00:00:00

  • Counseling on lifestyle habits in the United States and Sweden: a report comparing primary care health professionals' perspectives on lifestyle counseling in terms of scope, importance and competence.

    abstract:BACKGROUND:The role of primary care professionals in lifestyle counseling for smoking, alcohol consumption, physical activity, and diet is receiving attention at the national level in many countries. The U. S. and Sweden are two countries currently establishing priorities in these areas. A previously existing internati...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-15-83

    authors: Weinehall L,Johansson H,Sorensen J,Jerdén L,May J,Jenkins P

    更新日期:2014-05-03 00:00:00

  • Effectiveness of standardized nursing care plans to achieve A1C, blood pressure, and LDL-C goals among people with poorly controlled type 2 diabetes mellitus at baseline: four-year follow-up study.

    abstract:BACKGROUND:No studies that have measured the role of nursing care plans in patients with poorly controlled type 2 diabetes mellitus. Our objectives were firstly, to evaluate the effectiveness of implementing Standardized languages in Nursing Care Plans (SNCP) for improving A1C, blood pressure and low density lipoprotei...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-018-0800-z

    authors: Cárdenas-Valladolid J,López-de Andrés A,Jiménez-García R,de Dios-Duarte MJ,Gómez-Campelo P,de Burgos-Lunar C,San Andrés-Rebollo FJ,Abánades-Herranz JC,Salinero-Fort MA

    更新日期:2018-07-24 00:00:00

  • Development and evaluation of an online education tool on attention deficit hyperactivity disorder for general practitioners: the important contribution of co-production.

    abstract:BACKGROUND:Attention deficit hyperactivity disorder (ADHD) is underdiagnosed in the UK and the assessment and diagnosis pathway often involves a general practitioner (GP) referral to secondary care services. GPs' levels of knowledge and understanding about ADHD is often a significant barrier in patients accessing care....

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01289-5

    authors: French B,Daley D,Perez Vallejos E,Sayal K,Hall CL

    更新日期:2020-11-01 00:00:00

  • Perceptions and practices of general practitioners on providing oral health care to people with diabetes - a qualitative study.

    abstract:BACKGROUND:Poorly controlled diabetes leads to multiple complications including oral health problems. General practitioners (GPs) are at the forefront of management of chronic diseases in primary health care. Diabetes guidelines encourage a proactive role for GPs in oral health complications management in people with d...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-1102-9

    authors: Poudel P,Griffiths R,Wong VW,Arora A,Flack JR,Khoo CL,George A

    更新日期:2020-02-13 00:00:00

  • A qualitative study in rural and urban areas on whether--and how--to consult during routine and out of hours.

    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

    authors: Campbell NC,Iversen L,Farmer J,Guest C,MacDonald J

    更新日期:2006-04-26 00:00:00

  • GP's perspectives on laboratory test use for monitoring long-term conditions: an audit of current testing practice.

    abstract:BACKGROUND:We have shown previously that current recommendations in UK guidelines for monitoring long-term conditions are largely based on expert opinion. Due to a lack of robust evidence on optimal monitoring strategies and testing intervals, the guidelines are unclear and incomplete. This uncertainty may underly vari...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01331-6

    authors: Elwenspoek MMC,Mann E,Alsop K,Clark H,Patel R,Watson JC,Whiting P

    更新日期:2020-12-05 00:00:00

  • Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis.

    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

    authors: Linde K,Rücker G,Sigterman K,Jamil S,Meissner K,Schneider A,Kriston L

    更新日期:2015-08-19 00:00:00

  • Walking away from type 2 diabetes: trial protocol of a cluster randomised controlled trial evaluating a structured education programme in those at high risk of developing type 2 diabetes.

    abstract:BACKGROUND:The prevention of type 2 diabetes is a recognised health care priority globally. Within the United Kingdom, there is a lack of research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. This study aims to est...

    journal_title:BMC family practice

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1471-2296-13-46

    authors: Yates T,Davies MJ,Henson J,Troughton J,Edwardson C,Gray LJ,Khunti K

    更新日期:2012-05-29 00:00:00

  • Call-duration and triage decisions in out of hours cooperatives with and without the use of an expert system.

    abstract:BACKGROUND:Cooperatives delivering out of hours care in the Netherlands are hesitant about the use of expert systems during triage. Apart from the extra costs, cooperatives are not sure that quality of triage is sufficiently enhanced by these systems and believe that call duration will be prolonged drastically. No figu...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-9-11

    authors: Ong RS,Post J,van Rooij H,de Haan J

    更新日期:2008-02-13 00:00:00

  • Head of bed elevation to relieve gastroesophageal reflux symptoms: a systematic review.

    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

    authors: Albarqouni L,Moynihan R,Clark J,Scott AM,Duggan A,Del Mar C

    更新日期:2021-01-19 00:00:00

  • Improvement in the management of gout is vital and overdue: an audit from a UK primary care medical practice.

    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

    authors: Cottrell E,Crabtree V,Edwards JJ,Roddy E

    更新日期:2013-11-14 00:00:00

  • General practitioners' conceptions about treatment of depression and factors that may influence their practice in this area. A postal survey.

    abstract:BACKGROUND:The way GPs work does not appear to be adapted to the needs of depressive patients. Therefore we wanted to examine Swedish GPs' conceptions of depressive disorders and their treatment and GPs' ideas of factors that may influence their manner of work with depressive patients. METHODS:A postal questionnaire t...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-6-21

    authors: Andersson SJ,Troein M,Lindberg G

    更新日期:2005-05-16 00:00:00

  • The introduction of the practice nurse mental health in general practices in the Netherlands: effects on number of diagnoses of chronic and acute alcohol abuse.

    abstract:BACKGROUND:Since 2008 mental health practice nurses have been gradually introduced in general practices in the Netherlands as part of health policy aiming to improve early identification and treatment of mental health problems in primary care. This study aims to investigate the effect of the introduction of the practic...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-019-0938-3

    authors: Abidi L,Oenema A,Verhaak P,Tan FES,van de Mheen D

    更新日期:2019-04-02 00:00:00

  • The relationship between having a regular general practitioner (GP) and the experience of healthcare barriers: a cross-sectional study among young people in NSW, Australia, with oversampling from marginalised groups.

    abstract:BACKGROUND:Young people (12-24 years) visit general practice but may not have a 'regular' general practitioner (GP). Whether continuity of GP care influences experiences with, and barriers to, health care among young people is unknown. This paper explores the association between having a regular GP and experience of he...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01294-8

    authors: Kang M,Robards F,Luscombe G,Sanci L,Usherwood T

    更新日期:2020-10-28 00:00:00

  • Women with symptoms of uncomplicated urinary tract infection are often willing to delay antibiotic treatment: a prospective cohort study.

    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

    authors: Knottnerus BJ,Geerlings SE,Moll van Charante EP,ter Riet G

    更新日期:2013-05-31 00:00:00

  • Recent trends and variations in general practitioners' involvement in accident care in Switzerland: an analysis of claims data.

    abstract:BACKGROUND:As in other countries, there is concern and some fragmentary evidence that GPs' central role in the Swiss healthcare system as the primary provider of care might be changing or even be in decline. Our study gives a systematic account of GPs' involvement in accident care from 2008 to 2016 and identifies chang...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/s12875-020-01170-5

    authors: Höglinger M,Knöfler F,Schaumann-von Stosch R,Scholz-Odermatt SM,Eichler K

    更新日期:2020-06-05 00:00:00

  • General practitioner attitudes to the care of people with epilepsy: an examination of clustering within practices and prediction of patient-rated quality of care.

    abstract:BACKGROUND:There is wide variation in the quality of care provided by primary care practices to individuals with chronic illnesses. Individual doctor attitudes and interest have been demonstrated to influence patient outcomes in some instances. Given the trend towards larger practices and part-time working, continuity ...

    journal_title:BMC family practice

    pub_type: 杂志文章

    doi:10.1186/1471-2296-6-9

    authors: Thapar AK,Roland MO

    更新日期:2005-03-01 00:00:00

  • Does burnout among doctors affect their involvement in patients' mental health problems? A study of videotaped consultations.

    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

    authors: Zantinge EM,Verhaak PF,de Bakker DH,van der Meer K,Bensing JM

    更新日期:2009-08-26 00:00:00