Abstract:
BACKGROUND:As part of a broader study to improve the capacity for advance care planning (ACP) in primary healthcare settings, the research team set out to develop and validate a computerized algorithm to help primary care physicians identify individuals at risk of death, and also carried out focus groups and interviews with relevant stakeholder groups. Interviews with patients and family caregivers were carried out in parallel to algorithm development and validation to examine (1) views on early identification of individuals at risk of deteriorating health or dying; (2) views on the use of a computerized algorithm for early identification; and (3) preferences and challenges for ACP. METHODS:Fourteen participants were recruited from two Canadian provinces. Participants included individuals aged 65 and older with declining health and self-identified caregivers of individuals aged 65 and older with declining health. Semi-structured interviews were conducted via telephone. A qualitative descriptive analytic approach was employed, which focused on summarizing and describing the informational contents of the data. RESULTS:Participants supported the early identification of patients at risk of deteriorating health or dying. Early identification was viewed as conducive to planning not only for death, but for the remainder of life. Participants were also supportive of the use of a computerized algorithm to assist with early identification, although limitations were recognized. While participants felt that having family physicians assume responsibility for early identification and ACP was appropriate, questions arose around feasibility, including whether family physicians have sufficient time for ACP. Preferences related to the content of and approach to ACP discussions were highly individualized. Required supports during ACP include informational and emotional supports. CONCLUSIONS:This work supports the role of primary care providers in the early identification of individuals at risk of deteriorating health or death and the process of ACP. To improve ACP capacity in primary healthcare settings, compensation systems for primary care providers should be adjusted to ensure appropriate compensation and to accommodate longer ACP appointments. Additional resources and more established links to community organizations and services will also be required to facilitate referrals to relevant community services as part of the ACP process.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Kendell C,Kotecha J,Martin M,Han H,Jorgensen M,Urquhart Rdoi
10.1186/s12875-020-01206-wsubject
Has Abstractpub_date
2020-07-09 00:00:00pages
136issue
1issn
1471-2296pii
10.1186/s12875-020-01206-wjournal_volume
21pub_type
杂志文章abstract:BACKGROUND:A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops. METHODS:Twenty-nine practices were randomly allocated to one of thre...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-9-22
更新日期:2008-04-20 00:00:00
abstract:BACKGROUND:Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the c...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-52
更新日期:2014-03-25 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 general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about wei...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-9-58
更新日期:2008-10-14 00:00:00
abstract:BACKGROUND:Since Huntington's Disease (HD) is a familial disease with an average onset in the mid-thirties, one might expect that spousal carers are concerned with providing care for off-spring who may turn out to be affected. METHODS:This study involved ten face-to-face interviews with carers of spouses affected by H...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-38
更新日期:2005-09-14 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:Delay in cancer diagnosis may have serious prognostic consequences, and some patients experience delays lasting several months. However, we have no knowledge whether such delays are associated with general practitioner (GP) characteristics. The aim of the present study was to analyse whether GP and practice ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-100
更新日期:2011-09-26 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: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:Physicians' interpersonal performance is critical in medical practice, especially primary care practice. The General Practice Assessment Questionnaire (GPAQ) was developed in the United Kingdom to evaluate the quality of primary care from the viewpoint of patients. This questionnaire highlights the evaluatio...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/s12875-018-0873-8
更新日期:2018-11-28 00:00:00
abstract:BACKGROUND:Upper respiratory tract infections (URTI) are common. The etiologic factor is usually viral, but many physicians prescribe antibiotics. We aimed to evaluate parents' expectations of and knowledge about the role of antibiotics in childhood URTI. METHODS:The study was conducted in thirteen primary care pediat...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-4-20
更新日期:2003-12-30 00:00:00
abstract:BACKGROUND:Throat pain is a common complaint in the ambulatory setting. Diagnosis of group A Streptococcus is made with a culture, molecular test or a rapid antigen detection test from the tonsils or the posterior pharyngeal wall, while other areas of the oral cavity are considered unacceptable. The purpose of the stud...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01129-6
更新日期:2020-03-26 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:Maintaining a maternity care system is one of the biggest issues in Japan due to the decreasing number of obstetricians, especially in remote areas and islands. The aim of this qualitative study was to explore the challenges in women's health and maternity care in remote areas and islands for primary care ph...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0806-6
更新日期:2018-07-18 00:00:00
abstract:BACKGROUND:Practice accreditation is a widely used method to assess and improve the quality of healthcare services. In the Netherlands, a practice accreditation program was implemented in primary medical care. We aimed to identify determinants of impact of a practice accreditation program, building on the experiences o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0294-x
更新日期:2015-07-03 00:00:00
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
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Excessive antibiotics use increases the risk of resistance. Previous studies have shown that the Centor score combined with Rapid Antigen Detection Test (RADT) for Group A Streptococci can reduce unnecessary antibiotic prescribing in patients with sore throat. According to the former Swedish guidelines RADT ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0285-y
更新日期:2015-07-04 00:00:00
abstract:BACKGROUND:Primary health care systems are designed to provide comprehensive patient care. However, the ICD 9 coding system used for billing purposes in Canada neither characterizes nor captures the scope of clinical practice or complexity of physician-patient interactions. This study aims to describe the content of pr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-13-7
更新日期:2012-02-15 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:Frailty is a condition of increasing importance, given the aging adult population. With an anticipated shortage of geriatricians, primary care physicians will increasingly need to manage care for frail adults with complex functional risks and social-economic circumstances. METHODS:We used cross-sectional da...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0851-1
更新日期:2018-10-19 00:00:00
abstract:BACKGROUND:As obesity is rapidly becoming a major medical and public health problem, the aim of our study was to determine: 1) if obesity in Caucasian adolescents at 5 different Tanner stages are associated with obesity in adulthood and its obesity-associated abnormal glucose and lipid profiles, 2) the type of fat dist...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-3-18
更新日期:2002-10-14 00:00:00
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
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Alcohol dependence (AD) in Europe is prevalent and causes considerable health burden. Recognition by general practitioners (GPs) and provision of or referral to treatment may contribute to reduce this burden. This paper studied AD prevalence in varying European primary care settings and examined who received...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0308-8
更新日期:2015-07-29 00:00:00
abstract:BACKGROUND:The purpose of this pilot study was to evaluate and refine an adjuvant system of color-specific symbols that are added to medication bottles and to assess whether this system would increase the ability of patients 65 years of age or older in matching their medication to the indication for which it was prescr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-142
更新日期:2011-12-29 00:00:00
abstract:BACKGROUND:The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on t...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-115
更新日期:2011-10-20 00:00:00
abstract:BACKGROUND:Despite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient pers...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01142-9
更新日期:2020-04-22 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:UNLABELLED:This work describes the methodology used to assess a strategy for implementing clinical practice guidelines (CPG) for cardiovascular risk control in a health area of Madrid. BACKGROUND:The results on clinical practice of introducing CPGs have been little studied in Spain. The strategy used to implement a CP...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-21
更新日期:2011-04-19 00:00:00
abstract:BACKGROUND:It has for years been discussed whether practice staff should be involved in patient care in general practice to a higher extent. The research concerning task delegation within general practice is generally increasing, but the literature focusing on its influence on general practitioners' and their staff's j...
journal_title:BMC family practice
pub_type: 杂志文章,评审
doi:10.1186/s12875-016-0565-1
更新日期:2016-11-30 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