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 symptoms of GORD in adults. METHODS:We included controlled trials comparing the effect of head-of-bed elevation interventions to control in adults with GORD. Two independent reviewers screened articles, extracted data, and assessed quality of included studies. Primary outcomes were changes in GORD symptoms and use of PPIs. RESULTS:We screened 1206 records; and included five trials (four cross-over and one factorial) comprising 228 patients. All five included trials were judged to be at high-risk of performance bias and four of selection bias. Of five included trials, two used 'bed blocks' under the bed legs; one used 'sleeping on a wedge' pillow, and two used both. High heterogeneity in outcome measures and reported outcomes data precluded meta-analyses. The four studies that reported on GORD symptoms found an improvement among participants in the head-of-bed elevation; a high-quality crossover trial showed a clinical important reduction in symptom scores at 6 weeks (risk ratio of 2.1; 95% CI 1.2 to 3.6). These results are supported by the observed improvement in physiological intra-oesophageal pH measurements. CONCLUSIONS:Methodological and reporting limitations in available literature preclude definitive recommendations. However, head-of-bed elevation could be still considered as a cheap and safe alternative to drug interventions with unfavourable safety profiles. PROTOCOL REGISTRATION:Open Science Framework: http://osf.io/2hz3j.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Albarqouni L,Moynihan R,Clark J,Scott AM,Duggan A,Del Mar Cdoi
10.1186/s12875-021-01369-0subject
Has Abstractpub_date
2021-01-19 00:00:00pages
24issue
1issn
1471-2296pii
10.1186/s12875-021-01369-0journal_volume
22pub_type
杂志文章abstract:BACKGROUND:Māori men in New Zealand have higher mortality from prostate cancer, despite having lower incidence rates. The objective of this study was to examine patterns of screening for prostate cancer in primary care and follow-up investigations after an elevated prostate-specific antigen (PSA) result in Māori and no...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-145
更新日期:2014-08-26 00:00:00
abstract:BACKGROUND:While trust in physicians has been rigorously investigated regarding its concept, measurement, and factors, the studies have mainly focused on the attributes of the physicians. This approach can lead to a limited understanding of trust in physicians as trust is based on the relationship, an interaction of bo...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0875-6
更新日期:2018-11-29 00:00:00
abstract:BACKGROUND:Intimate partner violence (IPV) including physical, sexual and emotional violence, causes short and long term ill-health. Brief questions that reliably identify women experiencing IPV who present in clinical settings are a pre-requisite for an appropriate response from health services to this substantial pub...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-8-49
更新日期:2007-08-29 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: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: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: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: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:People who are diagnosed with both mental and chronic medical illness present unique challenges for the health care system. In resource-limited settings, such as rural India, people with depression and anxiety are often under-served, due to both stigma and lack of trained providers and resources. These chall...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0845-z
更新日期:2018-09-11 00:00:00
abstract:BACKGROUND:People with long term conditions (LTCs) make most of the daily decisions and carry out the activities which affect their health and quality of life. Only a fraction of each contact with a health care professional (HCP) is spent supporting this. This paper describes how care and support planning (CSP) and an ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1042-4
更新日期:2019-11-08 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:Female urinary incontinence is underdiagnosed and undertreated in primary care. There is little evidence on factors that determine whether women with urinary incontinence are referred to specialist services. This study aimed to investigate characteristics associated with referrals from primary to specialist ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01282-y
更新日期:2020-10-16 00:00:00
abstract:BACKGROUND:Over the last two decades, ultrasonography (US) has been shown to be an accurate tool for the diagnosis of suspected bone fractures; however, the integration of this application of US into routine care and outpatient settings needs to be explored. In this study, we surveyed German general practitioners (GPs)...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-1078-5
更新日期:2020-01-13 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: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:Audits have shown numerous deficiencies in the quality of hypertension and diabetes primary care in Barbados, despite distribution of regional guidelines. This study aimed to evaluate the knowledge, attitudes and practices, and the barriers faced by primary care practitioners in Barbados concerning the recom...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-96
更新日期:2010-12-03 00:00:00
abstract:BACKGROUND:In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-4-2
更新日期:2003-03-27 00:00:00
abstract:BACKGROUND:The Charlson comorbidity index is widely used in ICD-9 administrative data, however, there is no translation for Read/OXMIS coded data despite increasing use of the General Practice Research Database (GPRD). Our main objective was to translate the Charlson index for use with Read/OXMIS coded data such as the...
journal_title:BMC family practice
pub_type: 历史文章,杂志文章
doi:10.1186/1471-2296-11-1
更新日期:2010-01-05 00:00:00
abstract:BACKGROUND:The protection and promotion of breastfeeding is considered a priority in Europe where only 22% of infants less than 6 months old are exclusively breastfed. In Spain this percentage reaches 24.8% but in our city it falls to 18.26%. Various studies emphasise that the improvement of these results should be bas...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-12-144
更新日期:2011-12-30 00:00:00
abstract:BACKGROUND:The Mini-Mental State Examination (MMSE) has contributed to detecting cognitive impairment, yet few studies have evaluated its accuracy when used by general practitioners (GP) in an actual public-health setting. OBJECTIVES:We evaluated the accuracy of MMSE scores obtained by GPs by comparing them to scores ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-29
更新日期:2008-05-13 00:00:00
abstract:BACKGROUND:Comorbid chronic pain and depression is a challenging dyad of conditions to manage in primary care and reporting has shown to vary by ethnic group. Whether the relationship between depression and chronic pain varies by ethnicity is unclear. This study aims to explore chronic pain and depression reporting acr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0343-5
更新日期:2015-10-06 00:00:00
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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: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:Due to demographic change, general practitioners (GPs) are increasingly required to care for older people with complex health problems. Little is known about the subjective appraisals of GPs concerning the demanded changes. Our objective is to explore how general practitioners view their professional mandate...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0249-2
更新日期:2015-03-14 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:Metabolic syndrome (MetS) is a major public health challenge. General practitioners (GPs) could play a key role in its recognition. However, it often remains undiagnosed in primary care. This study assesses how well GPs and patients recognise MetS among patients with coronary heart disease or at least one of...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-76
更新日期:2009-11-30 00:00:00
abstract:BACKGROUND:Since the 1990s, professional institutions worldwide have emphasised the need to develop research in general practice to improve the health of the population. The recent creation of professorships in general practice in French Universities should foster research in this field. Our aim was to explore the view...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-136
更新日期:2014-07-21 00:00:00
abstract:BACKGROUND:It is commonplace for lay caregivers to overlook their own health concerns when supporting someone with advanced cancer. During this time, caregivers' needs as patients are often marginalised by health professionals, including General Practitioners (GPs), who may miss the breadth of caregivers' needs by focu...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-110
更新日期:2011-10-05 00:00:00
abstract:BACKGROUND:General Practice Co-Operatives provide most out of hours care in communities in Ireland. Limited data exists on patient complaints. This study reports on complaints at Kildare and West Wicklow Doctors on Call ('K Doc'), a GP Co-Operative in Ireland, examining the impact of a formal risk reduction strategy im...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0484-1
更新日期:2016-07-21 00:00:00