Abstract:
BACKGROUND:Depression is prevalent in people with type 2 diabetes and affects both glycemic control and overall quality of life. The aim of this trial was to evaluate the effect of the antidepressant paroxetine on metabolic control, quality of life and mental well-being in mildly depressed women with type 2 diabetes. METHODS:We randomised 15 mildly depressed women with non-optimally controlled type 2 diabetes to a 10-week single-blind treatment with either paroxetine 20 mg per day or placebo. Primary efficacy measurements were glycemic control and quality of life. Glycosylated hemoglobin A1c (GHbA1c) was used as a measure of glycemic control. Quality of life was evaluated using RAND-36. Mental state was assessed using two clinician-rated scoring instruments, Hamilton's Anxiety Scale (HAM-A) and Montgomery-Asberg's Depression Rating Scale (MADRS), and a patient-rated scoring instrument, Beck's Depression Inventory (BDI). RESULTS:At the end of the study no significant difference between groups in improvement of quality of life was found. A trend towards a superior improvement in glycemic control was found in the paroxetine group (p = 0.08). A superior increase in sex-hormone-binding-globuline (SHBG) levels was evidenced in the paroxetine group (p = 0.01) as a sign of improved insulin sensitivity. There was also a trend for superior efficacy of paroxetine in investigator-rated anxiety and depression. This notion was supported by a trend for superior decrease of serum cortisol levels in the paroxetine group (p = 0.06). CONCLUSION:Paroxetine has a beneficial effect on measures of insulin sensitivity and may improve glycemic control. Larger studies of longer duration are needed to verify the benefits of paroxetine in type 2 diabetes. While waiting for more conclusive evidence it seems sensible to augment standard care of type 2 diabetes with paroxetine even in patients who do not fulfil routine psychiatric criteria for initiation of antidepressant drug treatment.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Paile-Hyvärinen M,Wahlbeck K,Eriksson JGdoi
10.1186/1471-2296-4-7keywords:
subject
Has Abstractpub_date
2003-05-14 00:00:00pages
7issn
1471-2296journal_volume
4pub_type
临床试验,杂志文章,随机对照试验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:Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01304-9
更新日期:2020-11-06 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: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
更新日期:2020-12-05 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: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:Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun. As part of future activities of the Queen's University Family Medicine Development Program in the Balkans Region, technical assistance may be provided to ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-5-12
更新日期:2004-06-11 00:00:00
abstract:BACKGROUND:In order to proceed from a paper based registration to a surveillance system that is based on extraction of electronic health records (EHR), knowledge is needed on the number and representativeness of sentinel GPs using a government-certified EHR system and the quality of EHR data for research, expressed in ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-50
更新日期:2010-06-25 00:00:00
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::The editors have retracted this article [1] because it contains extensive overlap with an article published by the same authors in the Journal of Family & Community Medicine [2] and is therefore redundant. ...
journal_title:BMC family practice
pub_type: 杂志文章,撤回出版物
doi:10.1186/s12875-019-1043-3
更新日期:2019-11-05 00:00:00
abstract:BACKGROUND:Glycated hemoglobin (HbA1c) results vary by analytical method. Use of same-visit HbA1c testing methodology holds the promise of more efficient patient care, and improved diabetes management. Our objective was to test the feasibility of introducing a same-visit HbA1c methodology into busy family practice cent...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-6-28
更新日期:2005-07-13 00:00:00
abstract:BACKGROUND:Travel has become an integral part of Saudi life. People with diabetes face many challenges while travelling that can have detrimental effects on glycaemic control. However, no previous studies have investigated pre-travel counselling in Saudi Arabia. This study aims to assess the knowledge, attitudes and pr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01273-z
更新日期:2020-09-24 00:00:00
abstract:BACKGROUND:Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various 'new models of care', including general practice offering 'additi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0773-y
更新日期:2018-06-19 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: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
更新日期:2013-08-29 00:00:00
abstract:BACKGROUND:A rising number of people with chronic conditions is offered interventions to enhance self-management. The responsiveness of individuals to these interventions depends on patient characteristics. We aimed to develop and validate a tool to facilitate personalised counselling and support for self-management in...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0381-z
更新日期:2015-11-11 00:00:00
abstract:BACKGROUND:Long-term needs of stroke survivors are often not adequately addressed and many patients are dissatisfied with care post-discharge from hospital. Primary care could play an important role in identifying need in people with stroke. AIM:We aimed to explore, refine and test the feasibility and acceptability of...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0894-3
更新日期:2019-01-04 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: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:International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the associ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-180
更新日期:2013-11-27 00:00:00
abstract:BACKGROUND:Recurrent urinary tract infections (RUTIs) are commonly presented by women in primary care. In order to explore the poorly described experience of women with RUTIs a qualitative study was conducted that analysed data from a publically accessible internet-based self-help forum. METHODS:Qualitative Descriptio...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-162
更新日期:2014-09-26 00:00:00
abstract:BACKGROUND:This study evaluated the impact of multifaceted NPS MedicineWise programs that targeted all general practitioners (GPs) in Australia in 2009 and 2015 with the aim of reducing unnecessary prescribing of proton pump inhibitors (PPIs) and encouraged stepping down to a lower strength PPI or to discontinue treatm...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01158-1
更新日期:2020-05-09 00:00:00
abstract:BACKGROUND:Overweight, obesity and hypertension can be prevented through improvements in lifestyle including nutrition and physical activity. General practitioners (GPs) in Australia have access to over 90% of the population in the course of a year and therefore, the general practice setting may be ideal to assist pati...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-8
更新日期:2010-02-01 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:There are a substantial number of instruments for primary-care clinicians to assess physical-activity (PA). However, there are few studies that have explored the views of clinicians regarding comparative acceptability and ease of use. A better understanding of how clinicians perceive instruments could help o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0536-6
更新日期:2016-09-22 00:00:00
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: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: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:From 2015 to 2016 Germany faced an influx of 1.16 million asylum seekers. In the state of Hamburg Primary Care walk-in clinics (PCWC) were commissioned at refugee camps because the high number of residents (57,000 individuals) could not be provided with access to regular healthcare services. Our study aims w...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01253-3
更新日期:2020-09-21 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