Abstract:
OBJECTIVE:To assess the impact of teaching general practitioners to carry out structured assessments of their long term mentally ill patients. DESIGN:Randomised controlled trial. SETTING:Sixteen group general practices in South Thames (west) region. SUBJECTS:440 adults disabled by long term mental illness. INTERVENTIONS:Patients were identified by using practice data with help from local psychiatric and social services. In eight practices the practitioners were taught a structured assessment schedule to use with patients every six months for two years. MAIN OUTCOME MEASURES:Changes in drug treatments, referrals, consultation rates, and recording of preventive health data in the two years after intervention. RESULTS:Follow up data were available on 373 patients (84.7%). At least one structured assessment was recorded for 127 patients in the intervention group but only 29 had four assessments recorded. Participating practitioners considered the structured assessment to be time consuming and reported that it did not often lead directly to changes in treatment or referrals. Changes in treatment with neuroleptic drugs and referrals to community psychiatric nurses, however, were significantly more frequent in the intervention group (differences for intervention group minus control group adjusted for activity in two years before intervention were 14.3% (95% confidence interval 4.3% to 24.33%; P < 0.01) for neuroleptic drugs and 13.3% (2.0% to 24.6%; P < 0.05) for referrals). There were no significant differences in psychiatric admissions, use of the Mental Health Act, drug overdoses, prescriptions, referrals or admissions for physical problems, consultation rates, continuity of care, or recording of preventive data. CONCLUSIONS:Teaching general practitioners about the problems of long term mentally ill patients may increase their involvement in patients' psychiatric care. Regular structured assessments do not seem feasible in routine surgery appointments. More training for general practitioners and increased resources such as more nurse time may be necessary if improvements in care of long term mentally ill patients in general practice are to be generalised.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Kendrick T,Burns T,Freeling Pdoi
10.1136/bmj.311.6997.93subject
Has Abstractpub_date
1995-07-08 00:00:00pages
93-8issue
6997eissn
0959-8138issn
1756-1833journal_volume
311pub_type
临床试验,杂志文章,随机对照试验abstract::Organs for donation are in short supply in the United Kingdom, resulting in allegations that relatives of potential donors are not being asked for consent. Legislation on "required request" has been proposed to overcome this. The incidence, causes, complications, and patterns of organ donation in brain stem dead patie...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6706.1009
更新日期:1989-10-21 00:00:00
abstract:OBJECTIVE:To study the association between wheezy symptoms in young children and the presence of bacteria in the airways. DESIGN:Birth cohort study. SETTING:Clinical research unit in Copenhagen. PARTICIPANTS:Children of asthmatic mothers, from age 4 weeks to 3 years, with planned visits and acute admissions to the r...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c4978
更新日期:2010-10-04 00:00:00
abstract:OBJECTIVE:To examine the association between intake of different types of alcoholic drinks and mortality. DESIGN:Prospective population study with baseline assessment of alcohol intake, smoking habit, income, education, and body mass index, and 10-12 years' follow up of mortality. SETTING:Copenhagen city heart study,...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6988.1165
更新日期:1995-05-06 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. DESIGN:Population based randomised controlled trial. SETTING:Primary care (10 physiotherapy practices, one occupational health service, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.c1035
更新日期:2010-03-16 00:00:00
abstract:OBJECTIVE:To investigate the risk factors for HIV infection in patients attending clinics for sexually transmitted diseases in India. DESIGN:Descriptive study of HIV serology, risk behaviour, and findings on physical examination. SUBJECTS:2800 patients presenting to outpatient clinics between 13 May 1993 and 15 July ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7000.283
更新日期:1995-07-29 00:00:00
abstract::The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rule...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.311.7017.1422
更新日期:1995-11-25 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of classroom based cognitive behavioural therapy with attention control and usual school provision for adolescents at high risk of depression. DESIGN:Three arm parallel cluster randomised controlled trial. SETTING:Eight UK secondary schools. PARTICIPANTS:Adolescents (n=5030) ag...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.e6058
更新日期:2012-10-05 00:00:00
abstract::Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestatio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3677
更新日期:2017-08-17 00:00:00
abstract:OBJECTIVE:To determine the prevalence of sexually transmitted diseases in patients with normal and abnormal cervical smears. DESIGN:A prospective study of asymptomatic women with normal cervical smears attending their general practitioner and newly referred patients with abnormal smears attending a colposcopy clinic. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6768.82
更新日期:1991-01-12 00:00:00
abstract:OBJECTIVE:To compare the effects of treatments for coronavirus disease 2019 (covid-19). DESIGN:Living systematic review and network meta-analysis. DATA SOURCES:WHO covid-19 database, a comprehensive multilingual source of global covid-19 literature, up to 3 December 2020 and six additional Chinese databases up to 12 ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m2980
更新日期:2020-07-30 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of 4% dimeticone lotion for treatment of head louse infestation. DESIGN:Randomised controlled equivalence trial. SETTING:Community, with home visits. PARTICIPANTS:214 young people aged 4 to 18 years and 39 adults with active head louse infestation. INTERVENTIONS:Two app...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.38497.506481.8F
更新日期:2005-06-18 00:00:00
abstract:OBJECTIVE:To undertake a cost effectiveness analysis comparing first and second generation endometrial ablative techniques, hysterectomy, and the levonorgestrel releasing intrauterine system (Mirena) for treating heavy menstrual bleeding. DESIGN:Model based economic evaluation with data from an individual patient data...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.d2202
更新日期:2011-04-26 00:00:00
abstract:OBJECTIVE:To determine the relation between mothers' self reported drinking habits before, during, and after pregnancy and infants' mental and motor development at 18 months of age. DESIGN:Follow up study of all singleton live births born to primigravidas living in Dundee and booked into antenatal clinics from 1 May 1...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.303.6793.22
更新日期:1991-07-06 00:00:00
abstract:OBJECTIVE:To assess body shape trajectories in early and middle life in relation to risk of mortality. DESIGN:Prospective cohort study. SETTING:Nurses' Health Study and Health Professionals Follow-up Study. POPULATION:80 266 women and 36 622 men who recalled their body shape at ages 5, 10, 20, 30, and 40 years and p...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.i2195
更新日期:2016-05-04 00:00:00
abstract:OBJECTIVE:To examine the relation between diameters of the retinal arterioles and 10 year incidence of hypertension. DESIGN:Population based prospective cohort study. SETTING:Beaver Dam eye study. PARTICIPANTS:2451 normotensive people aged 43 to 84 years. MAIN OUTCOME MEASURES:Diameters of retinal arterioles and ve...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38124.682523.55
更新日期:2004-07-10 00:00:00
abstract:OBJECTIVE:To assess the impact of construction of microdams on the incidence of malaria in nearby communities in terms of possibly increasing peak incidence and prolonging transmission. DESIGN:Four quarterly cycles of malaria incidence surveys, each taking 30 days, undertaken in eight at risk communities close to dams...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7211.663
更新日期:1999-09-11 00:00:00
abstract:OBJECTIVES:To assess, as part of wider inspections by HM Inspectorate of Prisons, the extent and quality of health care in prisons in England and Wales. DESIGN:Inspections based on a set of "expectations" derived mainly from existing healthcare quality standards published by the prison service and existing ethical gui...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7120.1420
更新日期:1997-11-29 00:00:00
abstract::Accumulating data indicate that modifications in diet may reduce the risk of cancer by as much as one third and possibly by as much as two thirds. On the basis of the existing evidence, however, it is not possible to be certain which cancers are causally related to diet and what proportion of them are due to specific ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.308.6944.1610
更新日期:1994-06-18 00:00:00
abstract:OBJECTIVE:To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN:Meta-analysis. DATA SOURCES:Computerised databases for English language articles during 1987-2001. STUDY SELECTION:102 articles evaluating 118 disease management progra...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.325.7370.925
更新日期:2002-10-26 00:00:00
abstract::The right of consultants to study leave and expenses is not binding on trusts and has been eroded in directly managed units. Complaints led to a survey of consultants in North West Thames region. This showed that most consultants use their own time and money to maintain their knowledge by buying and consulting journal...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6889.1398
更新日期:1993-05-22 00:00:00
abstract::Doctors and other health professionals in developing countries are missing out on relevant information about health. A lot of the information they need is available in the developed countries, and those who have it are happy to share it with them. But transporting information, like food or medicines, from one part of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6959.939
更新日期:1994-10-08 00:00:00
abstract:OBJECTIVES:To investigate the circumstances since the 1950s in which people who were attracted to members of the same sex received treatments to change their sexual orientation, the referral pathway and the process of therapy, and its aftermath. DESIGN:A nationwide study based on qualitative interviews. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.37984.442419.EE
更新日期:2004-02-21 00:00:00
abstract:OBJECTIVES:To report on the country of training and ethnicity of consultants in different specialties in the NHS, on trends in intake to UK medical schools by ethnicity, and on the specialty choices made by UK medical graduates in different ethnic groups. DESIGN:Analysis of official databases of consultants and of stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38202.364271.BE
更新日期:2004-09-11 00:00:00
abstract:OBJECTIVE:To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays. DESIGN:Retrospective database study. SETTING:Palliative care unit in Germany. POPULATION:All admissions to palliative care unit between 1 January 1997 and 31 December 2008. MAIN OUTCOM...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g7370
更新日期:2014-12-16 00:00:00
abstract:OBJECTIVE:To investigate explanations for social inequalities in health with respect to health related social mobility and cumulative socioeconomic circumstances over the first three decades of life. DESIGN:Longitudinal follow up. SETTING:Great Britain. SUBJECTS:Data from the 1958 birth cohort study (all children bo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7055.449
更新日期:1996-08-24 00:00:00
abstract:OBJECTIVE:To examine doctors' perspectives about their experiences with handheld computers in clinical practice. DESIGN:Qualitative study of eight focus groups consisting of doctors with diverse training and practice patterns. SETTING:Six practice settings across the United States and two additional focus group sessi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.328.7449.1162
更新日期:2004-05-15 00:00:00
abstract:OBJECTIVES:To determine the accuracy of a clinical decision rule (the traffic light system developed by the National Institute for Health and Clinical Excellence (NICE)) for detecting three common serious bacterial infections (urinary tract infection, pneumonia, and bacteraemia) in young febrile children. DESIGN:Retro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f866
更新日期:2013-02-13 00:00:00
abstract::Monocycline is the most widely prescribed systemic antibiotic for acne largely because it needs to be given only once or twice a day and seems not to induce resistance. Up to April 1994 11 cases of minocycline induced systemic lupus erythematosus and 16 cases of hepatitis had been reported to the Committee on Safety o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7024.169
更新日期:1996-01-20 00:00:00
abstract:OBJECTIVES:To examine the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among ol...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f4240
更新日期:2013-07-23 00:00:00
abstract:OBJECTIVE:To develop and validate a prognostic model for early death in patients with traumatic bleeding. DESIGN:Multivariable logistic regression of a large international cohort of trauma patients. SETTING:274 hospitals in 40 high, medium, and low income countries PARTICIPANTS:Prognostic model development: 20,127 t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e5166
更新日期:2012-08-15 00:00:00