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Perisse A, Dao MC, Butty D, Derkenne C, Charton F, Fabre N, Grosset-Janin A, Lutringer M, Chanet A, Diop E, Attia C, Coudert A, Courson A, Maillot G, Augen AS, Bagary P, Sahuguet E, Remond O, Paleiron N, Bylicki O. Long-Term Consequences of Spirometry During Military Routine Medical Examinations on Smoking Cessation Compared to Minimal Advice. Mil Med 2024; 189:2016-2022. [PMID: 38109715 DOI: 10.1093/milmed/usad473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/21/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Smoking kills 8 million people a year worldwide. It is the most prevalent cause of death in France by cancer, cardiovascular, or respiratory diseases. Minimal advice consists in asking patients who smoke if they are interested in quitting. It is effective in reducing smoking. The French High Health Authority recommends its systematic use with patients, whatever their reason for seeking treatment. The beneficial effect of spirometry on smoking cessation is controversial. The objective of our study was to measure the consequences of spirometry associated with minimal advice, compared with only minimal advice in soldiers seen during a routine medical examination. METHODS Our prospective, longitudinal, open, multicenter, controlled, randomized study was conducted among French military smokers presenting for an occupational medicine visit. Each participant received, depending on their group (intervention or control), either minimal advice associated with an evaluation of lung function by mini-spirometer, or only minimal advice. Follow-up visits were performed at 6 and 12 months. The primary objective was self-reported tobacco use cessation at 6 months. RESULTS A total of 267 participants (126 in the intervention group and 141 for the control arm) were included in 10 centers between June 2019 and June 2020. The response rate was 75.6% at 6 months. The cessation rates were 17% and 18% in the intervention and control groups, respectively, with no significant difference between the two groups (P = 0.9). The cessation rate in the general population was 13% at 6 months. CONCLUSIONS Spirometry does not seem to influence smoke cessation on a military population at 6 months. The overall cessation rate in our study was well in excess of the 3-6% expected from only providing minimal which is underused in general practice and should be encouraged.
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Affiliation(s)
- Anne Perisse
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Marie-Cécile Dao
- 13th Military Medical Center, Service de Santé des Armées, Rochefort Air 17133, France
| | - Damien Butty
- 3rd Military Medical Center, Service de Santé des Armées, Lille Cedex 59001, France
| | | | - France Charton
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Nathalie Fabre
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Anais Grosset-Janin
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Manon Lutringer
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Aurore Chanet
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Elie Diop
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Claire Attia
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Anne Coudert
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Audrey Courson
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Gaelle Maillot
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Anne-Sophie Augen
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Pierre Bagary
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Emilie Sahuguet
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Odile Remond
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Nicolas Paleiron
- Department of Pneumology, Military hospital Sainte-Anne, Toulon 83800, France
| | - Olivier Bylicki
- Department of Pneumology, Military hospital Sainte-Anne, Toulon 83800, France
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Lionis C, Anastasaki M. Family Practice Research in low-resource settings: what we have missed and what we have to know. Fam Pract 2019; 36:253-254. [PMID: 30544193 DOI: 10.1093/fampra/cmy121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Marilena Anastasaki
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece
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Huas C, Petek D, Diaz E, Muñoz-Perez MA, Torzsa P, Collins C. Strategies to improve research capacity across European general practice: The views of members of EGPRN and Wonca Europe. Eur J Gen Pract 2019; 25:25-31. [PMID: 30607993 PMCID: PMC6394293 DOI: 10.1080/13814788.2018.1546282] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: The effectiveness of any national healthcare system is highly correlated with the strength of primary care within that system. A strong research basis is essential for a firm and vibrant primary care system. General practitioners (GPs) are at the centre of most primary care systems. Objectives: To inform on actions required to increase research capacity in general practice, particularly in low capacity countries, we collected information from the members of the European General Practice Research Network (EGPRN) and the European World Organization of Family Doctors (Wonca). Methods: A qualitative design including eight semi-structured interviews and two discursive workshops were undertaken with members of EGPRN and Wonca Europe. Appreciative inquiry methods were utilized. Krueger’s (1994) framework analysis approach was used to analyse the data. Results: Research performance in general practice requires improvements in the following areas: visibility of research; knowledge acquisition; mentoring and exchange; networking and research networks; collaboration with industry, authorities and other stakeholders. Research capacity building (RCB) strategies need to be both flexible and financially supported. Leadership and collaboration are crucial. Conclusion: Members of the GP research community see the clear need for both national and international primary care research networks to facilitate appropriate RCB interventions. These interventions should be multifaceted, responding to needs at different levels and tailored to the context where they are to be implemented.
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Affiliation(s)
- Caroline Huas
- a UVSQ, CESP, INSERM , Université Paris-Saclay, Univ. Paris-Sud , Villejuif , France.,b Fondation santé des étudiants de France , Paris , France
| | - Davorina Petek
- c Department of Family Medicine, Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia.,d Executive Board , European General Practice Research Network , Maastricht, The Netherlands
| | - Esperanza Diaz
- e Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.,f Norwegian Centre for Migration and Minority Health , Oslo , Norway
| | - Miquel A Muñoz-Perez
- g Departement de Salut, Generalitat de Catalunya , Institut Català de la Salut. IDIAP-Jordi Gol , Barcelona , Spain
| | - Peter Torzsa
- h Department of Family Medicine , Semmelweis University Faculty of Medicine , Budapest , Hungary
| | - Claire Collins
- d Executive Board , European General Practice Research Network , Maastricht, The Netherlands.,i The Irish College of General Practitioners , Dublin , Ireland
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Jamoulle M. New 2016 MeSH Addressing Information Gap, Poverty, Violence and Danger of Medicine Set the Tone for Policy-Makers in Patient Care. Int J Health Policy Manag 2016; 5:397-8. [DOI: 10.15171/ijhpm.2016.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 04/11/2016] [Indexed: 11/09/2022] Open
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Opportunities and barriers to enhance research capacity and outputs among academic family physicians in the Arab world. Prim Health Care Res Dev 2015; 17:98-104. [PMID: 26687846 DOI: 10.1017/s1463423615000377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To explore the current status of academic primary care research in Arab countries and investigate the barriers to its adequate implementation. BACKGROUND Research is an essential building block that ensures the advancement of the discipline of Family Medicine (FM). FM research thus ought to be contributed to by all family physicians; nevertheless, its development is being hindered worldwide by several challenges. The amount of research conducted by academic academic family physicians and general practitioners is scant. This phenomenon is more pronounced in the Arab countries. METHODS An online questionnaire was emailed to all academic family physicians practicing in member Arab countries of the World Organization of Family Doctors WONCA-East Mediterranean Region. FINDINGS Seventy-six out of 139 academic family physicians from eight Arab countries completed the questionnaire. Around 75% reported that they are required to conduct research studies, yet only 46% contributed to at least one publication. While 75% and 52.6% disclosed their interest in participating in a research team and in leading a research team respectively, 64.5% reported being currently involved in research activities. Of all, 56% have attended a research ethics course. Lack of training in research, the unavailability of a healthcare system that is supportive of research, insufficient financial resources, and the unavailability of electronic health records were perceived as major barriers in conducting FM research. CONCLUSION Although many physicians in Arab academic institutions expressed enthusiasm to conduct research projects, FM research infrastructure remains to be weak. This demonstrates the need for immense efforts from different parties particularly governments and academic institutions.
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Affiliation(s)
- Stephen May
- Deputy Principal; Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL9 7TA
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Cadwallader JS, Lebeau JP, Lasserre E, Letrilliart L. Patient and professional attitudes towards research in general practice: the RepR qualitative study. BMC FAMILY PRACTICE 2014; 15:136. [PMID: 25047280 PMCID: PMC4115489 DOI: 10.1186/1471-2296-15-136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 07/15/2014] [Indexed: 11/10/2022]
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 views of patients and relevant professionals on research in general practice. METHODS Qualitative study, using the grounded theory approach according to Strauss and Corbin, conducted in 2010 in three French regions. Nine focus groups were run to data saturation, and included 57 participants in four different categories: patients, non-academic GPs, academic GPs, academics in other disciplines. RESULTS Most of the participants in the four categories described research in general practice as specific to the population managed and relevant for health care. They considered that its grounding in day-to-day practice enabled pragmatic approaches. The influence of the pharmaceutical industry, rivalries between university disciplines and a possible gap between research and practice were considered as pitfalls. The barriers identified were representations of the medical researcher as a "laboratory worker", the lack of awareness of any research in the discipline, and lack of time and training. While the views of patients and non-academic GPs are mostly focused on professional issues and the views of academics other than GPs on technical issues, academic GPs are in a position to play a role of interface between the universities and general practices. CONCLUSIONS Although the role of GPs in research is perceived differently by the various protagonists, research in general practice has an undisputed legitimacy in France. Solutions for overcoming the identified barriers include research networks with appropriate resources and training and scientifically sound collaborative research projects, as already implemented in leading countries.
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Affiliation(s)
- Jean-Sébastien Cadwallader
- Department of General Practice, University of Tours, 10 Boulevard Tonnellé, BP 3223, Tours, Cedex 1 37032, France.
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Takeshima T, Kumada M, Mise J, Ishikawa Y, Yoshizawa H, Nakamura T, Okayama M, Kajii E. Reasons for encounter and diagnoses of new outpatients at a small community hospital in Japan: an observational study. Int J Gen Med 2014; 7:259-69. [PMID: 24940078 PMCID: PMC4051729 DOI: 10.2147/ijgm.s62384] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Although many new patients are seen at small hospitals, there are few reports of new health problems from such hospitals in Japan. Therefore, we investigated the reasons for encounter (RFE) and diagnoses of new outpatients in a small hospital to provide educational resources for teaching general practice methods. Methods This observational study was conducted at the Department of General Internal Medicine in a small community hospital between May 6, 2010 and March 11, 2011. We classified RFEs and diagnoses according to component 1, “Symptoms/Complaints”, and component 7, “Diagnosis/Diseases”, of the International Classification of Primary Care, 2nd edition (ICPC-2). We also evaluated the differences between RFEs observed and common symptoms from the guidelines Model Core Curriculum for Medical Students and Goals of Clinical Clerkship. Results We analyzed the data of 1,515 outpatients. There were 2,252 RFEs (1.49 per encounter) and 170 ICPC-2 codes. The top 30 RFE codes accounted for 80% of all RFEs and the top 55 codes accounted for 90%. There were 1,727 diagnoses and 196 ICPC-2 codes. The top 50 diagnosis codes accounted for 80% of all diagnoses, and the top 90 codes accounted for 90%. Of the 2,252 RFEs, 1,408 (62.5%) included at least one of the 36 symptoms listed in the Model Core Curriculum and 1,443 (64.1%) included at least one of the 35 symptoms in the Goals of Clinical Clerkship. On the other hand, “A91 Abnormal result investigation”, “R21 Throat symptom/complaint”, and “R07 Sneezing/nasal congestion”, which were among the top 10 RFEs, were not included in these two guidelines. Conclusion We identified the common RFEs and diagnoses at a small hospital in Japan and revealed the inconsistencies between the RFEs observed and common symptoms listed in the guidelines. Our findings can be useful in improving the general practice medical education curricula.
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Affiliation(s)
- Taro Takeshima
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan ; Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Maki Kumada
- Division of The Project for Integration of Community Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan ; Department of General Internal Medicine, Chikusei City Hospital, Chikusei, Japan
| | - Junichi Mise
- Division of Human Resources Development for Community Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | | | - Hiromichi Yoshizawa
- Department of General Internal Medicine, Chikusei City Hospital, Chikusei, Japan
| | - Takashi Nakamura
- Division of The Project for Integration of Community Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan ; Department of General Internal Medicine, Chikusei City Hospital, Chikusei, Japan
| | - Masanobu Okayama
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Eiji Kajii
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
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Buono N, Thulesius H, Petrazzuoli F, Van Merode T, Koskela T, Le Reste JY, Prick H, Soler JK. 40 years of biannual family medicine research meetings--the European General Practice Research Network (EGPRN). Scand J Prim Health Care 2013; 31:185-7. [PMID: 24191874 PMCID: PMC3860292 DOI: 10.3109/02813432.2013.847594] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To document family medicine research in the 25 EGPRN member countries in 2010. DESIGN Semi-structured survey with open-ended questions. SETTING Academic family medicine in 23 European countries, Israel, and Turkey. SUBJECTS 25 EGPRN national representatives. MAIN OUTCOME MEASURES Demographics of the general population and family medicine. Assessments, opinions, and suggestions. RESULTS EGPRN has represented family medicine for almost half a billion people and > 300,000 general practitioners (GPs). Turkey had the largest number of family medicine departments and highest density of GPs, 2.1/1000 people, Belgium had 1.7, Austria 1.6, and France 1.5. Lowest GP density was reported from Israel 0.17, Greece 0.18, and Slovenia 0.4 GPs per 1000 people. Family medicine research networks were reported by 22 of 25 and undergraduate family medicine research education in 20 of the 25 member countries, and in 10 countries students were required to do research projects. Postgraduate family medicine research was reported by 18 of the member countries. Open-ended responses showed that EGPRN meetings promoted stimulating and interesting research questions such as comparative studies of chronic pain management, sleep disorders, elderly care, healthy lifestyle promotion, mental health, clinical competence, and appropriateness of specialist referrals. Many respondents reported a lack of interest in family medicine research related to poor incentives and low family medicine status in general and among medical students in particular. It was suggested that EGPRN exert political lobbying for family medicine research. CONCLUSION Since 1974, EGPRN organizes biannual conferences that unite and promote primary care practice, clinical research and academic family medicine in 25 member countries.
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Affiliation(s)
- Nicola Buono
- 1European General Practice Research Network Council and Executive Board
| | - Hans Thulesius
- 1European General Practice Research Network Council and Executive Board
| | | | - Tiny Van Merode
- 1European General Practice Research Network Council and Executive Board
| | - Tuomas Koskela
- 1European General Practice Research Network Council and Executive Board
| | | | - Hanny Prick
- 1European General Practice Research Network Council and Executive Board
- 2EGPRN Office, Department of Family Medicine, University of Maastricht, The Netherlands
| | - Jean Karl Soler
- 1European General Practice Research Network Council and Executive Board
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Jahan S, Henary B. Attitudes of primary health care physician managers toward research: a pre-experimental study. Aust J Prim Health 2013; 19:171-6. [PMID: 22950877 DOI: 10.1071/py11146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 03/14/2012] [Indexed: 11/23/2022]
Abstract
Research in primary health care (PHC) is underdeveloped and scarce, especially in developing countries. It is important to understand the attitudes and aspirations of PHC physicians for the promotion of research. The aim of this study was to determine the attitudes of PHC physician managers toward research in Qassim province and to identify barriers that impede performing research in the PHC system. The study was based on social cognitive theory framework, and was pre-experimental with a 'one-group pre-test-post-test' design. The study participants were physician managers in PHC administration, Qassim. The participants' attitudes were measured by adapting statements from the Attitude Towards Research scale. The intervention was the 1-day training program 'Introduction to Research in Primary Health Care'. A total of 23 PHC physicians participated in the study. The mean age of the participants was 45.4 (±1.6) years, and the mean years of work experience was 16.2 (±2.2) years. Only one participant had an article published in a peer-reviewed journal. The results of the study showed that PHC physicians had a baseline positive attitude toward research that was further enhanced after participating in an introductory research-training program. During the pre-test, out of the total score of 63, the mean score on attitude toward research was 48.35 (±6.8) while the mean total attitude score in the post-test was 49.7 (±6.6). However, the difference was not statistically significant at P<0.05. The item with the highest score regarded the role of research in the improvement of health care services, while the lowest-scoring item was about support from administration to conduct research. The participants recognised lack of skills, lack of training and inadequate resources as major barriers in conducting research. Our study results suggest that the PHC physicians' positive attitudes toward research can be further improved through in-service training. To promote research in PHC in Qassim, regular research-training programs and incentives for conducting research should be provided to the PHC physicians.
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Affiliation(s)
- Saulat Jahan
- Primary Health Care Administration, Qassim, Saudi Arabia.
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Robinson N, Lorenc A, Falinski A, Banarsee R. The challenges of facilitating primary healthcare discussions on traditional, complementary and alternative medicine for childhood eczema: piloting a computerized template. PATIENT EDUCATION AND COUNSELING 2012; 89:517-524. [PMID: 22465483 DOI: 10.1016/j.pec.2012.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 03/01/2012] [Accepted: 03/02/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Healthcare practitioners (HCPs) experience barriers to changing routine consultation practice. Communication and recording of traditional, complementary and alternative medicines (TCAM) is inadequate. This pilot study explored the challenges of implementing a computerized template in primary care to facilitate communication on TCAM for paediatric eczema. METHODS A computerized template to record TCAM use, with links to evidence-based TCAM databases, was designed, based on qualitative research with patients and HCPs. Four London general practices implemented the template integrated with usual practice. Twelve focus groups during the 6 month study period explored HCPs' knowledge, communication and information sources regarding TCAM and perceived barriers to template implementation. RESULTS HCPs were initially enthusiastic about discussing TCAM, for improving communication and understanding patient's choices, but the template was used in under a third of consultations. HCPs were surprised at low TCAM use (10%) and lack of correlation with eczema or ethnicity. Reported barriers were time and remembering, due to busy, target-driven practice. CONCLUSION HCPs recognize the importance of discussing TCAM use for childhood eczema, and potential benefits for HCP-patient communication. PRACTICE IMPLICATIONS Future tools to facilitate TCAM discussion should prioritise use of existing IT systems and address barriers to use, especially lack of time.
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Soler JK, Okkes I, Oskam S, van Boven K, Zivotic P, Jevtic M, Dobbs F, Lamberts H. An international comparative family medicine study of the Transition Project data from the Netherlands, Malta and Serbia. Is family medicine an international discipline? Comparing incidence and prevalence rates of reasons for encounter and diagnostic titles of episodes of care across populations. Fam Pract 2012; 29:283-98. [PMID: 22308182 DOI: 10.1093/fampra/cmr098] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION This is a study of the epidemiology of family medicine (FM) in three practice populations from the Netherlands, Malta and Serbia. Incidence and prevalence rates, especially of reasons for encounter (RfEs) and episode labels, are compared. METHODOLOGY Participating family doctors (FDs) recorded details of all their patient contacts in an episode of care (EoC) structure using electronic patient records based on the International Classification of Primary Care (ICPC), collecting data on all elements of the doctor-patient encounter. RfEs presented by the patient, all FD interventions and the diagnostic labels (EoCs labels) recorded for each encounter were classified with ICPC (ICPC-2-E in Malta and Serbia and ICPC-1 in the Netherlands). RESULTS The content of family practice in the three population databases, incidence and prevalence rates of the common top 20 RfEs and EoCs in the three databases are given. CONCLUSIONS Data that are collected with an episode-based model define incidence and prevalence rates much more precisely. Incidence and prevalence rates reflect the content of the doctor-patient encounter in FM but only from a superficial perspective. However, we found evidence of an international FM core content and a local FM content reflected by important similarities in such distributions. FM is a complex discipline, and the reduction of the content of a consultation into one or more medical diagnoses, ignoring the patient's RfE, is a coarse reduction, which lacks power to fully characterize a population's health care needs. In fact, RfE distributions seem to be more consistent between populations than distributions of EoCs are, in many respects.
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Affiliation(s)
- Jean K Soler
- Mediterranean Institute of Primary Care, 19, Triq ir-Rand, Attard ATD1300, Malta.
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Current osteoarthritis treatment, prescribing influences and barriers to implementation in primary care. Prim Health Care Res Dev 2012; 13:373-81. [PMID: 22464219 DOI: 10.1017/s1463423612000072] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To explore general practitioners' (GPs) management of osteoarthritis (OA). BACKGROUND OA represents a large burden on primary care. Little is known about GPs' current management of OA, especially influences on their prescribing quality care and the barriers they face while doing so. METHODS A total of 1006 GPs were randomly selected and invited to participate in an online survey on assessment and treatment of OA, on factors influencing their management, burden on their practice, and on the need for improving care. FINDINGS There were 232 respondents (23%). National Institute for Health and Clinical Excellence (NICE) guidance (65%) and professional experience (64%) were the biggest influences on OA management. When assessing patients, pain and mobility were most frequently assessed, with quality of life, independent living, sleep and depression addressed by over half of them. In all, 52% did not use educational materials; only a third of users rated their current educational material as good or very good. Treatments employed were largely in line with NICE recommendations. Prescription review was reported by a high proportion (74%). Achieving adequate pain control and lack of time were the most frequently cited challenges, whereas more time with patients, collaboration with specialist colleagues and improved communication tools were the most common needs identified to improve OA management. In summary, national guidelines are an important influence for GP treatment of OA. This survey has highlighted issues about the adequacy of information available for OA, about GPs' need for more time with OA patients and their interaction with specialist colleagues.
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Supper I, Ecochard R, Bois C, Paumier F, Bez N, Letrilliart L. How do French GPs consider participating in primary care research: the DRIM study. Fam Pract 2011; 28:226-32. [PMID: 20829279 DOI: 10.1093/fampra/cmq073] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recruiting GPs is an issue faced by most research teams in primary care. OBJECTIVES To assess GPs' willingness and expectations with regard to research in French primary care and to identify factors that may increase their participation in research projects. METHODS Cross-sectional study conducted with a representative sample of 452 GPs from the Rhone-Alpes region in France. RESULTS Among 284 GPs (63%) who participated, 85 [29.9%, 95% confidence interval (CI) = 26.4-35.3%] were willing to participate in research as investigators and 83 (29.2%, 95% CI: 23.9-34.5%) had already participated in research projects. Multivariate analysis showed that an earlier participation in research projects [odds ratio (OR) = 3.3], a training practice (OR = 2.3), membership in a research network (OR = 2.1) and younger age (OR = 1.9 for 10 years less) were associated with the willingness to participate in future research projects. Whereas 55% of practitioners who already had an experience in research had participated in a therapeutic trial, those willing to participate in the future preferred to participate in descriptive (26%) or etiologic (22%) studies. Preventive, diagnostic and therapeutic procedures and quality of care were the domains, which interested GPs most. The most expected clinical themes concerned cardiovascular, metabolic, musculoskeletal and respiratory problems. CONCLUSIONS To meet the expectations of French GPs willing to participate in primary care research, it is advisable to diversify studies with respect to their types, domains and themes. Linkage to universities and research networks should also be encouraged.
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Affiliation(s)
- Irène Supper
- Department of General Practice, University of Lyon 1, Lyon, France
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Kruschinski C, Lange M, Lionis C, van Weel C, Hummers-Pradier E. Themes and methods of research presented at European General Practice Research Network conferences. Fam Pract 2010; 27:459-67. [PMID: 20427325 DOI: 10.1093/fampra/cmq023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The World Organization of Family Doctors (Wonca) defined core characteristics of general practice and general practitioners' competencies. It is unclear to which extent research has addressed these issues so far. OBJECTIVE To determine themes and research methods of general practice research as reflected by presentations at the European General Practice Research Network (EGPRN) meetings. METHODS Descriptive and retrospective study. All abstracts presented at each of the 14 EGPRN conferences between June 2001 and October 2007 were analysed for content and study design/methodology. Categories for content were developed inductively; a predefined hierarchical scheme was used for study designs. RESULTS A total of N=614 abstracts were classified. The main research topics were related to GP/health service issues (n=232), clinical (n=148) and patient-related themes (n=118). Original data (n=558) were mainly derived from cross-sectional designs (38.7%). Intervention studies (11.0%), longitudinal designs including case-control and cohort studies (13.3%) as well as instrumental research (2.2%) were less common. More than one-fourth of all original studies were qualitative studies (27.6%). Stratified analysis revealed that cross-sectional designs were less frequent in the second half of conferences. Analysis by country showed that, in contrast to different quantitative designs, the proportion of qualitative studies was comparable. CONCLUSIONS To test effectiveness of diagnostic and therapeutic interventions under primary care conditions, a higher proportion of experimental studies would be preferable. This could increase the acceptance of general practitioners' specific approaches and provide clear guidance on approaches and procedures, especially in health care systems not predominantly based on primary care.
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Royen PV, Sandholzer H, Griffiths F, Lionis C, Rethans JJ, Galí F, Eilat-Tsanani S, Hummers-Pradier E. Are presentations of abstracts at EGPRN meetings followed by publication? Eur J Gen Pract 2010; 16:100-5. [DOI: 10.3109/13814788.2010.482582] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Setting priorities in clinical and health services research: Properties of an adapted and updated method. Int J Technol Assess Health Care 2010; 26:217-24. [DOI: 10.1017/s0266462310000012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objectives: The objectives of this study is to review the set of criteria of the Institute of Medicine (IOM) for priority-setting in research with addition of new criteria if necessary, and to develop and evaluate the reliability and validity of the final priority score.Methods: Based on the evaluation of 199 research topics, forty-five experts identified additional criteria for priority-setting, rated their relevance, and ranked and weighted them in a three-round modified Delphi technique. A final priority score was developed and evaluated. Internal consistency, test–retest and inter-rater reliability were assessed. Correlation with experts’ overall qualitative topic ratings were assessed as an approximation to validity.Results: All seven original IOM criteria were considered relevant and two new criteria were added (“potential for translation into practice”, and “need for knowledge”). Final ranks and relative weights differed from those of the original IOM criteria: “research impact on health outcomes” was considered the most important criterion (4.23), as opposed to “burden of disease” (3.92). Cronbach's alpha (0.75) and test–retest stability (interclass correlation coefficient = 0.66) for the final set of criteria were acceptable. The area under the receiver operating characteristic curve for overall assessment of priority was 0.66.Conclusions: A reliable instrument for prioritizing topics in clinical and health services research has been developed. Further evaluation of its validity and impact on selecting research topics is required.
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Kalabay L. Primary care research in Hungary. Results and experiences in comparison with Europe. Orv Hetil 2010; 151:707-13. [DOI: 10.1556/oh.2010.28862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A közlemény a magyar alapellátási rendszerben korábban körzeti, ma háziorvosok által végzett tudományos kutatások történetét, eredményeit és a jelenlegi helyzetet tekinti át, előremutató javaslatokkal a jövőre nézve. Beavatja az olvasót ennek a területnek sajátosságaiba, vizsgálómódszereibe, céljaiba. Áttekinti és összehasonlítja az Európában és Magyarországon vizsgált kutatási témákat, eredményeket, infrastrukturális különbségeket és perspektívákat, információt ad a téma iránt érdeklődő olvasónak a további tájékozódás forrásaihoz.
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Affiliation(s)
- László Kalabay
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar Családorvosi Tanszék Budapest Kútvölgyi út 4. 1125
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Lionis C, Symvoulakis EK, Vardavas CI. Implementing family practice research in countries with limited resources: a stepwise model experienced in Crete, Greece. Fam Pract 2010; 27:48-54. [PMID: 19884125 DOI: 10.1093/fampra/cmp078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The need for a cost-effective decision-making process is increasingly seen as a challenge within modern family practice. The role of family practice research is well recognized in countries with readily available resources and capacity. However, the situation is different in a number of countries with limited financial resources and current low research capacity. This article reports on an empirical model of 10 steps developed and applied in Crete, Greece. It aims to exchange views on how to better design and undertake actions in order to develop future family practice research in countries with limited resources.
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Affiliation(s)
- Christos Lionis
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
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Hummers-Pradier E, Beyer M, Chevallier P, Eilat-Tsanani S, Lionis C, Peremans L, Petek D, Rurik I, Soler JK, Stoffers HE, Topsever P, Ungan M, Royen PV. The Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe. Part 1. Background and methodology1. Eur J Gen Pract 2010; 15:243-50. [DOI: 10.3109/13814780903452184] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Factors influencing European GPs' engagement in smoking cessation: a multi-country literature review. Br J Gen Pract 2009; 59:682-90. [PMID: 19674514 DOI: 10.3399/bjgp09x454007] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Smoking cessation advice by GPs is an effective and cost-effective intervention, but is not implemented as widely as it could be. AIM This wide-ranging Europe-wide literature review, part of the European Union (EU) PESCE (General Practitioners and the Economics of Smoking Cessation in Europe) project, explored the extent of GPs' engagement in smoking cessation and the factors that influence their engagement. METHOD Two searches were conducted, one for grey literature, across all European countries, and one for academic studies. Data from eligible studies published from 1990 onwards were synthesised and reported under four categories of influencing factors: GP characteristics, patient characteristics, structural factors, and cessation-specific knowledge and skills. RESULTS The literature showed that most GPs in Europe question the smoking status of all new patients but fewer routinely ask this of regular patients, or advise smokers to quit. The proportion offering intensive interventions or prescribing treatments is lower still. Factors influencing GPs' engagement in smoking cessation include GPs' own smoking status and their attitudes towards giving smoking cessation advice; whether patients present with smoking-related symptoms, are pregnant, or heavy smokers; time, training, and reimbursement are important structural factors; and some GPs lack knowledge and skills regarding the use of specific cessation methods and treatments, or have limited awareness of specialist cessation services. No single factor or category of factors explains the variations in GPs' engagement in smoking cessation. CONCLUSION Strategies to improve the frequency and quality of GPs' engagement in smoking cessation need to address the multifaceted influences on GPs' practice and to reflect the widely differing contexts across Europe.
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Sharan P, Gallo C, Gureje O, Lamberte E, Mari JJ, Mazzotti G, Patel V, Swartz L, Olifson S, Levav I, de Francisco A, Saxena S. Mental health research priorities in low- and middle-income countries of Africa, Asia, Latin America and the Caribbean. Br J Psychiatry 2009; 195:354-63. [PMID: 19794206 PMCID: PMC3432479 DOI: 10.1192/bjp.bp.108.050187] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies suggest a paucity of and lack of prioritisation in mental health research from low- and middle-income (LAMI) countries. AIMS To investigate research priorities in mental health among researchers and other stakeholders in LAMI countries. METHOD We used a two-stage design that included identification, through literature searches and snowball technique, of researchers and stakeholders in 114 countries of Africa, Asia, Latin America and the Caribbean; and a mail survey on priorities in research. RESULTS The study identified broad agreement between researchers and stakeholders and across regions regarding research priorities. Epidemiology (burden and risk factors), health systems and social science ranked highest for type of research. Depression/anxiety, substance use disorders and psychoses; and children and adolescents, women, and people exposed to violence/trauma were prioritised among the disorders and population groups respectively. Important criteria for prioritising research were burden of disease, social justice, and availability of funds. Stakeholder groups differed in the importance they gave to the personal interest of researchers as a criterion for prioritising research. Researchers' and stakeholders' priorities were consistent with burden of disease estimates, however suicide was underprioritised compared with its burden. Researchers' and stakeholders' priorities were also largely congruent with the researchers' projects. CONCLUSIONS The results of this first ever conducted survey of researchers and stakeholders regarding research priorities in mental health suggest that it should be possible to develop consensus at regional and international levels regarding the research agenda that is necessary to support health system objectives in LAMI countries.
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Affiliation(s)
- P Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi - 110029, India.
| | - C Gallo
- Departamento de Bioquímica, Biología Molecular y Farmacología, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia
,Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - O Gureje
- Department of Psychiatry, University of Ibadan, Nigeria
| | - E Lamberte
- Social Development Research Center, De La Salle University, Manila, Philippines
| | - JJ Mari
- Department of Psychiatry, Federal University of São Paulo, Brazil
| | - G Mazzotti
- Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
,Department of Psychiatry, Federal University of São Paulo, Brazil
| | - V Patel
- Departamento de Psiquiatría, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L Swartz
- London School of Hygiene & Tropical Medicine, UK and Sangath, India
| | - S Olifson
- Department of Psychology, Stellenbosch University and Human Sciences Research Council, Cape Town, South Africa
| | - I Levav
- Global Forum for Health Research, Geneva, Switzerland
| | - A de Francisco
- Department of Psychology, Stellenbosch University and Human Sciences Research Council, Cape Town, South Africa
| | - S Saxena
- Mental Health Services, Ministry of Health, Jerusalem, Israel
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Dobbs F, Soler JK, Sandholzer H, Yaman H, Petrazzuoli F, Peremans L, Van Royen P. The development of research capacity in Europe through research workshops--the EGPRN perspective. Fam Pract 2009; 26:331-4. [PMID: 19497988 DOI: 10.1093/fampra/cmp022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Frank Dobbs
- Institute of Postgraduate Medicine and Primary Care, Faculty of Life and Health Sciences, University of Ulster, Coleraine, UK
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Lionis C, Allen J, Sapouna V, Alegakis A, Svab I. Towards the establishment of a new target strategy for WONCA Europe: A key informants study. Eur J Gen Pract 2009; 14:76-82. [DOI: 10.1080/13814780802410148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Über Pioniere in der Allgemeinmedizin. Wien Med Wochenschr 2009; 159:173-82. [DOI: 10.1007/s10354-009-0666-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 12/29/2008] [Indexed: 11/27/2022]
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Soler JK, Carelli F, Lionis C, Yaman H. The wind of change: after the European definition--orienting undergraduate medical education towards general practice/family medicine. Eur J Gen Pract 2008; 13:248-51. [PMID: 18324511 DOI: 10.1080/13814780701814986] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Traditionally, medical students are trained in an algorithmic manner, to focus on excluding serious but rare diseases by conceptualizing diagnoses through a process of exclusion based on systematic and technological investigation of an extensive list of potential diagnoses applicable to the patient's presenting symptoms and signs. Students are not often exposed to common diseases, and trivialize all that which cannot be addressed within a strictly medical model. This paper reflects on the recommendations of the EURACT Educational Agenda document, and proposes a return to empiricism in basic medical training by introducing students to primary healthcare, disease, and decision-making processes early in their training. The authors recommend the teaching of communication skills within primary care doctor-patient encounters, the exploration of new ways of teaching the doctor-patient relationship, and that students and young doctors be encouraged to prioritize quality over quantity. Will this stem the current trends towards increasing workload and burnout?
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28
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Bernal-Delgado E, Peiró S, Sotoca R. Prioridades de investigación en servicios sanitarios en el Sistema Nacional de Salud. Una aproximación por consenso de expertos. GACETA SANITARIA 2006; 20:287-94. [PMID: 16942716 DOI: 10.1157/13091144] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of the present paper was to identify and prioritise health services research issues, from the perspective of Spanish NHS enrollees' health needs. METHODS 13 experts attended to a structured consensual meeting by using a two-phase process, sharing both Nominal Group and Delphi Technique features. Health Services Research Priorities were identified and scored (7 to 9, high relevance; 4 to 6 mild relevance and 1 to 3, low or no relevance). Results were sorted regarding the median score and its dispersion. RESULTS 53 research issues were identified. Strategies to improve effectiveness in health care, information to patients, health care quality and safety, equity, access and sustainability were considered of high priority and high consensus; just 4 items had remarkable dispersion (Intercuartile interval [ICI] > or = 2). Organizational improvement, productivity and efficiency enhancement, workforce and equipments were classified of mild priority. Additionally, this group of items reached very low consensus: 59% of them reached ICI > or = 2. CONCLUSIONS Our approach offers reference about priorities to Spanish health services researchers, and also, orientation to financers and users of this kind of research, though several limitations have been described.
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Affiliation(s)
- Enrique Bernal-Delgado
- Instituto Aragonés de Ciencias de la Salud, Red de investigación cooperativa en Epidemiología y Salud Pública, Zaragoza, España.
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Anastasiou F, Antonakis N, Chaireti G, Theodorakis PN, Lionis C. Identifying dyspepsia in the Greek population: translation and validation of a questionnaire. BMC Public Health 2006; 6:56. [PMID: 16515708 PMCID: PMC1420284 DOI: 10.1186/1471-2458-6-56] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2005] [Accepted: 03/04/2006] [Indexed: 11/24/2022] Open
Abstract
Background Studies on clinical issues, including diagnostic strategies, are considered to be the core content of general practice research. The use of standardised instruments is regarded as an important component for the development of Primary Health Care research capacity. Demand for epidemiological cross-cultural comparisons in the international setting and the use of common instruments and definitions valid to each culture is bigger than ever. Dyspepsia is a common complaint in primary practice but little is known with respect to its incidence in Greece. There are some references about the Helicobacter Pylori infection in patients with functional dyspepsia or gastric ulcer in Greece but there is no specific instrument for the identification of dyspepsia. This paper reports on the validation and translation into Greek, of an English questionnaire for the identification of dyspepsia in the general population and discusses several possibilities of its use in the Greek primary care. Methods The selected English postal questionnaire for the identification of people with dyspepsia in the general population consists of 30 items and was developed in 1995. The translation and cultural adaptation of the questionnaire has been performed according to international standards. For the validation of the instrument the internal consistency of the items was established using the alpha coefficient of Chronbach, the reproducibility (test – retest reliability) was measured by kappa correlation coefficient and the criterion validity was calculated against the diagnosis of the patients' records using also kappa correlation coefficient. Results The final Greek version of the postal questionnaire for the identification of dyspepsia in the general population was reliably translated. The internal consistency of the questionnaire was good, Chronbach's alpha was found to be 0.88 (95% CI: 0.81–0.93), suggesting that all items were appropriate to measure. Kappa coefficient for reproducibility (test – retest reliability) was found 0.66 (95% CI: 0.62–0.71), whereas the kappa analysis for criterion validity was 0.63 (95% CI: 0.36–0.89). Conclusion This study indicates that the Greek translation is comparable with the English-language version in terms of validity and reliability, and is suitable for epidemiological research within the Greek primary health care setting.
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Affiliation(s)
- Foteini Anastasiou
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece, P.O. Box: 2208, 71003, Heraklion, Crete, Greece
| | | | - Georgia Chaireti
- Health Centre of Agia Barbara, 70003, Agia Barbara, Crete, Greece
| | - Pavlos N Theodorakis
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece, P.O. Box: 2208, 71003, Heraklion, Crete, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece, P.O. Box: 2208, 71003, Heraklion, Crete, Greece
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Ovhed I, van Royen P, Håkansson A. What is the future of primary care research? Probably fairly bright, if we may believe the historical development. Scand J Prim Health Care 2005; 23:248-53. [PMID: 16272075 DOI: 10.1080/02813430500316692] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To study one aspect of the development of primary care research from 1975 to 2003. DESIGN Quantitative bibliometric study. SETTING Pub Med database. SUBJECTS Four Nordic countries (Denmark, Finland, Norway, and Sweden), seven countries from the rest of Europe (Belgium, France, Germany, Italy, the Netherlands, Spain, and the UK), and seven countries from the rest of the world (Australia, Canada, India, Japan, New Zealand, South Africa, and the USA). MAIN OUTCOME MEASURES Number of primary healthcare publications per million inhabitants. Percentage of publications in primary healthcare of all publications in human medicine. RESULTS In 2003, New Zealand, the UK, and Australia were in the lead, with barely 20 primary care publications per million inhabitants, followed by Norway, Sweden, the Netherlands, and Denmark, where the corresponding figure was around 10. A vigorous increase in publications from 1975 to 2003 was clearly seen in most of the countries. However, during the same period the proportion of publications from primary care in relation to all publications in human medicine was only moderately increased, or virtually unchanged. CONCLUSION It is believed that primary care research has a future, and it is hoped it may even be bright. However, searching Pub Med gave but one aspect of the historical development, and in particular the comparisons between countries may be questionable.
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Affiliation(s)
- Ingvar Ovhed
- Blekinge Unit for Research and Development, Karlskrona, Sweden
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Smith SM, Allwright S, Byrne M, Brazier H, O'Dowd T, Murphy AW. International variations in the generation of the evidence base for primary care. Eur J Gen Pract 2005; 11:33-4. [PMID: 15841065 DOI: 10.3109/13814780509178017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Susan M Smith
- Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
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