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Palacio-Vieira J, Segura L, Anderson P, Wolstenholme A, Drummond C, Bendtsen P, Wojnar M, Kaner E, Keurhorst MN, van Steenkiste B, Kłoda K, Mierzecki A, Parkinson K, Newbury-Birch D, Okulicz-Kozaryn K, Deluca P, Colom J, Gual A. Improving screening and brief intervention activities in primary health care: Secondary analysis of professional accuracy based on the AUDIT-C. J Eval Clin Pract 2018; 24:369-374. [PMID: 29194899 DOI: 10.1111/jep.12854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/30/2017] [Accepted: 10/30/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND OBJECTIVE The ODHIN trial found that training and support and financial reimbursement increased the proportion of patients that were screened and given advice for their heavy drinking in primary health care. However, the impact of these strategies on professional accuracy in delivering screening and brief advice is underresearched and is the focus of this paper. METHOD From 120 primary health care units (24 in each jurisdiction: Catalonia, England, the Netherlands, Poland, and Sweden), 746 providers participated in the baseline and the 12-week implementation periods. Accuracy was measured in 2 ways: correctness in completing and scoring the screening instrument, AUDIT-C; the proportion of screen-negative patients given advice, and the proportion of screen-positive patients not given advice. Odds ratios of accuracy were calculated for type of profession and for intervention group: training and support, financial reimbursement, and internet-based counselling. RESULTS Thirty-two of 36 711 questionnaires were incorrectly completed, and 65 of 29 641 screen-negative patients were falsely classified. At baseline, 27% of screen-negative patients were given advice, and 22.5% screen-positive patients were not given advice. These proportions halved during the 12-week implementation period, unaffected by training. Financial reimbursement reduced the proportion of screen-positive patients not given advice (OR = 0.56; 95% CI, 0.31-0.99; P < .05). CONCLUSION Although the use of AUDIT-C as a screening tool was accurate, a considerable proportion of risky drinkers did not receive advice, which was reduced with financial incentives.
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Affiliation(s)
- J Palacio-Vieira
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - L Segura
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - P Anderson
- Institute of Health and Society, Newcastle University, Newcastle, UK.,Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - A Wolstenholme
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - C Drummond
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK.,National Institute for Health Research Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - P Bendtsen
- Department of Medical Specialist and Department of Medicine and Health, Linköping University, Motala, Sweden
| | - M Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - E Kaner
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - M N Keurhorst
- Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - B van Steenkiste
- Department of Family Medicine, Maastricht University, Maastricht, The Netherlands
| | - K Kłoda
- Independent Laboratory of Family Physician Education, Pomeranian Medical University, Szczecin, Poland
| | - A Mierzecki
- Independent Laboratory of Family Physician Education, Pomeranian Medical University, Szczecin, Poland
| | - K Parkinson
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | - K Okulicz-Kozaryn
- State Agency for Prevention of Alcohol-Related Problems, Warsaw, Poland
| | - P Deluca
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - J Colom
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - A Gual
- Institut Clínic de Neurosciences, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain.,IDIBAPS, Barcelona, Spain.,Red de Trastornos Adictivos (RETICS), Instituto Carlos III, Madrid, Spain
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Caamano-Isorna F, Ramkumar MR, Doallo S, Corral M, Rodriguez-Holguin S, Cadaveira F, Nemtsov AV, Gilder D, Ehlers C, Gizer I, Yehuda R, Razvodovsky Y, Thorens G, Achab S, Peraro L, Lobello S, Rosa-Rizzotto E, Caroli D, Polato F, De Lazzari F, Grinakis E, Stathaki D, Sfakianaki E, Mouzas J, Salem B, Lesch OM, Mouzas I, Koulentaki M, Grinakis E, Liodaki N, Sfakianaki K, Stathaki D, Pikraki K, Aggouridaki R, Hovhannisyan K, Skagert E, Thornqvist K, Ohlsson M, Wikstrom MM, Tonnesen H, Anderson P, Gual A, Spak F, Bendtsen P, Keurhorst M, Segura L, Colom J, Reynolds J, Drummond C, Deluca P, van Steenkiste B, Mierzecki A, Kloda K, Wallace P, Newbury-Birch D, Kaner E, Laurant M, Wojnar M, Anderson P, Gual A, Spak F, Bendtsen P, Keurhorst M, Segura L, Colom J, Reynolds J, Drummond C, Deluca P, van Steenkiste B, Mierzecki A, Kloda K, Wallace P, Newbury-Birch D, Kaner E, Laurant M, Wojnar M, Anderson P, Gual A, Spak F, Bendtsen P, Keurhorst M, Segura L, Colom J, Reynolds J, Drummond C, Deluca P, van Steenkiste B, Mierzecki A, Kloda K, Wallace P, Newbury-Birch D, Kaner E, Laurant M, Wojnar M. EPIDEMIOLOGY. Alcohol Alcohol 2013. [DOI: 10.1093/alcalc/agt118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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van Vugt S, Broekhuizen L, Zuithoff N, de Jong P, Butler C, Hood K, Coenen S, Goossens H, Little P, Almirall J, Blasi F, Chlabicz S, Davies M, Godycki-Cwirko M, Hupkova H, Kersnik J, Mierzecki A, Mölstad S, Moore M, Schaberg T, De Sutter A, Torres A, Touboul P, Verheij T. Incidental chest radiographic findings in adult patients with acute cough. Ann Fam Med 2012; 10:510-5. [PMID: 23149527 PMCID: PMC3495924 DOI: 10.1370/afm.1384] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Imaging may produce unexpected or incidental findings with consequences for patients and ordering of future investigations. Chest radiography in patients with acute cough is among the most common reasons for imaging in primary care, but data on associated incidental findings are lacking. We set out to describe the type and prevalence of incidental chest radiography findings in primary care patients with acute cough. METHODS We report on data from a cross-sectional study in 16 European primary care networks on 3,105 patients with acute cough, all of whom were undergoing chest radiography as part of a research study workup. Apart from assessment for specified signs of pneumonia and acute bronchitis, local radiologists were asked to evaluate any additional finding on the radiographs. For the 2,823 participants with good-quality chest radiographs, these findings were categorized according to clinical relevance based on previous research evidence and analyzed for type and prevalence by network, sex, age, and smoking status. RESULTS Incidental findings were reported in 19% of all participants, and ranged from 0% to 25% by primary care network, with the network being an independent contributor (P <.001). Of all participants 3% had clinically relevant incidental findings. Suspected nodules and shadows were reported in 1.8%. Incidental findings were more common is older participants and smokers (P <. 001). CONCLUSIONS Clinically relevant incidental findings on chest radiographs in primary care adult patients with acute cough are uncommon, and prevalence varies by setting.
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Affiliation(s)
- Saskia van Vugt
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands.
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Bukowska H, Mierzecki A, Wesolowska T, Chelstowski K, Goracy I, Naruszewicz M. Tu-P10:414 Relationship of homocysteine levels with paraoxonase activity and lipoprotein profile in adult population of West Pomerania. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81115-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jastrzebska M, Goracy I, Bukowska H, Mierzecki A, Klimek K, Chelstowski K, Naruszewicz M. We-P11:110 Effect of fenofibrate on the hemostatic system in patients with the metabolic syndrome in relation to some gene polymorphisms and smoking status. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81464-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Piñeiro R, Brotons C, Bulc M, Ciurana R, Drenthen T, Durrer D, Godycki-Cwirko M, Görpelioglu S, Kloppe P, Lionis C, Mancini M, Martins C, Mierzecki A, Pichler I, Pullerits L, Sammut MR, Sghedoni D, Sheehan M, Thireos EA. Healthy diet in primary care: views of general practitioners and nurses from Europe. Eur J Clin Nutr 2005; 59 Suppl 1:S77-80. [PMID: 16052199 DOI: 10.1038/sj.ejcn.1602177] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Most of the national colleges of general practitioners (GPs) do not have their own dietary/nutritional tools, and GPs and nurses do not have the time, knowledge, or skills to advise their patients about desirable dietary practices. OBJECTIVE To assess the usefulness of a simple and practical guide on healthy diet to be used by European GPs and nurses. DESIGN A postal survey was mailed to 171 GPs and nurses from 12 European countries to obtain information about the usefulness of a guide on healthy diet developed by EUROPREV. RESULTS The perception of health professionals is that the main source of information on healthy diet for the population was the media. In all, 95% of GPs and nurses reported that the guide was useful; 93, 95, and 82% reported that the concepts were concise, easy to understand, and realistic, respectively. Also, 77% reported that the type of counselling recommended was feasible and could be applied, 94% reported that the implementation measures proposed could be effective and 88% reported that the Traditional Mediterranean Diet Pyramid is useful, but some concerns about the content were mentioned. CONCLUSIONS GPs and nurses from Europe think that a practical guide on healthy diet developed by EUROPREV could be used to advise patients in primary care, although the Traditional Mediterranean Diet Pyramid should be modified.
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Affiliation(s)
- R Piñeiro
- Spanish Society of Family and Community Medicine, Barcelona, Spain
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Borowski M, Kamiński M, Kładny J, Mierzecki A, Myśliwiec L, Pisarski P, Snop S, Staniewski H, Turek Z. [Role of alcoholism in the development of upper gastrointestinal tumors]. Pol Tyg Lek 1990; 45:171-3. [PMID: 2216960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A preliminary report on the results of studies on the relationship between alcohol abuse and upper gastrointestinal tumours is presented. Alcohol abuse was measured with the aid of a questionnaire. GGTP and mean MCV were determined. Within the 1st September, 1986--30th September, 1987, 75 patients with the cancer of the upper gastrointestinal tract and 107 patients with benign lesions to this area were examined. Alcohol abuse was found in 33% of patients with the cancer and 19% of patients with benign lesions to the upper gastrointestinal tract. This difference is statistically significant (p greater than 0.05). The results of GGTP and MCV values were statistically insignificant in both groups. The authors have found more marked correlation of alcohol abuse with the cancer of the upper gastrointestinal tract in relation to the oral cavity and pharynx than the stomach. Further studies including larger groups of patients are recommended.
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Affiliation(s)
- M Borowski
- Instytutu Chirurgii, Szczekowo-Twarzowej PAM
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Filipiak K, Parafiniuk W, Szumiłowicz G, Listewnik M, Mierzecki A. [Experimental and clinical studies of knitted double-velour prostheses of Polish production]. Pol Tyg Lek 1988; 43:768-70. [PMID: 3237516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Wiechowski S, Mierzecki A. [Surgical treatment of cerebral circulatory disorders caused by the pathologic elongation of the internal carotid arteries]. Pol Tyg Lek 1986; 41:777-81. [PMID: 3774606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Kruczyk I, Mierzecki A. [Therapeutic results in the so-called idiopathic pneumothorax]. Wiad Lek 1979; 32:369-72. [PMID: 462981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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