2,317 research outputs found
ABC of Multimorbidity
No full textABC of Multimorbidity is the first title to provide primary care practitioners with a practical approach to the complex issues of treating and managing patients with more than one morbidity.<p></p>
Ageing populations and earlier diagnosis of chronic conditions mean more people are living longer with multimorbidity. However, treatment guidelines are often designed for treatment in isolation of other morbidities. Multimorbidity management therefore requires a more patient centred approach and greater knowledge and coordination of existing services. Effective multimorbidity management both improves overall patient well-being and reduces the overall demand on health services.<p></p>
ABC of Multimorbidity examines how multimorbidities can be addressed within primary care, from the GP and family physician consultation through to the effective use of a range of health care services. It addresses complex issues such as polypharmacy, mental health, patient safety, patient involvement in self-management, and the role of the practitioner. It then provides guidance on how multimorbidities can be best treated and managed within primary care through specific interventions to improve outcomes.<p></p>
From an international, primary care editor and contributor team, ABC of Multimorbidity is a practical resource for general practitioners, family physicians, practice and specialist nurses, and others caring for multimorbid patients. It is also relevant for junior doctors, medical trainees and students
General practitioner empathy, patient enablement, and patient-reported outcomes in primary care in an area of high socio-economic deprivation in Scotland - a pilot prospective study using structural equation modelling
Full text link<b>Objective</b> The aim of this pilot prospective study was to investigate the relationships between general practitioners (GPs) empathy, patient enablement, and patient-assessed outcomes in primary care consultations in an area of high socio-economic deprivation in Scotland.<p></p>
<b>Methods</b> This prospective study was carried out in a five-doctor practice in an area of high socio-economic deprivation in Scotland. Patients’ views on the consultation were gathered using the Consultation and Relational Empathy (CARE) Measure and the Patient Enablement Instrument (PEI). Changes in main complaint and well-being 1 month after the contact consultation were gathered from patients by postal questionnaire. The effect of GP empathy on patient enablement and prospective change in outcome was investigated using structural equation modelling.<p></p>
<b>Results</b> 323 patients completed the initial questionnaire at the contact consultation and of these 136 (42%) completed and returned the follow-up questionnaire at 1 month. Confirmatory factor analysis confirmed the construct validity of the CARE Measure, though omission of two of the six PEI items was required in order to reach an acceptable global data fit. The structural equation model revealed a direct positive relationship between GP empathy and patient enablement at contact consultation and a prospective relationship between patient enablement and changes in main complaint and well-being at 1 month.<p></p>
<b>Conclusion</b> In a high deprivation setting, GP empathy is associated with patient enablement at consultation, and enablement predicts patient-rated changes 1 month later. Further larger studies are desirable to confirm or refute these findings.<p></p>
<b>Practice implications</b> Ways of increasing GP empathy and patient enablement need to be established in order to maximise patient outcomes. Consultation length and relational continuity of care are known factors; the benefit of training and support for GPs needs to be further investigate
Horace Stewart, Mercer Bratcher, and George W. Matthews Receiving Awards
No full textOne black and white photographic print showing (from left to right) George W. Matthews, Mercer Bratcher of Ohio State Employment Services and President of the Board of Trustees of the Akron Community Service Center, and photographer Horace Stewart holding plaques. Mr. Mathews was the owner of the first African-American barber shop in Akron, Ohio and the first African-American hotel in the city, the Matthews Hotel, located on N. Howard Street
Stewart, Ollie
Full text linkOllie Anderson Stewart (1906-1977), journalist, was the first African American war correspondent to go abroad during World War II. Notable among the correspondents from whom he solicited information was Mercer Cook, an author, professor of romance languages at Howard University, and later, ambassador to several African countries. Cook provided invaluable recollections of his associations with Baker. (His father, Will Marion Cook (1869-1944), was the famed violinist, composer and orchestral director.) The collection covers intermittent periods from 1953-1977, and was transferred to MSRC by a brother Dr. James W. Stewart in 1977-78
More time for complex consultations in a high deprivation practice is associated with increased patient enablement
No full textBackgroundEvidence of the beneficial effects of longer consultations in general practice is limited.AimTo evaluate the effect of increasing consultation length on patient enablement in general practice in an area of extreme socioeconomic deprivation.Design of studyLongitudinal study using a ‘before and after’ design.SettingKeppoch Medical Centre in Glasgow, which serves the most deprived practice area in Scotland.MethodParticipants were 300 adult patients at baseline, before the introduction of longer consultations, and 324 at follow-up, more than 1 year after the introduction of longer consultations. The intervention studied was more time in complex consultations. Patient satisfaction, perceptions of the GPs’ empathy, GP stress, and patient enablement were collected by faceto-face interview. Additional qualitative data were obtained by individual interviews with the GPs, relating to their perceptions of the impact of the longer consultations.ResultsResponse rates of 70% were obtained. Overall, 53% of consultations were complex. GP stress was higher in complex consultations. Patient satisfaction and perception of the GPs’ empathy were consistently high. Average consultation length in complex consultations was increased by 2.5 minutes by the intervention. GP stress in consultations was decreased after the introduction of longer consultations, and patient enablement was increased. GPs’ views endorsed these findings, with more anticipatory and coordinated care being possible in the longer consultations.ConclusionMore resource to provide more time in complex consultations in an area of extreme deprivation is associated with an increase in patient enablement
Complementary medicine and the NHS:Experiences of integration with UK primary care
Full text linkIntroduction: Complementary and alternative medicine (CAM), often accessed privately, can be integrated with conventional care. Little is known about current integration in the UK National Health Service (NHS). We provide an overview of integrated CAM services accessed from UK primary care for musculoskeletal and mental health conditions, to identify key features and barriers and facilitators to integration. Methods: Descriptive analysis of integrated services accessed from primary care providing CAM alongside conventional NHS care for musculoskeletal and/or mental health problems. A purposive sample was identified through personal contacts, social media, literature/internet searches, conferences, and patient/professional organisations. Questionnaires, documentary analysis and stakeholder meetings collected data on the service's history, features, integration, success and sustainability. Data was tabulated. Results: From 38 sites identified, twenty sites were selected. Acupuncture and homeopathy were most common, followed by massage, osteopathy and mindfulness. GPs were often instrumental initiating services. NHS staff enthusiasm facilitated integration, as did an NHS setting, patient/public support, and being adjunctive to an NHS service. The main barriers to integration were funding, negative perceptions of CAM from the clinicians, funders and lobby groups, and local NHS staff attitudes/lack of knowledge. Reduced funding was often why services closed. Conclusions: Various models for integrating CAM with UK primary care were identified. Social prescribing and NHS/patient co-funded CAM may be potentially sustainable models for future integration. Lack of funding and negative perceptions of CAM remain the primary challenge to integration. Evaluating effectiveness and cost-effectiveness of integrated services is vital to ensure sustainability.</p
Enhancing research quality and reporting: why the Journal of Comorbidity is now publishing study protocols
Full text linkThe Journal of Comorbidity was launched in 2011 and has since become established as a high-quality journal that publishes open-access, peer-reviewed articles, with a focus on advancing the clinical management of patients with comorbidity/multimorbidity. To further enhance research quality and reporting of studies in this field, the journal is now offering authors the opportunity to publish a summary of their study protocols – a move designed to generate interest and raise awareness in ongoing clinical research and to enable researchers to detail their methodologies in order that replication by scientific peers is possible.Journal of Comorbidity 2014;4(1):55−5
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