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Blood pressure changes following antihypertensive medication reduction, by drug class and dose chosen for withdrawal: exploratory analysis of data from the OPTiMISE trial
Aims: Deprescribing of antihypertensive drugs is recommended for some older patients with polypharmacy, but there is little evidence to inform which drug (or dose) should be withdrawn. This study used data from the OPTiMISE trial to examine whether short-term outcomes of deprescribing vary by drug class…
Does cranberry extract reduce antibiotic use for symptoms of acute uncomplicated urinary tract infections (CUTI)? A feasibility randomised trial
OBJECTIVES: To determine the feasibility of conducting a randomised trial of the effectiveness of cranberry extract in reducing antibiotic use by women with symptoms of acute, uncomplicated urinary tract infection (UTI). DESIGN: Open-label feasibility randomised parallel group trial. SETTING: Four general practi…
‘I’m fine!’: Assertions of lack of support need among patients with chronic obstructive pulmonary disease: A mixed-methods study
Objectives: To understand how people with Chronic Obstructive Pulmonary Disease (COPD) disavow their support needs and the impact on care. Methods: Two stage mixed-method design. Stage 1 involved sub-analyses of data from a mixed-method population-based longitudinal study exploring the needs of pa…
Experience of implementing and delivering group consultations in UK general practice: a qualitative study
Background: Group consultations are a relatively new concept in UK primary care and are a suggested solution to current workload pressures in general practice. Little is known about the experience of implementing and delivering this approach from staff and organisational perspectives. Aim: To explore the…
Supporting bereavement and complicated grief in primary care: a realist review
Background Bereavement can have significant impacts on physical and mental health, and a minority of people experience complicated and prolonged grief responses. Primary care is ideally situated to offer bereavement care, yet UK provision remains variable and practitioners feel uncertain how best to suppo…
‘A silent epidemic of grief’: a survey of bereavement care provision in the UK and Ireland during the COVID-19 pandemic
Objectives To investigate the experiences and views of practitioners in the UK and Ireland concerning changes in bereavement care during the COVID-19 pandemic. Design Online survey using a snowball sampling approach. Setting Practitioners working in hospitals, hospices, care homes and community settin…
Viral cultures for COVID-19 infectious potential assessment – a systematic review
Objective: to review the evidence from studies relating SARS-CoV-2 culture with the results of reverse transcriptase polymerase chain reaction (RT-PCR) and other variables which may influence the interpretation of the test, such as time from symptom onset Methods: We searched LitCovid, medRxiv, Google Sch…
Addressing and Overcoming Barriers to E-Cigarette Use for Smoking Cessation in Pregnancy: A Qualitative Study
E-cigarettes may have a role in supporting pregnant women who would otherwise smoke to stop smoking. The study aimed to understand pregnant women’s vaping experiences, in particular how vaping to stop smoking is facilitated and how barriers to this are overcome. We conducted semi structured telephone…
Clinical prediction models to predict the risk of multiple binary outcomes: a comparison of approaches
Clinical prediction models (CPMs) can predict clinically relevant outcomes or events. Typically, prognostic CPMs are derived to predict the risk of a single future outcome. However, there are many medical applications where two or more outcomes are of interest, meaning this should be more widely reflected…
Association between antihypertensive treatment and adverse events: systematic review and meta-analysis
Objective: To examine the association between antihypertensive treatment and specific adverse events. Design: Systematic review and meta-analysis. Eligibility criteria: Randomised controlled trials of adults receiving antihypertensives compared with placebo or no treatment, more antihypertensive drugs c…
Calculating the sample size required for developing a clinical prediction model
Clinical prediction models aim to predict outcomes in individuals, to inform diagnosis or prognosis in healthcare. Hundreds of prediction models are published in the medical literature each year, yet many are developed using a dataset that is too small for the total number of participants or outcome events. This le…
External validation of prognostic models predicting pre-eclampsia: individual participant data meta-analysis
Background Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our obje…
Mental health in the UK during the COVID-19 pandemic: cross-sectional analyses from a community cohort study
Objectives Previous pandemics have resulted in significant consequences for mental health. Here, we report the mental health sequelae of the COVID-19 pandemic in a UK cohort and examine modifiable and non-modifiable explanatory factors associated with mental health outcomes. We focus on the first wa…
How do people who use drugs experience treatment? A qualitative analysis of views about opioid substitution treatment in primary care (iCARE study)
Objective: To understand the most significant aspects of care experienced by people in opioid substitution treatment (OST) in primary care settings. Design: Semistructured individual interviews were conducted, following the critical incidents technique. Interview transcripts were analysed following a thematic an…
GPs’ and patients’ views on the value of diagnosing anxiety disorders in primary care: a qualitative interview study
Background: In the UK between 1998 and 2008, GPs’ recording of anxiety symptoms increased, but their recording of anxiety disorders decreased. The reason for this decline is not clear, nor are the treatment implications for primary care patients. Aim: To understand GPs’ and patients’ views on the value o…
Contribution of paramedics in primary and urgent care: a systematic review
Background: Within the UK, there are now opportunities for paramedics to work across a variety of healthcare settings away from their traditional ambulance service employer, with many opting to move into primary care. Aim: To provide an overview of the types of clinical roles paramedics are undertaking in pri…
Implementation of remote consulting in UK primary care following the COVID-19 pandemic: a mixed-methods longitudinal study
Background: To reduce contagion of COVID-19, in March 2020 UK general practices implemented predominantly remote consulting via telephone, video, or online consultation platforms. Aim: To investigate the rapid implementation of remote consulting and explore impact over the initial months of the COVID-1…
Barriers to postpartum diabetes screening: a qualitative synthesis of clinicians’ views
Background: Gestational diabetes (GDM) is an important risk factor for developing type 2 diabetes (T2DM) later in life. Postpartum screening provides an opportunity for early detection and management of T2DM, but uptake is poor. Aim: To explore barriers to screening from clinicians’ perspectives to guide fu…
Combining patient talk about internet use during primary care consultations with retrospective accounts. A qualitative analysis of interactional and interview data
Despite widespread acknowledgement of internet use for information about health, patients report not disclosing use of online health information in consultations. This paper compares patients' reported use of the internet with matched video recordings of consultations. The concepts of doctorability and…