Cross-sectional 7-year follow-up of anxiety in primary care patients

2004 ◽  
Vol 19 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Shoshana S. Colman ◽  
Meryl Brod ◽  
Lori P. Potter ◽  
Don P. Buesching ◽  
Clayton R. Rowland
Keyword(s):  
Primary Care ◽  
Cross Sectional ◽  
Primary Care Patients

scholarly journals Cross-sectional associations between inflammation, sickness behaviour, health anxiety and self-rated health in a Swedish primary care population

2019 ◽  
Vol 17 ◽  
pp. 205873921984435 ◽  
Author(s):  
Karin Lodin ◽  
Mats Lekander ◽  
Predrag Petrovic ◽  
Gustav Nilsonne ◽  
Erik Hedman-Lagerlöf ◽  
...  
Keyword(s):  
Primary Care ◽  
Interleukin 6 ◽  
Health Anxiety ◽  
Health State ◽  
Sickness Behaviour ◽  
Cross Sectional ◽  
Primary Care Population ◽  
Self Rated Health ◽  
Primary Care Patients ◽  
Low Levels

This study investigated associations between inflammatory markers, sickness behaviour, health anxiety and self-rated health in 311 consecutive primary care patients. Poor self-rated health was associated with high sickness behaviour ( ρ = 0.28, P < 0.001; ρ = 0.42, P = 0.003) and high health anxiety ( ρ = 0.31, P < 0.001; ρ = –0.32, P = 0.003). High levels of interleukin 6 were associated with poor self-rated health in men ( ρ = 0.26, P = 0.009). Low levels of interleukin-6 were associated with poor self-rated health in women ( ρ = –0.15, P = 0.04), but this association was non-significant when adjusted for health anxiety ( ρ = –0.08, P = 0.31). These results are consistent with the theory that interoceptive processes draw on both inflammatory mediators and the state of sickness behaviour in inferring health state.

scholarly journals Two-year effectiveness of a stepped-care depression prevention intervention and predictors of incident depression in primary care patients with diabetes type 2 and/or coronary heart disease and subthreshold depression: data from the Step-Dep cluster randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e020412 ◽  
Author(s):  
Alide Danielle Pols ◽  
Marcel C Adriaanse ◽  
Maurits W van Tulder ◽  
Martijn W Heymans ◽  
Judith E Bosmans ◽  
...  
Keyword(s):  
Primary Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cumulative Incidence ◽  
Stepped Care ◽  
Subthreshold Depression ◽  
Depression Prevention ◽  
Primary Care Patients

IntroductionMajor depressive disorders (MDD), diabetes mellitus type 2 (DM2) and coronary heart disease (CHD) are leading contributors to the global burden of disease and often co-occur.ObjectivesTo evaluate the 2-year effectiveness of a stepped-care intervention to prevent MDD compared with usual care and to develop a prediction model for incident depression in patients with DM2 and/or CHD with subthreshold depression.MethodsData of 236 Dutch primary care patients with DM2/CHD with subthreshold depression (Patient Health Questionnaire 9 (PHQ-9) score ≥6, no current MDD according to the Mini International Neuropsychiatric Interview (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria)) who participated in the Step-Dep trial were used. A PHQ-9 score of ≥10 at minimally one measurement during follow-up (at 3, 6, 9, 12 and 24 months) was used to determine the cumulative incidence of MDD. Potential demographic and psychological predictors were measured at baseline via web-based self-reported questionnaires and evaluated using a multivariable logistic regression model. Model performance was assessed with the Hosmer-Lemeshow test, Nagelkerke’s R2explained variance and area under the receiver operating characteristic curve (AUC). Bootstrapping techniques were used to internally validate our model.Results192 patients (81%) were available at 2-year follow-up. The cumulative incidence of MDD was 97/192 (51%). There was no statistically significant overall treatment effect over 24 months of the intervention (OR 1.37; 95% CI 0.52 to 3.55). Baseline levels of anxiety, depression, the presence of >3 chronic diseases and stressful life events predicted the incidence of MDD (AUC 0.80, IQR 0.79–0.80; Nagelkerke’s R20.34, IQR 0.33–0.36).ConclusionA model with 4 factors predicted depression incidence during 2-year follow-up in patients with DM2/CHD accurately, based on the AUC. The Step-Dep intervention did not influence the incidence of MDD. Future depression prevention programmes should target patients with these 4 predictors present, and aim to reduce both anxiety and depressive symptoms.Trial registration numberNTR3715.

scholarly journals Alopecia and Iron Deficiency: An Interventional Pilot Study in Primary Care to Improve the Request of Ferritin

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Maria Salinas ◽  
Maria Leiva-Salinas ◽  
Emilio Flores ◽  
Maite López-Garrigós ◽  
Carlos Leiva-Salinas
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Pilot Study ◽  
Iron Deficiency ◽  
Laboratory Testing ◽  
Laboratory Tests ◽  
Young Female ◽  
Cross Sectional ◽  
Primary Care Patients ◽  
Cross Sectional Studies

Background. The aim was to study the demographic and laboratory pattern of primary care patients with alopecia undergoing laboratory testing, more specifically, the request of hemoglobin and ferritin and values showing anemia and iron deficiency, and to evaluate the effects of an intervention involving automatic ferritin registration and measurement when not requested. Methods. Retrospective and prospective observational cross-sectional studies were conducted, as well as an intervention to automatically register and measure ferritin when not requested by the general practitioner. Results. There were 343 and 1032 primary care laboratory requests prompted by alopecia in the retrospective and prospective studies. Hemoglobin was requested in almost every patient and ferritin in 88%. 5% of the cohort had anemia, and 25% had iron deficiency. The intervention registered and measured that 123 ferritin and 24 iron deficiencies were detected in patients with alopecia, all women, at a cost of 10.6€. Conclusion. Primary care patients with alopecia and laboratory tests request were mainly young female. Our intervention added ferritin when not requested, detecting iron deficiency in 27.9% of women, potentially avoiding the adverse effects of iron deficiency on hair loss.

scholarly journals Risk factors for a positive SARS-CoV-2 PCR in patients with common cold symptoms in a primary care setting – a retrospective analysis based on a joint documentation standard

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Johannes Just ◽  
Marie-Therese Puth ◽  
Felix Regenold ◽  
Klaus Weckbecker ◽  
Markus Bleckwenn
Keyword(s):  
Primary Care ◽  
Common Cold ◽  
Odds Ratio ◽  
Care Setting ◽  
Primary Care Setting ◽  
False Negative ◽  
First Grade ◽  
Cross Sectional ◽  
Policy Makers ◽  
Primary Care Patients

Abstract Background Combating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the large and heterogeneous group of patients with common cold symptoms is an important element of this effort, but often hindered by limited testing resources, false-negative test results and the lack of pathognomonic symptoms in COVID-19. Therefore, we aimed to identify anamnestic items with an increased/decreased odds ratio for a positive SARS-CoV-2 PCR (CovPCR) result in a primary care setting. Methods We performed a multi-center cross-sectional cohort study on predictive clinical characteristics for a positive CovPCR over a period of 4 weeks in primary care patients in Germany. Results In total, 374 patients in 14 primary care centers received CovPCR and were included in this analysis. The median age was 44.0 (IQR: 31.0–59.0) and a fraction of 10.7% (n = 40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51–13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11–0.97). Furthermore, patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72–15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97–39.67). Conclusions Several anamnestic criteria may be helpful to assess pre-test probability of COVID-19 in patients with common cold symptoms.

scholarly journals Acceptability and Results of Dementia Screening Among Older Adults in the United States

2017 ◽  
Vol 15 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Amanda Harrawood ◽  
Nicole R. Fowler ◽  
Anthony J. Perkins ◽  
Michael A. LaMantia ◽  
Malaz A. Boustani
Keyword(s):  
United States ◽  
Older Adults ◽  
Primary Care ◽  
The United States ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Community Screening ◽  
Positive Screen ◽  
Dementia Screening ◽  
Primary Care Patients

Objectives: To measure older adults acceptability of dementia screening and assess screening test results of a racially diverse sample of older primary care patients in the United States. Design: Cross-sectional study of primary care patients aged 65 and older. Setting: Urban and suburban primary care clinics in Indianapolis, Indiana, in 2008 to 2009. Participants: Nine hundred fifty-four primary care patients without a documented diagnosis of dementia. Measurements: Community Screening Instrument for Dementia, the Mini-Mental State Examination, and the Telephone Instrument for Cognitive Screening. Results: Of the 954 study participants who consented to participate, 748 agreed to be screened for dementia and 206 refused screening. The overall response rate was 78.4%. The positive screen rate of the sample who agreed to screening was 10.2%. After adjusting for demographic differences the following characteristics were still associated with increased likelihood of screening positive for dementia: age, male sex, and lower education. Patients who believed that they had more memory problems than other people of their age were also more likely to screen positive for dementia. Conclusion: Age and perceived problems with memory are associated with screening positive for dementia in primary care.

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