Promoting Best Practice in General Practitioner Management of Osteoarthritis of the Hip and Knee: Arthritis and Musculoskeletal Quality Improvement (AMQuIP) Program

2007 ◽  
Vol 13 (2) ◽  
pp. 104 ◽  
Author(s):  
Kay Jones ◽  
Leon Piterman
Keyword(s):  
General Practitioner ◽  
Best Practice ◽  
Patient Management ◽  
Management Strategies ◽  
Practice Management ◽  
Management Systems ◽  
Face To Face ◽  
Evidence Based Guidelines ◽  
Breakthrough Series Collaborative

This paper reports on the outcomes of a pilot study to optimise general practitioner (GP) management of patients with osteoarthritis (OA) of the hip and knee by identifying gaps between their current practice and best practice. The Breakthrough Series collaborative methodology with several Plan-Do-Study-Act (PDSA) cycles was employed. Participants comprised two Victorian Divisions of General Practice (one rural, one metropolitan), 12 general practitioners/practices (GPs/practices), 10 patients per GP/practice. GPs/practices attended an orientation and three learning workshops and a videoconference. GPs/practices completed PDSA cycles between workshops and reported results at the workshops. GPs/practices reported use of guidelines, change in patient management and change in practice management/systems. All recruited patients completed the SF-12v2 Health survey and WOMAC Osteoarthritis Index questionnaire twice; nine patients participated in face-to-face interviews twice. Follow-up activities including focus groups and face-to-face interviews were held six months after the final workshop. All GPs/practices used the guidelines/key messages, introduced "new" management strategies to patients, and made positive changes to their practice management/systems. Patients reported positive changes and outcomes. There was little difference between rural and metropolitan results. By using a structured methodology and evidence-based guidelines/key messages, GPs can introduce new patient management strategies, and by identifying gaps in practice management/systems, positive change can be achieved.

Effectiveness of best practice management guides for improving invasive species management: a review

2017 ◽  
Vol 39 (1) ◽  
pp. 39 ◽  
Author(s):  
Michael J. Coleman ◽  
Brian M. Sindel ◽  
Richard A. Stayner
Keyword(s):  
Invasive Species ◽  
Best Practice ◽  
Formative Evaluation ◽  
Management Strategies ◽  
Cost Effective ◽  
Practice Management ◽  
Invasive Species Management ◽  
Quantitative Evidence ◽  
Species Management ◽  
Extension Professionals

Best practice management (BPM) guides are a key component of invasive species extension in Australia, and are becoming a more important way of reaching land managers with comprehensive invasive species management strategies. However, little is known about the quantifiable benefits of these guides as a stand-alone extension approach, or in comparison with other approaches. We therefore reviewed the existing literature to determine when this form of extension was appropriate, what determines the success or failure of BPM guides in facilitating best practice invasive species management, how effective they had been in the Australian context, and what methods were available to evaluate BPM guide effectiveness. BPM guides are most appropriately used in support of other forms of extension and enforcement of invasive species regulations; as a cost-effective alternative to more labour-intensive extension techniques; or in bringing together disparate information in a single comprehensive source for land managers and extension practitioners. They appear to be most appropriately distributed at mid- and late-stages of the invasion curve. Limited quantitative evidence of the effectiveness of BPM guides for invasive species in Australia is available, although there is a consensus that these materials are popular among target audiences, despite a range of studies having shown face-to-face extension to be more effective. Unfortunately, many factors make successful evaluation of a BPM guide difficult, such that extension professionals are less likely to consider the possibility of evaluation. However, we argue that extension professionals need to consider evaluation of written BPM guides, where time and funding makes this possible. Ideally this will involve formative evaluation to improve the content and messages of the guide, as well as summative evaluation to determine its effectiveness among the target audience and for the target species. We also suggest a range of economic evaluation possibilities that warrant further exploration and trial.

scholarly journals P638 Changes in the management of IBD patients since the onset of COVID-19 pandemic. A path towards the implementation of telemedicine in Spain?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S572-S573
Author(s):  
J Del Hoyo Francisco ◽  
M Millán ◽  
A Garrido-Marín ◽  
P Nos ◽  
M Barreiro-de Acosta ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Patient Management ◽  
Daily Practice ◽  
Survey Study ◽  
Relevant Issue ◽  
Face To Face ◽  
Communication Difficulties ◽  
Inflammatory Bowel

Abstract Background COVID-19 pandemic increased medical services demand aside from interrupting daily clinical practice for other diseases such as Inflammatory Bowel Disease (IBD). Here we present the results of a survey to gain the perception of IBD specialists in their patient-management using telemedicine in their daily practice. Methods This was an observational survey study among physicians focused on IBD (gastroenterologist, surgeons, and pediatricians) members of the Spanish Working Group on Crohn’s Disease and Ulcerative Colitis (GETECCU), the Spanish Association of Gastroenterology (AEG), and the Spanish Association of Coloproctology (AECP), regarding changes of management of IBD patients. Results We received a total of 269 responses to the survey (from May to June 2020). Before the pandemic, nearly all the respondents reported performing very frequently their visits face-to-face (n=251, 93.3%) while, during the pandemic, the telephone visits were the most frequent visits performed (n=138, 51,3%). Regarding communication difficulties, 157 (58.4%) respondents reported the impossibility of performing a proper examination as the most relevant issue. Also, 114 (42.4%) respondents considered remote visits more time-consuming than face-to-face visits. Most gastroenterologists (n=188, 83.2%) considered patients with active perianal disease in special need of face-to-face consultation and more than half of the surgeons (n=35, 50.7%) reported having performed an immediate postoperative follow-up remotely. Conclusion Most IBD units have implemented remote visits during the pandemic, but most professionals found them more time-consuming and unsuitable for some disease profiles. Therefore, there is a need for the development of better telemedicine systems that can meet professionals’ and patients′ requirements.

Realtime teleconsultations versus face-to-face consultations in dermatology: immediate and six-month outcome

2003 ◽  
Vol 9 (4) ◽  
pp. 204-209 ◽  
Author(s):  
Håkan Granlund ◽  
Carl-Johan Thoden ◽  
Christer Carlson ◽  
Kari Harno
Keyword(s):  
Patient Satisfaction ◽  
General Practitioner ◽  
Analogue Scale ◽  
Controlled Study ◽  
Face To Face ◽  
Consultation Group ◽  
The Face ◽  
Patient Groups

We evaluated the outcome of both realtime teleconsultations and face-to-face consultations in dermatology. Forty-six patients were enrolled in an open controlled study. Twenty-nine patients (60%) answered the questionnaire sent to them after six months. Over the six-month follow-up, similar proportions of the two patient groups had visited a general practitioner or a specialist in the consulting hospital. At follow-up, overall patient satisfaction with the consultation, measured on a linear analogue scale (0–10), had fallen only slightly and to the same extent after both types of consultation, that is by 1.2 (SD 3.7) after realtime teleconsultations and by 1.4 (SD 4.5) after face-to-face consultations. The proportions of patients who would prefer the same mode of consultation for their next appointment had decreased from 83% to 50% in the realtime teleconsultation group and from 83% to 62% in the face-to-face consultation group. However, in neither group was the change significant. The study suggests that patient satisfaction with teleconsultation is well preserved after six months.

Writing to Meet Your Match

2013 ◽  
pp. 210-234
Author(s):  
Christyne Berzsenyi
Keyword(s):  
Impression Management ◽  
Management Strategies ◽  
Internet Dating ◽  
Written Text ◽  
Self Reflection ◽  
Face To Face ◽  
Positive Attitudes ◽  
Study Participants

After ten years, Internet dating has become mainstreamed with members producing and consuming a great deal of written text before meeting face-to-face. Through a twenty-one-prompt questionnaire and follow up interviews, four case study participants describe their efforts at self-reflection, self-representation, and interaction with other members. The following chapter analyzes email questionnaire responses and interview excerpts that discuss each participant’s perceptions of the rhetorical process of writing profiles, interpreting others’ profiles, and exchanging emails to facilitate courtship. In addition, this chapter analyzes the discourse of participants’ self-presentations in comparison with their reported self-perceptions and impression management strategies. Findings suggest that more effective members composed their e-texts after a methodical process of understanding the communication genre, the expectations and behaviors of their target audiences, and their own relationship objectives. Further, participants with greater experience with cyber dating have more positive experiences, which led to positive attitudes and greater satisfaction with e-dating.

Stage one seminoma: Evidence based guidelines for follow up

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4546-4546
Author(s):  
J. M. Martin ◽  
T. Panzarella ◽  
D. R. Zwahlen ◽  
P. W. Chung ◽  
P. Warde
Keyword(s):  
At Risk ◽  
Prospective Studies ◽  
Management Strategies ◽  
Evidence Based ◽  
Weighted Mean ◽  
Kaplan Meier ◽  
Cochrane Database ◽  
Patients At Risk ◽  
Evidence Based Guidelines

4546 Background: Several management strategies are used following ochiectomy for stage one seminoma (SOS) of the testis. The aim of this systematic review (SR) is to provide evidence based guidelines for the follow-up (FU) schedule for each strategy regarding investigations required, frequency of assessment and overall duration. Methods: A SR of all prospective studies in SOS published since 1980 in MEDLINE, EMBASE and the Cochrane database was performed in November 2005. Data was extracted regarding the time, location and method of detection of first relapses, duration of FU, relapse free rates, and numbers of patients at risk. Five strategies were identified: Surveillance (S), Extended-field Radiotherapy (EFRT), Para-aortic Radiotherapy (PART) and either one (C1) or two (C2) cycles of Carboplatin chemotherapy. For each strategy Kaplan-Meier relapse free estimates were used to calculate weighted mean cumulative hazards of relapse over time. These were used to calculate yearly weighted mean relapse hazards. Weights used were based on numbers of patients at risk in each trial. Results: Fifteen prospective studies with a total of 5277 patients were identified. Actuarial relapse data was available in 4185 (79.3%) patients and 4850 (91.9%) had the location of relapse documented. Method of relapse detection was infrequently reported. The median time to relapse with all strategies was 12–16 months. Annual hazard ratios for relapse decreased with increasing length of FU and relapse location depended on the strategy used ( Table ). Conclusions: 1. The investigations performed need to reflect locations at risk of relapse. This should include computerised tomography (CT) of the abdomen and pelvis for Survillance and adjuvant Carboplatin, with CT of the pelvis only for Para-aortic RT. 2. Long term FU data on patients treated with Carboplatin is not available, and further FU is necessary. 3. Frequency of FU should reflect the annual hazard of relapse. We suggest 3 times per year when the risk is >5%, 2 times per year when the risk is 1–5%, and annually until the risk is <0.3%. [Table: see text] No significant financial relationships to disclose.

Copying clinic letters to patients: a survey of patient attitudes

2006 ◽  
Vol 121 (6) ◽  
pp. 588-591 ◽  
Author(s):  
A Liapi ◽  
P J Robb ◽  
A Akthar
Keyword(s):  
General Practitioner ◽  
Best Practice ◽  
Healthcare Professionals ◽  
Telephone Survey ◽  
Patient Choice ◽  
Psychiatric Clinic ◽  
Department Of Health ◽  
Patient Consent ◽  
Patient Groups

Guidance from the Department of Health, published in 2000, stated that, ‘as a matter of right’, communications between clinicians would be copied to patients. In further guidance, the department indicated that, from April 2004, patients would receive copies of correspondence exchanged between healthcare professionals. There has been little research on this issue, and the few existing publications have come from the hospital psychiatric clinic setting.We examined the attitudes of 100 patients attending an ENT clinic as well as those of 100 parents of children attending a paediatric ENT clinic in a general hospital out-patient setting. At the end of consultations, patients or parents were invited to take part in the survey by completing a short questionnaire. Forty-three per cent of the adult patients and 44 per cent of the parents requested a copy of the clinic letter. These people were followed up by a telephone survey, three weeks after the copy of the clinic letter to the general practitioner was posted to the patient or parent. Eighty-one per cent of the patients and 77 per cent of the parents were successfully contacted for the follow-up telephone survey. Sixty per cent of the adults and 77 per cent of the parents reported that the copy of the clinic letter was helpful. There were no differences in responses between the adult patient and paediatric patient groups.In this study, less than half of both groups requested a copy of the ENT clinic letter to their general practitioner. To follow Department of Health guidance and copy the letter without patient consent is arguably contradictory to best practice and also to the concept of patient choice. There are significant financial implications in adopting the departmental guidance. We propose patients should be offered a copy of their clinic letter on request.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

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