Disease relevance of Primary Health Care

• Preventive strategies in sexually transmitted diseases for the primary care physician. US Preventive Services Task Force [1].
• Currently, similar structured treatment and education programs targeted to primary health care physicians are being introduced for both insulin-treated NIDDM and arterial hypertension [2].
• PURPOSE: To identify key systems issues from the Indian Health Service (IHS) experience that must be addressed to improve metabolic control among patients with non-insulin-dependent diabetes mellitus (NIDDM) who were followed in primary care settings [3].
• Education about hereditary breast cancer may be needed among primary care providers to enhance appropriate referral of African American women to genetic counseling for BRCA1/2 mutations [4].
• METHODS: Population-based case-control study in Norfolk, England, involving adult patients, ages 18-70, with an inflammatory polyarthritis of <12 months' duration who were recruited from the Norfolk Arthritis Register. Controls, matched for sex and date of birth, were selected from the primary care register of the Norwich Health Authority [5].

Psychiatry related information on Primary Health Care

• A randomized trial of buprenorphine maintenance for heroin dependence in a primary care clinic for substance users versus a methadone clinic [6].
• Evaluation of ICD-10 PHC mental health guidelines in detecting and managing depression within primary care [7].
• However, although most primary care physicians recognize broad-spectrum mood and anxiety disorders, they may not make a specific diagnosis such as major depressive disorder or panic disorder [8].
• Acute and one-year outcome of a randomised controlled trial of brief cognitive therapy for major depressive disorder in primary care [9].
• BACKGROUND: Little is known about the prescribing habits and impact of life style or disease factors on the outcome of cisapride treatment for dyspepsia in primary care [10].

High impact information on Primary Health Care

• Methadone maintenance in primary care: a randomized controlled trial [11].
• Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial [12].
• MAIN OUTCOME MEASURES: Insurer coverage decisions for GH in specific case scenarios were compared with the recommendations of primary care physicians and pediatric endocrinologists [13].
• Collaborative management to achieve treatment guidelines. Impact on depression in primary care [14].
• PARTICIPANTS--We identified 260 primary care physicians who provided 10 or more prescriptions for zomepirac (zomepirac prescribers) and 308 who provided 10 or more prescriptions for NSAIDs other than zomepirac (other-NSAID prescribers) in Medicaid during the study period [15].

Chemical compound and disease context of Primary Health Care

• PATIENTS AND METHODS: We enrolled 437 primary-care patients (73% of those eligible) with chronic renal insufficiency (estimated creatinine clearance consistently < 50 mL/min with the last serum creatinine level > 1.4 mg/dL) who were attending an urban academic general internal medicine practice [16].
• Single-dose trimethoprim treatment of cystitis was compared with 7-day treatment in a randomized double-blind study in primary health care [17].
• Environmental exposure of primary care personnel to ribavirin aerosol when supervising treatment of infants with respiratory syncytial virus infections [18].
• A telephone survey of the 197 board-certified pediatricians actively engaged in primary care in the Minneapolis-St Paul metropolitan area was conducted to assess their cholesterol screening practices and hypercholesterolemia management [19].
• Management of pelvic inflammatory disease by primary care physicians. A comparison with Centers for Disease Control and Prevention guidelines [20].

Biological context of Primary Health Care

• In 1948 the National Health Service in Great Britain designated primary care to be the responsibility of the general practice branch of the medical profession [21].
• Because physicians in the Primary Care Internal Medicine Training Program were significantly more likely to identify principal psychosocial problems, their concordance scores were significantly lower than those of standard internal medicine track physicians [22].
• After adjusting for sex differences, RA patients were more likely than DM patients to report having a specialist as their primary care doctor [23].
• Treatment decisions were left to patients and their primary care physicians.RESULTS: After 9 and 18 months of follow-up, there were no significant differences in lipid values, blood pressure control, fasting blood glucose, body-mass index, or number of smokers between the two groups [24].
• Overall, the Workshop covered most of the principal areas which will be the focus of the Worldwide Project on Sleep and Health. Presentations ranged from the basic science of melatonin receptors to the epidemiology of untreated insomnia, and finally, to the education of primary care physicians [25].

Anatomical context of Primary Health Care

• PATIENTS AND METHODS: A convenience sample of 18 patients with primary hyperparathyroidism and a comparison sample of 20 patients with benign thyroid disease were scheduled by their primary care physician to have surgery [26].
• Detailed history, physical examination, laboratory and follow-up data were obtained from 821 women coming to a primary care clinic over a two-year period with the symptoms of urinary tract (UTI) or vaginal infection [27].
• CONCLUSIONS: Pharmacological stress echocardiography with either dipyridamole or dobutamine was safe and feasible, providing an excellent tool for prognostic assessment of coronary artery disease in a primary care cardiology centre [28].
• Many of these diagnostic tests are laboratory based, including semen analysis, serum progesterone level, serum basal follicle-stimulating hormone level, and clomiphene citrate challenge, and can be done by the primary care physician [29].
• Polyhydramnios was defined as 25 cm or greater in total vertical height in all four quadrants (amniotic fluid index) in any nonreferral patient (ie, primary care population) undergoing sonographic examination with a singleton pregnancy, normal fetal anatomical survey, normal glucose screening, and negative antibody screen [30].

Associations of Primary Health Care with chemical compounds

• Our study, therefore, suggests that nicotine gum is a cost-effective adjunct to physician's advice against cigarette smoking in a primary care setting [31].
• Initial antidepressant choice in primary care. Effectiveness and cost of fluoxetine vs tricyclic antidepressants [32].
• Physicians often fail to achieve recommended low-density lipoprotein (LDL) cholesterol goals for their patients using lipid-lowering therapies in the primary care setting [33].
• The Expert Advisory Group's recommendations to establish cancer centres, cancer units, and a network involving primary care for the treatment of cancer patients in the UK is based on the view that specialisation in cancer care will improve outcomes [34].
• The key to success is a combination of trained primary-care physicians, health workers, inexpensive phenobarbital, drug compliance, health education, and follow-up [35].

Gene context of Primary Health Care

• Prevalence of hereditary hemochromatosis in 16031 primary care patients [36].
• INTERVENTION: Serum transferrin saturation screening tests were offered to all adult patients in participating primary care practices [36].
• Compared to PGY-1 residents, PGY-2 and PGY-3 residents were more likely to report more encounters with established patients, but were not more likely to feel like the primary care provider [37].
• METHODS: A total of 181 consecutive patients (131 < 18 yr), referred to our celiac clinic by primary care physicians for suspect CD [38].
• The aim of the present study is to validate different tests for diagnosing alcoholism (CAGE, Alcohol Clinical Index, MCV, GGT, GOT/GPT and GGT/AP) in primary care and compare their diagnostic efficacy [39].

Analytical, diagnostic and therapeutic context of Primary Health Care

• METHODS: Concentrations of plasma atrial (ANP and N-terminal ANP) and B-type (BNP) natriuretic peptides were measured by radioimmunoassay in 122 consecutive patients referred to a rapid-access heart-failure clinic with a new primary-care diagnosis of heart failure [40].
• METHODS: A randomized controlled trial was conducted in which primary care patients meeting DSM-III-R criteria for current major depression were assigned to pharmacotherapy (where nortriptyline hydrochloride was given) or interpersonal psychotherapy provided in a standardized framework or a primary physician's usual care [41].
• DESIGN: A prospective cohort study of 222 HIV-seropositive women and 302 HIV-seropositive men who attended a hospital-affiliated methadone maintenance program with on-site primary care [42].
• Prostate cancer screening and beliefs about treatment efficacy: a national survey of primary care physicians and urologists [43].
• One of the primary concerns of the National Cholesterol Education Program about mass screening for elevated blood cholesterol has been the readiness of primary care physicians to deal with a large number of referrals [44].

References