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Clinical presentation, diagnosis, and management

This section covers the clinical decision-making process primary care physicians employ in patient management. This section covers, though is not limited to, diagnostic practices, referral practices, and shared-decision making.

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  1. Many survivors of critical illness suffer from long-lasting physical, cognitive, and mental health sequelae. The number of affected patients is expected to markedly increase due to the COVID-19 pandemic. Many ...

    Authors: KFR Schmidt, J. Gensichen, S. Gehrke-Beck, R. P. Kosilek, F. Kühne, C Heintze, L. M. Baldwin and D. M. Needham

    Citation: BMC Family Practice 2021 22:160

    Content type: Review

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  2. The bereaved families of COVID-19 victims are among the most vulnerable social groups in the COVID-19 pandemic. This highly infectious and contagious disease has afflicted these families with numerous psycholo...

    Authors: Fateme Mohammadi, Khodayar Oshvandi, Farshid Shamsaei, Fateme Cheraghi, Masoud Khodaveisi and Mostafa Bijani

    Citation: BMC Family Practice 2021 22:94

    Content type: Research article

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  3. Anxiety disorders are highly prevalent mental health conditions and are managed predominantly in primary care. We conducted a systematic review and meta-analysis of psychological and pharmacological treatments...

    Authors: Erin L. Parker, Michelle Banfield, Daniel B. Fassnacht, Timothy Hatfield and Michael Kyrios

    Citation: BMC Family Practice 2021 22:92

    Content type: Research article

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  4. Vertigo, dizziness and balance disorders (VDB) are common in older people and cause restrictions in mobility and social participation. Due to a multifactorial aetiology, health care is often overutilised, but ...

    Authors: Verena Regauer, Eva Seckler, Eva Grill, Richard Ippisch, Klaus Jahn, Petra Bauer and Martin Müller

    Citation: BMC Family Practice 2021 22:89

    Content type: Research article

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  5. Possible cases of SARS-CoV-2 infection were diagnosed in primary care in Madrid, some of these cases had pneumonia. Most of the SARS-CoV-2 pneumonia published data came from hospitalised patients. This study s...

    Authors: Marina Guisado-Clavero, Ana Herrero Gil, Marta Pérez Álvarez, Marta Castelo Jurado, Ana Herrera Marinas, Vanesa Aguilar Ruiz, Ileana Gefaell Iarrondo, Miguel Menéndez Orenga and Sara Ares-Blanco

    Citation: BMC Family Practice 2021 22:83

    Content type: Research article

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  6. Cognitive behavioral therapy for chronic insomnia (CBT-i) is the treatment of choice for this condition but is underutilized in patients who attend primary care. The purpose of the present feasibility-pilot st...

    Authors: Isabel Torrens, Magdalena Esteva, Caterina Vicens, María Rosa Pizá-Portell, María Clara Vidal-Thomàs, Cristina Vidal-Ribas, Patricia Lorente-Montalvo and Elena Torres-Solera

    Citation: BMC Family Practice 2021 22:77

    Content type: Research article

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  7. About 0.9 billion people in the world have hypertension. The mortality due to hypertension increased dramatically over the last decades. Healthcare professionals should support patients with hypertension to mo...

    Authors: Indre Treciokiene, Maarten Postma, Thang Nguyen, Tanja Fens, Jurgis Petkevicius, Raimondas Kubilius, Jolanta Gulbinovic and Katja Taxis

    Citation: BMC Family Practice 2021 22:63

    Content type: Research article

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  8. Migraine affects 80.8 million people in Western Europe and is the first cause of disability among people between ages 15 and 49 worldwide. Despite being a highly prevalent and disabling condition, migraine rem...

    Authors: Angel L. Guerrero, Andrea Negro, Philippe Ryvlin, Kirill Skorobogatykh, Rainel Sanchez-De La Rosa, Heike Israel-Willner, Christina Sundal and E. Anne MacGregor

    Citation: BMC Family Practice 2021 22:54

    Content type: Research article

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  9. In western Kenya, women often present with late-stage cervical cancer despite prior contact with the health care system. The aim of this study was to predict primary health care providers’ behaviour in examini...

    Authors: Emily Mwaliko, Guido Van Hal, Hilde Bastiaens, Stefan Van Dongen, Peter Gichangi, Barasa Otsyula, Violet Naanyu and Marleen Temmerman

    Citation: BMC Family Practice 2021 22:52

    Content type: Research article

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  10. Since 2015, pharmacists have been integrating into English general practices and more recently into primary care networks. General practice-based pharmacists provide a range of patient-facing services, such as...

    Authors: Georgios Dimitrios Karampatakis, Nilesh Patel, Graham Stretch and Kath Ryan

    Citation: BMC Family Practice 2021 22:48

    Content type: Research article

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  11. The successful management of hypertension requires sustained engagement in self-care behaviour such as adhering to medication regimens and diet. Bandura’s Social Cognitive Theory suggests that self-efficacy is...

    Authors: Felicia Clara Jun Hui Tan, Prawira Oka, Hajira Dambha-Miller and Ngiap Chuan Tan

    Citation: BMC Family Practice 2021 22:44

    Content type: Research article

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  12. Given the risks of opioids, clinicians are under growing pressure to treat pain with non-opioid medications. Yet non-opioid analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) have their own risk...

    Authors: Michelle S. Keller, Lyna Truong, Allison M. Mays, Jack Needleman, Mary Sue V. Heilemann and Teryl K. Nuckols

    Citation: BMC Family Practice 2021 22:41

    Content type: Research article

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  13. Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remain...

    Authors: Malak Al Shammari, Ali Hassan, Nouf AlShamlan, Sarah Alotaibi, Manar Bamashmoos, Amani Hakami, Abdullatif Althunyan, Shymaa Basager, Sameerah Motabgani, Sawsan Aljubran and Hind S. Alsaif

    Citation: BMC Family Practice 2021 22:39

    Content type: Research article

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  14. To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with ...

    Authors: Harjit K. Singh, Gerard A. Kennedy and Ieva Stupans

    Citation: BMC Family Practice 2021 22:35

    Content type: Research article

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  15. Postural hypotension (PH), the reduction in blood pressure when rising from sitting or lying 0to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in pr...

    Authors: Sinead T. J. McDonagh, Natasha Mejzner and Christopher E. Clark

    Citation: BMC Family Practice 2021 22:1

    Content type: Research article

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  16. The Netherlands Triage Standard (NTS) is a widely used decision support tool for telephone triage at Dutch out-of-hours primary care services (OHS-PC), which, however, has never been validated against clinical...

    Authors: Daphne C. Erkelens, Frans H. Rutten, Loes T. Wouters, L. Servaas Dolmans, Esther de Groot, Roger A. Damoiseaux and Dorien L. Zwart

    Citation: BMC Family Practice 2020 21:256

    Content type: Research article

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  17. 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 com...

    Authors: Johannes Just, Marie-Therese Puth, Felix Regenold, Klaus Weckbecker and Markus Bleckwenn

    Citation: BMC Family Practice 2020 21:251

    Content type: Research article

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  18. Non-alcoholic fatty liver disease (NAFLD) is an emerging novel cardiovascular disease (CVD) risk factor. It’s prevalence is increasing globally. However, there is paucity in the evidence showing the associatio...

    Authors: Hayatul Najaa Miptah, Anis Safura Ramli, Mariam Mohamad, Hilwati Hashim and Zahirah Tharek

    Citation: BMC Family Practice 2020 21:238

    Content type: Research article

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  19. Urinary tract infections (UTIs) are one of the most common infections in primary care. Previous research showed that GPs find it challenging to diagnose UTIs and frequently divert from guidelines leading to un...

    Authors: Michelle Spek, Jochen W. L. Cals, Guy J. Oudhuis, Paul H. M. Savelkoul and Eefje G. P. M. de Bont

    Citation: BMC Family Practice 2020 21:231

    Content type: Research article

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  20. Most patients with destructive bone lesions undergo a comprehensive diagnostic procedure to ensure that proper treatment decisions are pursued. For patients with multiple myeloma, this can lead to delays in di...

    Authors: Phichayut Phinyo, Titinat Maihom, Areerak Phanphaisarn, Pakorn Kerdsinchai, Ekarat Rattarittamrong, Jayanton Patumanond and Dumnoensun Pruksakorn

    Citation: BMC Family Practice 2020 21:215

    Content type: Research article

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  21. Female urinary incontinence is underdiagnosed and undertreated in primary care. There is little evidence on factors that determine whether women with urinary incontinence are referred to specialist services. T...

    Authors: Ipek Gurol-Urganci, Rebecca S. Geary, Jil B. Mamza, Masao Iwagami, Dina El-Hamamsy, Jonathan Duckett, Andrew Wilson, Douglas Tincello and Jan van der Meulen

    Citation: BMC Family Practice 2020 21:211

    Content type: Research article

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  22. Transthyretin amyloidosis (also known as ATTR amyloidosis) is a systemic, life-threatening disease characterized by transthyretin (TTR) fibril deposition in organs and tissue. A definitive diagnosis of ATTR am...

    Authors: Morie Gertz, David Adams, Yukio Ando, João Melo Beirão, Sabahat Bokhari, Teresa Coelho, Raymond L. Comenzo, Thibaud Damy, Sharmila Dorbala, Brian M. Drachman, Marianna Fontana, Julian D. Gillmore, Martha Grogan, Philip N. Hawkins, Isabelle Lousada, Arnt V. Kristen…

    Citation: BMC Family Practice 2020 21:198

    Content type: Guidelines

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  23. Multimorbidity is of increasing prevalence and importance. It has been associated with poorer health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity in ...

    Authors: Sai Zhen Sim, Hui Li Koh, Sabrina Poay Sian Lee, Doris Yee Ling Young and Eng Sing Lee

    Citation: BMC Family Practice 2020 21:190

    Content type: Research article

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  24. Acute otitis media (AOM) is a common and most often self-limiting infection in childhood, usually managed in general practice. Even though antibiotics are only recommended when certain diagnostic and clinical ...

    Authors: Jonas K. Olsen, Jesper Lykkegaard, Malene Plejdrup Hansen, Frans B. Waldorff, Jørgen Lous and Merethe K. Andersen

    Citation: BMC Family Practice 2020 21:177

    Content type: Research article

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  25. The responsibility for helping patients understand potential health benefits and risks, especially regarding screening tests, falls largely to general practitioners (GPs). The Berlin Numeracy Test (BNT) specif...

    Authors: Hendrik Friederichs, Roman Birkenstein, Jan C. Becker, Bernhard Marschall and Anne Weissenstein

    Citation: BMC Family Practice 2020 21:143

    Content type: Research article

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  26. Rectal bleeding and a change in bowel habits are considered to be alarm symptoms for colorectal cancer and they are also common symptoms for inflammatory bowel disease. However, most patients with these sympto...

    Authors: Cecilia Högberg, Pontus Karling, Jörgen Rutegård and Mikael Lilja

    Citation: BMC Family Practice 2020 21:129

    Content type: Research article

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  27. Urinary tract infections are one of the most common reasons for prescribing antibiotics in primary care. Current guidelines recommend fosfomycin, nitrofurantoin, or trimethoprim - sulfamethoxazol as empiric fi...

    Authors: Andreas Plate, Andreas Kronenberg, Martin Risch, Yolanda Mueller, Stefania Di Gangi, Thomas Rosemann and Oliver Senn

    Citation: BMC Family Practice 2020 21:125

    Content type: Research article

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  28. The 2017 Canadian opioid Guideline made both strong recommendations, indicating that all or almost all fully informed patients would choose the recommended course of action, and weak recommendations, in which ...

    Authors: Jason W. Busse, David Juurlink, D. Norman Buckley and Gordon H. Guyatt

    Citation: BMC Family Practice 2020 21:109

    Content type: Correspondence

    Published on:

    The original article was published in BMC Family Practice 2019 20:59

  29. Unhealthy alcohol use is the third leading cause of preventable death in the United States. Evidence demonstrates that screening for unhealthy alcohol use and providing persons engaged in risky drinking with b...

    Authors: Alison N. Huffstetler, Anton J. Kuzel, Roy T. Sabo, Alicia Richards, E. Marshall Brooks, Paulette Lail Kashiri, Gabriela Villalobos, Albert J. Arias, Dace Svikis, Beth A. Bortz, Ashley Edwards, John Epling, Deborah J. Cohen, Michael L. Parchman, Jonathan Winter, Patricia Wessler…

    Citation: BMC Family Practice 2020 21:93

    Content type: Study protocol

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  30. The 2017 American College of Cardiology and American Heart Association guideline defined hypertension as blood pressure (BP) ≥ 130/80 mmHg compared to the traditional definition of ≥140/90 mmHg. This change ra...

    Authors: Bumsoo Park, Katarzyna Budzynska, Nada Almasri, Sumaiya Islam, Fanar Alyas, Rachel L. Carolan, Benjamin E. Abraham, Pamela A. Castro-Camero, Maria E. Shreve, Della A. Rees and Lois Lamerato

    Citation: BMC Family Practice 2020 21:91

    Content type: Research article

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  31. This study evaluated the impact of multifaceted NPS MedicineWise programs that targeted all general practitioners (GPs) in Australia in 2009 and 2015 with the aim of reducing unnecessary prescribing of proton ...

    Authors: Jianyun Wu, Scott Dickinson, Zain Elgebaly, Suzanne Blogg, Aine Heaney, Yien Soo, Benjamin Daniels and Lynn Weekes

    Citation: BMC Family Practice 2020 21:85

    Content type: Research article

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  32. Patients with high cardiovascular risk are usually cared for in primary care settings. Assessment of the effectiveness of long-time care was a subject of many European studies in the last two decades. This pap...

    Authors: Zoltán Jancsó, Imre Rurik, László Kolozsvári, Lajos Mester, Anna Nánási, Csaba Oláh, Tímea Ungvári, Katalin Vraukó TCs, László Kalabay and Péter Torzsa

    Citation: BMC Family Practice 2020 21:83

    Content type: Research article

    Published on:

  33. Ankylosing spondylitis (AS) often has a long period from first symptom presentation to diagnosis. We examined the occurrence of symptoms, prescriptions and diagnostic tests in primary care electronic records o...

    Authors: Mohammed T. Bashir, Lisa Iversen and Christopher Burton

    Citation: BMC Family Practice 2020 21:78

    Content type: Research article

    Published on:

  34. In western countries, psychological stress is among the most common causes of long-lasting sick leave and a frequent reason to consult the general practitioner (GP). This study aimed to investigate how GPs man...

    Authors: Jesper Lykkegaard, Anders Prior and Marianne Rosendal

    Citation: BMC Family Practice 2020 21:67

    Content type: Research article

    Published on:

  35. In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains...

    Authors: Aapo Tahkola, Päivi Korhonen, Hannu Kautiainen, Teemu Niiranen and Pekka Mäntyselkä

    Citation: BMC Family Practice 2020 21:62

    Content type: Research article

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  36. The oldest old (individuals over 90 years) are a fast-growing population. Characterizing their specificity would be helpful to adapt health care. This study aimed to characterize the cognitive, functional, nut...

    Authors: Emile Escourrou, Florence Durrieu, Bruno Chicoulaa, Julie Dupouy, Stéphane Oustric, Sandrine Andrieu and Virginie Gardette

    Citation: BMC Family Practice 2020 21:58

    Content type: Research article

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  37. We aimed to describe primary care management at the time of a suicide attempt (SA) and after the SA.

    Authors: Nadia Younes, Mathieu Rivière, Frédéric Urbain, Romain Pons, Thomas Hanslik, Louise Rossignol, Christine Chan Chee and Thierry Blanchon

    Citation: BMC Family Practice 2020 21:55

    Content type: Research article

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  38. Experienced and anticipated regret influence physicians’ decision-making. In medicine, diagnostic decisions and diagnostic errors can have a severe impact on both patients and physicians. Little empirical rese...

    Authors: Beate S. Müller, Norbert Donner-Banzhoff, Martin Beyer, Jörg Haasenritter, Angelina Müller and Carola Seifart

    Citation: BMC Family Practice 2020 21:53

    Content type: Research article

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  39. Stratified care involves subgrouping patients based on key characteristics, e.g. prognostic risk, and matching these subgroups to appropriate early treatment options. The STarT MSK feasibility and pilot cluste...

    Authors: Benjamin Saunders, Jonathan C. Hill, Nadine E. Foster, Vince Cooper, Joanne Protheroe, Adrian Chudyk, Carolyn Chew-Graham and Bernadette Bartlam

    Citation: BMC Family Practice 2020 21:31

    Content type: Research article

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  40. Musculoskeletal (MSK) pain from the five most common presentations to primary care (back, neck, shoulder, knee or multi-site pain), where the majority of patients are managed, is a costly global health challen...

    Authors: J. C. Hill, S. Garvin, Y. Chen, V. Cooper, S. Wathall, B. Saunders, M. Lewis, J. Protheroe, A. Chudyk, K. M. Dunn, E. Hay, D. van der Windt, C. Mallen and N. E. Foster

    Citation: BMC Family Practice 2020 21:30

    Content type: Research article

    Published on:

  41. Vitamin D (VD) may increase sirtuin 1 (SIRT1) and subsequently PPAR-γ coactivator 1α (PGC-1α) and irisin levels and these improvements may reduce insulin resistance (IR). The aim was to assess the effects of v...

    Authors: Peivasteh Safarpour, Milad Daneshi-Maskooni, Mohammadreza Vafa, Mitra Nourbakhsh, Leila Janani, Mohsen Maddah, Fatemeh-Sadat Amiri, Fereshteh Mohammadi and Homa Sadeghi

    Citation: BMC Family Practice 2020 21:26

    Content type: Research article

    Published on:

  42. Patient reported outcome measures (PROMs) are increasingly used to assess impact of disease and treatment on quality of life and symptoms; however, their use in primary care is fragmented.

    Authors: Grace M. Turner, Ian Litchfield, Sam Finnikin, Olalekan Lee Aiyegbusi and Melanie Calvert

    Citation: BMC Family Practice 2020 21:14

    Content type: Research article

    Published on:

  43. Detection and treatment of atrial fibrillation (AF) are important given the serious health consequences. AF may be silent or paroxysmal and remain undetected. It is unclear whether general practitioners (GPs) ...

    Authors: N. Verbiest - van Gurp, D. van Mil, H. A. M. van Kesteren, J. A. Knottnerus and H. E. J. H. Stoffers

    Citation: BMC Family Practice 2019 20:175

    Content type: Research article

    Published on:

    The Correction to this article has been published in BMC Family Practice 2020 21:24

  44. Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management.

    Authors: Diana Fernández, Carlos Brotons, Irene Moral, Mateja Bulc, Mélanie Afonso, Hülya Akan, Susana Pinto, Jasna Vucak and Carlos Manuel da Silva Martins

    Citation: BMC Family Practice 2019 20:162

    Content type: Research article

    Published on:

  45. Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary ...

    Authors: Ricard Carrillo Muñoz, José Luis Ballve Moreno, Iván Villar Balboa, Yolanda Rando Matos, Oriol Cunillera Puertolas, Jesús Almeda Ortega, Estrella Rodero Perez, Xavier Monteverde Curto, Carles Rubio Ripollès, Noemí Moreno Farres, Austria Matos Mendez, Jean Carlos Gomez Nova, Marta Bardina Santos, Johan Josué Villarreal Miñano, Diana Lizzeth Pacheco Erazo and Anabella María Hernández Sánchez

    Citation: BMC Family Practice 2019 20:156

    Content type: Research article

    Published on:

  46. The changes in the models of care for mental disorders towards a community focus and deinstitutionalisation might have risen General practitioners’ (GPs) workload, increasing their mental health concerns and t...

    Authors: C. Barcons, B. García, C. Sarri, E. Rodríguez, O. Cunillera, N. Parellada, B. Fernández, C. E. Alvarado, C. Barrio, J. C. Fleta, D. Ruiz and R. Torrubia

    Citation: BMC Family Practice 2019 20:155

    Content type: Research article

    Published on:

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