Risultati per: Il medico di medicina generale e il dolore oncologico

90% di quelli estremamente pretermine sottoposto a cure dolorose

Colpiti 10 milioni di italiani. Esperta, ‘verso trattamenti personalizzati’

Bartoletti,attenzione a sottobosco professionisti ‘improvvisati’

I trattamenti mirano a contrastare gli effetti collaterali delle terapie

Mi chiamo Federica Aimeri, sono un medico di medicina generale che lavora in un piccolo paese di campagna del nord Italia, in provincia di Cuneo. Sono anche una lettrice del…

I trattamenti mirano a contrastare effetti collaterali terapie

Iss,adesione 43% indagini su seno, 41% su cervice e 27% su colon

Dall’anno accademico 2025/26, esclusivamente in lingua inglese

Insulti dai no vax, ‘sono terrorizzato’

Insulti dai no vax, ‘sono terrorizzato’

Ordinaria di Medicina interna a Perugia, si insedierà nel 2028

L’Agenas ha chiuso un bando di gara per realizzare una piattaforma che sarà impiegata innanzitutto dai medici, ma anche dagli assistiti

Tosolini, dovremo impegnarci sempre di più nella ricerca

‘Necessario un modello organizzativo dipartimentale’

Objectives
The first COVID-19 lockdown raised concerns about reduced access to primary care, especially for people with chronic diseases particularly at risk in the absence of follow-up. However, the COVIQuest trial, evaluating the impact of a general practitioner (GP) phone call (intervention) to chronic patients with cardiovascular disease (CVD) or mental health disorder (MHD) concluded that the intervention had no effect at 1 month on the rate of self-reported hospitalisations in the CVD subtrial, whereas the intervention group in MHD subtrial might have a higher rate. This second part of the study aimed to describe the 6 month hospitalisation and specialised consultation rates, using the French health data system (Système National des Données de Santé). The secondary objective was to describe these rates during the same period in 2019.

Design
A cluster randomised controlled trial, with clusters being GPs.

Setting
Primary care, 149 GPs from eight French regions.

Participants
Patients ≥70 years old with chronic CVD or ≥18 years old with MHD.

Interventions
A standardised GP-initiated phone call aiming to evaluate patient’s need for urgent care (vs usual care for control groups).

Primary and secondary outcome measures
The occurrence of at least one hospitalisation at end point 31 October 2020 (randomisation 30 April 2020), excluding those starting on 30 April 2020, was measured as planned. Another main outcome was the occurrence of at least one specialised consultation during the same period. These 6 month effects were studied, using a logistic regression model within a generalised estimating equation framework, for each subtrial.

Results
4640 patients were included: 3274 cardiovascular (mean age 79.9±7.0 years; 57.8% male) and 1366 psychiatric (53.2±7.0; 36.5%). For both subtrials, the intervention patients were significantly more hospitalised than the control patients, respectively, 17.3% versus 14.9% of CVD patients (OR=1.26 (1.05 to 1.52)); 14.4% versus 10.7% of MHD patients (OR=1.40 (1.00 to 1.96)). During the same period in 2019, the hospitalisation rates were, respectively, 16.3%, 18.2%, 15.8% and 14.8%. The proportions of patients with at least one specialised consultation were not different between the intervention and control groups, respectively, 24.6% versus 24.3% for CVD patients (OR=1.06 (0.85 to 1.32)); 26.5% versus 24.4% for MHD patients (OR=1.15 (0.84 to 1.57)). During the same period in 2019, these rates were, respectively, 22.7%, 24.6%, 28.0% and 25.5%.

Conclusions
The intervention was associated with higher rates of hospitalisation at 6 months in patients with MHD or CVD. No intervention impact was found in outpatient care. These results are difficult to interpret because of a potential artefact induced by national campaigns promoting medical use during lockdown, overlapping the study inclusion period. This study showed that medico-administrative databases could represent a complementary cost-effective tool to clinical research for long-term and healthcare consumption outcomes.

Trial registration number
NCT04359875.

Mozione sulla scelta dei non vulnerabili da mandare in Albania