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Systematic opportunistic screening f...
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Kenealy, Timothy William.
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Systematic opportunistic screening for type 2 diabetes in general practice.
Record Type:
Electronic resources : Monograph/item
Title/Author:
Systematic opportunistic screening for type 2 diabetes in general practice./
Author:
Kenealy, Timothy William.
Description:
223 p.
Notes:
Source: Dissertation Abstracts International, Volume: 65-11, Section: B, page: 5627.
Contained By:
Dissertation Abstracts International65-11B.
Subject:
Health Sciences, Medicine and Surgery. -
Online resource:
http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3155372
ISBN:
0496159062
Systematic opportunistic screening for type 2 diabetes in general practice.
Kenealy, Timothy William.
Systematic opportunistic screening for type 2 diabetes in general practice.
- 223 p.
Source: Dissertation Abstracts International, Volume: 65-11, Section: B, page: 5627.
Thesis (Ph.D.)--The University of Auckland (New Zealand), 2004.
Some 70,000 people in New Zealand may have undiagnosed diabetes. This study aims to develop 'systematic opportunistic screening' for diabetes, testing people attending a general practitioner (GP) for some other reason, and to trial this process with Auckland GPs. The literature on how to change doctor behaviour is reviewed for both theoretical perspectives and empirical evidence. Two of the most promising strategies are computer reminders within a medical consultation and having patients influence doctors. Literature reviews cover GP attitudes to diabetes, guidelines and preventive care and the role of a computer in a GP consultation.
ISBN: 0496159062Subjects--Topical Terms:
1017756
Health Sciences, Medicine and Surgery.
Systematic opportunistic screening for type 2 diabetes in general practice.
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Systematic opportunistic screening for type 2 diabetes in general practice.
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223 p.
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Source: Dissertation Abstracts International, Volume: 65-11, Section: B, page: 5627.
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Advisers: Bruce Arroll; Keith Petrie.
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Thesis (Ph.D.)--The University of Auckland (New Zealand), 2004.
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Some 70,000 people in New Zealand may have undiagnosed diabetes. This study aims to develop 'systematic opportunistic screening' for diabetes, testing people attending a general practitioner (GP) for some other reason, and to trial this process with Auckland GPs. The literature on how to change doctor behaviour is reviewed for both theoretical perspectives and empirical evidence. Two of the most promising strategies are computer reminders within a medical consultation and having patients influence doctors. Literature reviews cover GP attitudes to diabetes, guidelines and preventive care and the role of a computer in a GP consultation.
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The Mail Survey (response rate 154/212, 72.6%) reports GP attitudes to guidelines and preventive care. Factor analysis showed five 'guidelines' factors and two 'preventive care' factors that might indicate differential motivations to screening for diabetes.
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The Focus Group Study, of 35 GPs in 5 groups, discussed guidelines, diabetes and computer reminders in a consultation. The analysis suggested that GPs would respond to a patient reminder and may respond to a computer reminder to screen for diabetes.
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The Screening Reminder Trial involved 107 GPs randomly allocated across four interventions: Computer reminders, Patient reminders, Both and Usual care. The main outcome measures were whether a patient who was eligible for diabetes screening and who visited a GP during the trial had a glucose test done within the trial. The trial ran for two months. Analysis was by intention-to-treat and allowed for clustering by GP. Compared with the Usual care group (screening rate 15.5%), the Odds Ratio of eligible patients being screened were; Computer group OR 2.55 (1.68--3.88), Patient group OR 1.72 (1.21--2.43) and Both group OR 1.69 (1.11--2.59). The Computer reminders were more acceptable to GPs than were the Patient intervention. The findings suggest that a simple computer reminder can implement systematic opportunistic screening for diabetes in New Zealand. If all GPs in New Zealand used the computer reminders for one year, some 8000 patients might benefit from having their diabetes treated for five years longer than they would have under 'usual care'.
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http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3155372
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