[Rational and practical pharmacotherapy for a group practice].
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Journal Article↗
Biomedical subjects
H Lamberts
Publications and source records attributed to H Lamberts.
Patients with chronic alcohol abuse in Dutch family practices.
Routine data from the Dutch Transition project on 236 027 episodes of care collected by 54 family physicians (FPs) for 93 297 patient years in their listed practices and classified with the International Classification of Primary Care, were used to analyse chronic alcohol abuse episodes of care in Dutch family practices. Data on 332 episodes are presented. In a subsample with a 4-year registration period, 70 patients were identified. Important reasons for an encounter are the patient's explicit presentation of the problem and the FPs' initiatives. FPs show considerable sensitivity to psychosocial problems, including alcohol abuse. It is concluded that over the years registered FPs actively deal with chronic alcohol abuse in approximately 2% of all visiting men aged 25-64 years. In an average Dutch family practice with 2200 listed patients, approximately 20 patients are known by the FP to have chronic alcohol abuse. Real life studies in registered family practice populations are necessary to better establish how patients with abundant alcohol consumption as a risk factor develop the chronic alcohol abuse episode of care, and what FPs can do to prevent this effectively.
Adult↗
Classification of reasons why persons seek primary care: pilot study of a new system.
In 1978, the World Health Organization formed a group to begin work on the Reason for Encounter Classification (RFEC), which is designed to classify the reasons why patients seek care at the primary level. The relatively simple classification is based on two axes--chapters and components--and uses a three-character alpha-numeric code. Chapters, which are named by body systems or more general terms, are the reasons that health care was sought. Five of the seven components, or subdivisions of chapters, contain rubrics identified by the same two-digit numerical code. A pilot study with a training exercise was carried out in The Netherlands by nine family physicians to confirm the feasibility of using the new classification system in primary care settings. Training consisted of viewing videotapes of encounters and an exercise of coding 76 vignettes by the RFEC. Within 2 months, the physicians in the subsequent pilot study had collected and coded 7,503 reasons for encounters. Results of the pilot study confirm that the RFEC is feasible, easy to use in practice, and different from disease-oriented classifications in its system of classifying the reasons for encounter. The pilot study results have been used to modify the RFEC in preparation for a field trial in ambulatory care settings worldwide.
Disease↗