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Biomedical subjects

J F Grace

Publications and source records attributed to J F Grace.

7 recordsLinked to original sources
PubMed2005

Clinical assessment alone will not benefit patients with coronary heart disease: failure to achieve cholesterol targets in 12,045 patients--the Healthwise II study.

Healthwise II, a nurse-led audit programme in primary care during 1999-2002, assessed the uptake of secondary preventative measures for coronary heart disease (CHD). Risk factors, cardiovascular medications and blood cholesterol were recorded; 'at risk' patients were invited for a review after 6 months. Of 17,570 patients assessed, CHD was clinically present in 12,045 (69%); in these, aspirin usage was high (78%) but fewer patients were on a beta-blocker (40%), angiotensin-converting enzyme inhibitor (27%) or statin (49%). Blood pressure (BP) was controlled (<140/90) in only 41% of patients. Total cholesterol was >5 mmol/l in 49% of all CHD patients, half of whom were taking a statin. In the statin users, total cholesterol was uncontrolled (>5 mmol/l) in 38%. At follow-up, BP control remained at 42%, statin use increased to 57% and cholesterol remained elevated in 46%. Simple assessment in an audit programme fails to trigger change, and risk-factor modification for CHD remains inadequate.

Age Factors↗
PubMed1987

Referral to hospital: perceptions of patients, general practitioners and consultants about necessity and suitability of referral.

A sample of new referrals from general practitioners to hospital specialists was examined from the points of view of the patient, general practitioner and consultant concerned with regard to the adequacy of the general practitioners' performance before referral, his ability to have managed without referral and the suitability of the specialist seen. Little agreement was found between the opinions expressed by the three groups, although some of the opinions expressed within the groups were found to be associated with characteristics of the groups.

Consultants↗
PubMed1986

Reasons for referral to hospital: extent of agreement between the perceptions of patients, general practitioners and consultants.

A sample of referrals to hospital out-patient clinics by general practitioners was examined from the points of view of the patient, general practitioner and consultant with regard to the perceived reason for the referral. A considerable degree of disagreement was found between the opinions of the three parties involved. Possible explanations for, and the consequences of this lack of agreement are considered and certain remedies suggested.

Consultants↗
PubMed1984

General practice management of childhood urinary tract infection.

The incidence of urinary tract infections (UTI) in the paediatric population of a group practice was recorded. A questionnaire involving two case studies was sent to general practitioners and paediatric consultants in the region to assess the management of children suspected of having UTI and the attitudes to referral of these cases to the paediatrician. Disturbing inconsistencies in the management plans were found among both general practitioners and consultants. The reasons for these inconsistencies and the implications arising from them are discussed.

Child↗
PubMed1980

An examination of the prescribed therapeutic experience of five-year-olds in general practice.

The number and therapeutic grouping of prescriptions given to children before reaching their fifth birthday were examined. The records of 92 children were looked at. Between them they had received 1,241 individual prescriptions of which 33 per cent were for antibiotics, and 31 per cent for an antihistamine or cough linctus. Ninety-six per cent of the children had received at least one course of antibiotics and the average child 4.5 courses (SD +/- 3.9); 89 per cent had received an antihistamine or cough linctus, and 50 per cent a skin preparation.

Child, Preschool↗