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OBJECTIVES To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care(More)
Strict control of systolic blood pressure is known to slow progression of chronic kidney disease (CKD). Here we compared audit-based education (ABE) to guidelines and prompts or usual practice in lowering systolic blood pressure in people with CKD. This 2-year cluster randomized trial included 93 volunteer general practices randomized into three arms with(More)
Many people use online applications to communicate with friends, book travel and hotels, order goods, organise diaries and conduct their affairs. It is therefore reasonable that patients may expect to interact with their general practice online. Internationally online access is provided by some general medical services providers 1 and in certain specialist(More)
Currently in the UK, prenatal diagnosis of genetic conditions and Down's syndrome requires invasive diagnostic tests such as amniocentesis and chorionic villus sampling (CVS). Procedural related miscarriage rates of about 1% have been quoted for these tests which are not usually done before 11 weeks' gestation. 1 Annually in the UK, 32 000 women have an(More)
INTRODUCTION An increasing number of people are living with multimorbidity. The evidence base for how best to manage these patients is weak. Current clinical guidelines generally focus on single conditions, which may not reflect the needs of patients with multimorbidity. The aim of the 3D study is to develop, implement and evaluate an intervention to(More)
BACKGROUND In England, guidance from National Institute for Clinical Excellence (NICE) states women with a family history of breast cancer presenting to primary care should be reassured or referred.We reviewed the evidence for interventions that might be applied in primary care and conducted an audit of whether low risk women are correctly advised and(More)
BACKGROUND Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC) and National Institute for Health and Clinical Excellence (NICE) but there is evidence of substantial under-recording. AIM To determine whether a simple coding strategy improved recording of maltreatment-related concerns in(More)
BACKGROUND Recruitment to research studies in primary care is challenging despite widespread implementation of electronic patient record (EPR) systems which potentially make it easier to identify eligible cases. METHODS Literature review and applying the learning from a European research readiness assessment tool, the TRANSFoRm International Research(More)
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