International journal of family medicine最新文献

What Are the Factors Influencing Implementation of Advanced Access in Family Medicine Units? A Cross-Case Comparison of Four Early Adopters in Quebec. 影响家庭医学单位先进可及性实施的因素有哪些?魁北克四个早期采用者的跨案例比较。

International journal of family medicine Pub Date : 2017-01-01 Epub Date: 2017-07-10 DOI: 10.1155/2017/1595406

Sabina Abou Malham, Nassera Touati, Lara Maillet, Isabelle Gaboury, Christine Loignon, Mylaine Breton

{"title":"What Are the Factors Influencing Implementation of Advanced Access in Family Medicine Units? A Cross-Case Comparison of Four Early Adopters in Quebec.","authors":"Sabina Abou Malham, Nassera Touati, Lara Maillet, Isabelle Gaboury, Christine Loignon, Mylaine Breton","doi":"10.1155/2017/1595406","DOIUrl":"https://doi.org/10.1155/2017/1595406","url":null,"abstract":"Introduction: Advanced access is an organizational model that has shown promise in improving timely access to primary care. In Quebec, it has recently been introduced in several family medicine units (FMUs) with a teaching mission. The objectives of this paper are to analyze the principles of advanced access implemented in FMUs and to identify which factors influenced their implementation.Methods: A multiple case study of four purposefully selected FMUs was conducted. Data included document analysis and 40 semistructured interviews with health professionals and staff. Cross-case comparison and thematic analysis were performed.Results: Three out of four FMUs implemented the key principles of advanced access at various levels. One scheduling pattern was observed: 90% of open appointment slots over three- to four-week periods and 10% of prebooked appointments. Structural and organizational factors facilitated the implementation: training of staff to support change, collective leadership, and openness to change. Conversely, family physicians practicing in multiple clinical settings, lack of team resources, turnover of clerical staff, rotation of medical residents, and management capacity were reported as major barriers to implementing the model.Conclusion: Our results call for multilevel implementation strategies to improve the design of the advanced access model in academic teaching settings.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2017 ","pages":"1595406"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/1595406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35244500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Women's Joint Decision on Contraceptive Use in Gedeo Zone, Southern Ethiopia: A Community Based Comparative Cross-Sectional Study. 埃塞俄比亚南部Gedeo地区妇女对避孕药具使用的共同决定:一项基于社区的比较横断面研究。

International journal of family medicine Pub Date : 2017-01-01 Epub Date: 2017-03-07 DOI: 10.1155/2017/9389072

Akine Eshete, Yohannes Adissu

{"title":"Women's Joint Decision on Contraceptive Use in Gedeo Zone, Southern Ethiopia: A Community Based Comparative Cross-Sectional Study.","authors":"Akine Eshete, Yohannes Adissu","doi":"10.1155/2017/9389072","DOIUrl":"https://doi.org/10.1155/2017/9389072","url":null,"abstract":"A community based comparative cross-sectional study design was employed to assess the mutual consent of women about family planning use in urban and rural villages of Gedeo zone. Two-thirds (67.4%) of women made joint decision on contraceptive use, varying between urban (70.9%) and rural (63.4%) settings. This difference was statistically significant where women in urban setup had a 41% (AOR, 1.41; 95% CI (1.15, 2.01) added chance of making joint decision than the rural counterpart. In both settings, attitude towards contraceptive method was an independent predictor of joint contraceptive decision (AOR = 2.85) in urban and (AOR = 2.81) rural women. Contrarily, different factors were found to be associated with joint contraceptive decision in either setup. In urban, having better knowledge about contraceptive methods (AOR = 2.9) and having lower age difference (AOR = 2.2) were found to be strong predictors of joint decision on contraceptive use, while having too many children (AOR = 2.2) and paternal support (AOR = 7.1) in rural setups. Lower level of joint decision making on contraceptive use was reported in both setups. Factors associated with joint decision varied between the two setups, except for attitude towards contraceptive methods. Future family planning program should address sociocultural, knowledge and attitude factors.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2017 ","pages":"9389072"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/9389072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34877246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 31

Type of Multimorbidity and Patient-Doctor Communication and Trust among Elderly Medicare Beneficiaries 老年医保受益人多病类型与医患沟通与信任

International journal of family medicine Pub Date : 2016-10-05 DOI: 10.1155/2016/8747891

R. Garg, Chan Shen, N. Sambamoorthi, K. Kelly, U. Sambamoorthi

{"title":"Type of Multimorbidity and Patient-Doctor Communication and Trust among Elderly Medicare Beneficiaries","authors":"R. Garg, Chan Shen, N. Sambamoorthi, K. Kelly, U. Sambamoorthi","doi":"10.1155/2016/8747891","DOIUrl":"https://doi.org/10.1155/2016/8747891","url":null,"abstract":"Background. Effective communication and high trust with doctor are important to reduce the burden of multimorbidity in the rapidly aging population of the US. However, the association of multimorbidity with patient-doctor communication and trust is unknown. Objective. We examined the relationship between multimorbidity and patient-doctor communication and trust among the elderly. Method. We used the Medicare Current Beneficiary Survey (2012) to analyze the association between multimorbidity and patient-doctor communication and trust with multivariable logistic regressions that controlled for patient's sociodemographic characteristics, health status, and satisfaction with care. Results. Most elderly beneficiaries reported effective communication (87.5–97.5%) and high trust (95.4–99.1%) with their doctors. The elderly with chronic physical and mental conditions were less likely than those with only physical conditions to report effective communication with their doctor (Adjusted Odds Ratio [95% Confidence Interval] = 0.80 [0.68, 0.96]). Multimorbidity did not have a significant association with patient-doctor trust. Conclusions. Elderly beneficiaries had high trust in their doctors, which was not affected by the presence of multimorbidity. Elderly individuals who had a mental condition in addition to physical conditions were more likely to report ineffective communication. Programs to improve patient-doctor communication with patients having cooccurring chronic physical and mental health conditions may be needed.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/8747891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64584948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

General Practitioners' Participation in a Large, Multicountry Combined General Practitioner-Patient Survey: Recruitment Procedures and Participation Rate 全科医生参与大型多国联合全科医生-患者调查:招募程序和参与率

International journal of family medicine Pub Date : 2016-03-07 DOI: 10.1155/2016/4929432

P. Groenewegen, S. Gress, W. Schäfer

{"title":"General Practitioners' Participation in a Large, Multicountry Combined General Practitioner-Patient Survey: Recruitment Procedures and Participation Rate","authors":"P. Groenewegen, S. Gress, W. Schäfer","doi":"10.1155/2016/4929432","DOIUrl":"https://doi.org/10.1155/2016/4929432","url":null,"abstract":"Background. The participation of general practitioners (GPs) is essential in research on the performance of primary care. This paper describes the implementation of a large, multicountry study in primary care that combines a survey among GPs and a linked survey among patients that visited their practice (the QUALICOPC study). The aim is to describe the recruitment procedure and explore differences between countries in the participation rate of the GPs. Methods. Descriptive analyses were used to document recruitment procedures and to assess hypotheses potentially explaining variation in participation rates between countries. Results. The survey was implemented in 31 European countries. GPs were mainly selected through random sampling. The actual implementation of the study differed between countries. The median participation rate was 30%. Both material (such as the payment system of GPs in a country) and immaterial influences (such as estimated survey pressure) are related to differences between countries. Conclusion. This study shows that the participation of GPs may indeed be influenced by the context of the country. The implementation of complex data collection is difficult to realize in a completely uniform way. Procedures have to be tuned to the context of the country.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/4929432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64404057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 48

Trajectories of Change in Obesity among Tehranian Families: Multilevel Latent Growth Curve Modeling 德黑兰家庭肥胖变化轨迹:多水平潜在增长曲线模型

International journal of family medicine Pub Date : 2016-03-03 DOI: 10.1155/2016/2639624

M. Akbarzadeh, A. Moghimbeigi, H. Mahjub, A. Soltanian, M. Daneshpour, N. Morris

{"title":"Trajectories of Change in Obesity among Tehranian Families: Multilevel Latent Growth Curve Modeling","authors":"M. Akbarzadeh, A. Moghimbeigi, H. Mahjub, A. Soltanian, M. Daneshpour, N. Morris","doi":"10.1155/2016/2639624","DOIUrl":"https://doi.org/10.1155/2016/2639624","url":null,"abstract":"Objectives. To evaluate the trajectories of change in obesity within and between Tehranian families, who participated in the Tehran Lipid and Glucose Study (TLGS). Methods. This study is a family-based longitudinal design, in four waves. A total of 14761 individuals, within 3980 families, were selected. Three anthropometric measurements, body mass index (BMI), waist circumference (WC), and a body shape index (ABSI), were recorded. Multilevel latent growth curve modeling (MLGCM) approach was used for evaluating the change trajectories in obesity within and between the families. Results. The mean age of the subjects in the present study was 33.28 ± 19.01 (range 3–89 years) and 50.1% were male. Obesity was significantly increased (P < 0.001). Individuals with more fat become obese slower, whereas families with more fat become obese faster (P < 0.001). The initial value and growth rate of WC and ABSI were greater in men than in women, while this result is contrary to BMI (P < 0.001). Conclusions. Our findings demonstrated that there is an alarming increase in the obesity trend in Tehranian families. The important role of the family in the prevention of obesity is highlighted, underlining the need for public health programs, as family centered educations to lifestyle modification, which can address this emerging crisis.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/2639624","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64288802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Improving System Integration: The Art and Science of Engaging Small Community Practices in Health System Innovation 改进系统集成:参与卫生系统创新的小社区实践的艺术和科学

International journal of family medicine Pub Date : 2016-01-24 DOI: 10.1155/2016/5926303

P. Pariser, L. Pus, I. Stanaitis, H. Abrams, N. Ivers, G. Baker, E. Lockhart, G. Hawker

{"title":"Improving System Integration: The Art and Science of Engaging Small Community Practices in Health System Innovation","authors":"P. Pariser, L. Pus, I. Stanaitis, H. Abrams, N. Ivers, G. Baker, E. Lockhart, G. Hawker","doi":"10.1155/2016/5926303","DOIUrl":"https://doi.org/10.1155/2016/5926303","url":null,"abstract":"This paper focuses on successful engagement strategies in recruiting and retaining primary care physicians (PCPs) in a quality improvement project, as perceived by family physicians in small practices. Sustained physician engagement is critical for quality improvement (QI) aiming to enhance health system integration. Although there is ample literature on engaging physicians in hospital or team-based practice, few reports describe factors influencing engagement of community-based providers practicing with limited administrative support. The PCPs we describe participated in SCOPE: Seamless Care Optimizing the Patient Experience, a QI project designed to support their care of complex patients and reduce both emergency department (ED) visits and inpatient admissions. SCOPE outcome measures will inform subsequent papers. All the 30 participating PCPs completed surveys assessing perceptions regarding the importance of specific engagement strategies. Project team acknowledgement that primary care is challenging and new access to patient resources were the most important factors in generating initial interest in SCOPE. The opportunity to improve patient care via integration with other providers was most important in their commitment to participate, and a positive experience with project personnel was most important in their continued engagement. Our experience suggests that such providers respond well to personalized, repeated, and targeted engagement strategies.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/5926303","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64447225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Differences between Groups of Family Physicians with Different Attitudes towards At-Risk Drinkers: A Post Hoc Study of the ODHIN Survey in Portugal 对高危饮酒者持不同态度的家庭医生群体之间的差异:葡萄牙ODHIN调查的事后研究

International journal of family medicine Pub Date : 2016-01-17 DOI: 10.1155/2016/3635907

F. Rosário, M. Wojnar, Cristina Ribeiro

{"title":"Differences between Groups of Family Physicians with Different Attitudes towards At-Risk Drinkers: A Post Hoc Study of the ODHIN Survey in Portugal","authors":"F. Rosário, M. Wojnar, Cristina Ribeiro","doi":"10.1155/2016/3635907","DOIUrl":"https://doi.org/10.1155/2016/3635907","url":null,"abstract":"Introduction. We have recently shown that family physicians can be classified into two groups based on their attitudes towards at-risk drinkers: one with better and the other with worse attitudes. Objective. To compare the two groups regarding demographics, alcohol-related clinical practice, knowledge of sensible drinking limits, and barriers and facilitators to working with at-risk drinkers. Methods. A random sample of 234 Portuguese family physicians who answered the Optimizing Delivery of Health Care Interventions survey was included. The questionnaire asked questions on demographics, alcohol-related clinical practice, knowledge of sensible drinking limits, and barriers and facilitators to working with at-risk drinkers. Results. Family physicians with better attitudes were younger (p = 0.005) and less experienced (p = 0.04) and with higher male proportion (p = 0.01). This group had more hours of postgraduate training (p < 0.001), felt more prepared to counsel risky drinkers (p < 0.001), and considered themselves to have better counselling efficacy (p < 0.001). More family physicians in the group with worse attitudes considered that doctors cannot identify risky drinkers without symptoms (p = 0.01) and believed counselling is difficult (p = 0.005). Conclusions. Family physicians with better attitudes had more education on alcohol and fewer barriers to work with at-risk drinkers. These differences should be taken into account when designing implementation programs seeking to increase alcohol screening and brief advice.","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3635907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"64339419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

A Focus Group on Dental Pain Complaints with General Medical Practitioners: Developing a Treatment Algorithm. 焦点小组对牙齿疼痛投诉与全科医生:发展治疗算法。

International journal of family medicine Pub Date : 2016-01-01 Epub Date: 2016-07-04 DOI: 10.1155/2016/4760672

Ava Elizabeth Carter, Geoff Carter, Robyn Abbey

{"title":"A Focus Group on Dental Pain Complaints with General Medical Practitioners: Developing a Treatment Algorithm.","authors":"Ava Elizabeth Carter, Geoff Carter, Robyn Abbey","doi":"10.1155/2016/4760672","DOIUrl":"https://doi.org/10.1155/2016/4760672","url":null,"abstract":"Objective. The differential diagnosis of pain in the mouth can be challenging for general medical practitioners (GMPs) as many different dental problems can present with similar signs and symptoms. This study aimed to create a treatment algorithm for GMPs to effectively and appropriately refer the patients and prescribe antibiotics. Design. The study design is comprised of qualitative focus group discussions. Setting and Subjects. Groups of GMPs within the Gold Coast and Brisbane urban and city regions. Outcome Measures. Content thematically analysed and treatment algorithm developed. Results. There were 5 focus groups with 8-9 participants per group. Addressing whether antibiotics should be given to patients with dental pain was considered very important to GMPs to prevent overtreatment and creating antibiotic resistance. Many practitioners were unsure of what the different forms of dental pains represent. 90% of the practitioners involved agreed that the treatment algorithm was useful to daily practice. Conclusion. Common dental complaints and infections are seldom surgical emergencies but can result in prolonged appointments for those GMPs who do not regularly deal with these issues. The treatment algorithm for referral processes and prescriptions was deemed easily downloadable and simple to interpret and detailed but succinct enough for clinical use by GMPs. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 ","pages":"4760672"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/4760672","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34318069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

"Negotiorum Gestio" in Family Medicine, Informed Consent Obtainment, and Disciplinary Responsibility. 全科医学中的 "Negotiorum Gestio"、知情同意的获得和纪律责任。

International journal of family medicine Pub Date : 2016-01-01 Epub Date: 2016-03-24 DOI: 10.1155/2016/5767065

Søren Birkeland

{"title":"\"Negotiorum Gestio\" in Family Medicine, Informed Consent Obtainment, and Disciplinary Responsibility.","authors":"Søren Birkeland","doi":"10.1155/2016/5767065","DOIUrl":"10.1155/2016/5767065","url":null,"abstract":"Introduction. Negotiorum gestio (NG) denotes an action where a person well intendedly acts on behalf of another without obtaining the latter's prior consent. In broad terms, NG-like actions have played a considerable role in health care provision. In some settings, health care delivery with only little or presumed patients' consent has been the rule rather than the exception. However, bioethical principles regarding patient autonomy and obtainment of the patient's informed consent (IC) before intervention are now increasingly materialized in the law of many countries. Aim. To study legal consequences of NG in family medicine and IC handling options. Methods. Case law examination. Results. A disciplinary board case is described concerning a family doctor conducting unlawful NG by not coming up to legal IC requirements. Discussion and Conclusion. The practical and legal implications of IC and possible role of novel Shared Decision-Making approaches in coming up to regulation and bioethical demands are discussed. It is concluded that a doctor may run an unnecessary legal risk when conducting NG in decision-competent patients and furthermore it is suggested that novel Shared Decision-Making approaches could help in obtaining a rightful and practicable IC. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 ","pages":"5767065"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4823499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34429118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ten-Year Trends in the Morbidity of Diabetes Mellitus and Antidiabetic Drug Utilization in Croatia: A Study Based on Routinely Collected Data. 克罗地亚糖尿病发病率和降糖药使用的十年趋势:一项基于常规收集数据的研究

International journal of family medicine Pub Date : 2016-01-01 Epub Date: 2016-07-04 DOI: 10.1155/2016/9837496

Renata Pavlov, Ivančica Topličan, Mladenka Vrcić Keglević

{"title":"Ten-Year Trends in the Morbidity of Diabetes Mellitus and Antidiabetic Drug Utilization in Croatia: A Study Based on Routinely Collected Data.","authors":"Renata Pavlov, Ivančica Topličan, Mladenka Vrcić Keglević","doi":"10.1155/2016/9837496","DOIUrl":"https://doi.org/10.1155/2016/9837496","url":null,"abstract":"Objectives. To investigate trends of diabetes mellitus (DM) morbidity and antidiabetic drug utilization in Croatian primary health care (PHC) from 2005 to 2014. Method. Routinely collected morbidity data from all PHC units, presented in Croatian health-statistics yearbooks, were retrieved. Data on drug utilization were retrieved from the Annual Reports of the Croatian Agency for Medicinal Products and Medical Devices (ATC/DDD, antidiabetic, A10). Results. Total morbidity increased by 33.3% and DM increased by 65.6%, mostly in patients over age 65 (from 50% to 57%). Estimated DM prevalence in adults increased from 3.9% to 6.4%. Increased morbidity was followed by an even higher increase in drug utilization (120%). Metformin was first, with a constant increase (from 18% to 39%), followed by glimepiride, while glibenclamide use decreased. Total utilization of insulin increased even more, mostly for aspart (600%) and newly introduced glargine and detemir, while human insulin usage sharply decreased. Spending also increased, mostly for aspart (from 21% to 61% of total). Conclusions. Increased DM is followed by a higher increase in antidiabetic drug utilization; this trend will continue in the future. In Croatian PHC, metformin has primacy along with insulin analogues. ","PeriodicalId":89569,"journal":{"name":"International journal of family medicine","volume":"2016 ","pages":"9837496"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/9837496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34707025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5