The interpretation of low mood and worry by high users of secondary care with medically unexplained symptoms

DA - 20111021 IS - 1471-2296 (Electronic) IS - 1471-2296 (Linking) LA - eng PT - Journal Article SB - IMPeer reviewedPublisher PD

Gérer la diversité en milieu clinique : compte rendu de la première Conférence nationale des Migrant Friendly Hospitals [Managing diversity in Swiss Health care]

The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients

Approches du risque et usage d'outils électroniques en médecine de premier recours en 2021

Notre sélection d'articles parus en 2021 propose un éclairage sur des sujets en lien avec le risque chez nos patient·e·s et l'usage d'outils électroniques. Ils abordent le thème des cibles tensionnelles, du télémonitoring, et du régime riche en acides gras oméga 3 chez la personne âgée et/ou à haut risque cardiovasculaire. Ils présentent le rôle des médecins de premier recours dans la prise en charge de patient·e·s avec une stéatopathie métabolique, et dans le dépistage des violences conjugales dans tous les couples. Ils évaluent les risques de récidive d'épisode dépressif à l'arrêt d'un traitement antidépresseur. Enfin, ils discutent la place des applications pour la communication avec les patient·e·s allophones et du vapotage dans l'arrêt du tabac.Our selection of articles published in 2021 sheds light on topics related to risk, and to the use of electronic tools in primary care medicine. They cover blood pressure targets, telemonitoring, and the omega-3 fatty acid diet in the elderly and/or in patients with high cardiovascular risk. They present the role of primary care physicians in the management of patients with NAFLD, and in screening for domestic violence in all couples. They assess the risk of recurrence of a depressive episode after stopping antidepressant treatment. Finally, they discuss the place of apps to communicate with foreign-speaking patients and of vaping in smoking cessation

Text-messaging to reduce missed appointment in a youth clinic: a randomised controlled trial

BACKGROUND: To assess the effectiveness of text-messages in reducing the proportion of non-attendance in a youth clinic of a University Hospital. METHODS: Patients who registered for an appointment and provided a mobile phone number were randomly selected to receive or not a text-message reminder before the planned appointment. A 10% reduction in the proportion of missed appointments was considered clinically and economically useful and the study was powered accordingly. RESULTS: The proportion of missed appointments was 16.4% (95% CI 13.1% to 19.8%) in the text-message group (N 462) and 20.0% (95% CI 16.6% to 23.4%) in the control group (N 529), showing no significant effect of the intervention (p=0.346). CONCLUSIONS: In our primary care youth clinic, text-message reminders are not effective in reducing the proportion of missed appointments. This may in part be due to the fact that most patients are referred by a professional or by their parents and do not initiate appointments themselves

Text-messaging versus telephone reminders to reduce missed appointments in an academic primary care clinic: a randomized controlled trial

Telephone or text-message reminders have been shown to significantly reduce the rate of missed appointments in different medical settings. Since text-messaging is less resource-demanding, we tested the hypothesis that text-message reminders would be as effective as telephone reminders in an academic primary care clinic

Gérer la diversité en milieu clinique : compte rendu de la première Conférence nationale des Migrant Friendly Hospitals*

The development of Migrant Friendly Hospitals is an important first step towards eliminating health care disparities in Switzerland and an important reminder to health policy makers and practitioners across the health care system of their responsibility to provide non-discriminatory quality health care to all patients

The ABC of primary care for university students: a 3-step structured approach at Geneva University Hospitals

University and college students present specific health issues with vulnerabilities related to mental health and sexual health, risk-taking behaviors, and delayed access to primary care. A new student outpatient clinic was created in September 2016 at Geneva University Hospitals to respond to the health needs of this population. We present here the clinical management framework developed for a primary care consultation with students. A 3-step approach (ABC) was designed by expert consensus using different sources. A post-consultation satisfaction survey was conducted among students attending the clinic. The approach proposed 3 steps comprising general information, social evaluation, and preventive care. The importance of offering modern means of communication (online appointments, email exchanges with clinicians) was emphasized by experts. The question of cultural identity and connectedness was also addressed, especially for international students or those coming from a different Swiss region. In November 2018, a survey conducted among 128 patients out of 449 consultations showed that 94.5% agreed or totally agreed to recommend the consultation to fellow students, and 89% considered that care providers adequately addressed their specific student-related issues. A specific approach is needed in primary care for university/college students requiring particular competences across several domains. Our findings suggest that our approach is effective to cover the main health challenges faced by students. A comparison of the outcomes of this novel 3-step primary care consultation approach with non-structured approaches should be evaluated in future studies, including clinician's satisfaction, elements of patient's participation to governance, and medico-economic aspects

Nouveautés 2012 en médecine interne générale ambulatoire

Ten articles published in 2012 and of interest for the practice of ambulatory general internal medicine are reviewed in this paper. Topics of public health issues, such as the association between sleep disorders and prediabetes, the association between prediabetes and stroke, and the harmful effects of prolonged sitting are tackled. Other focuses include hepatitis C screening, abdominal aortic aneurysm screening and prostatic cancer screening. Therapeutic aspects are reviewed, such as the management of nongonococcal urethritis, the treatment of iron deficiency without anemia and the substitution of subclinical hypothyroidism. Finally a new study about aspirin and cancer prevention is discussed