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- Kassolik, Krzysztof, et al.
(författare)
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Recommendations of the Polish Society of Physiotherapy, the Polish Society of Family Medicine, the College of Family Physicians in Poland and the European Rural and Isolated Practitioners Association regarding the use of simple forms of Physiotherapy, including massage and self-massage in primary care, endorsed by the Polish Society of Physiotherapy Specialists
- 2019
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Ingår i: Family Medicine and Primary Care Review. - 1734-3402. ; 21:3, s. 277-288
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Forskningsöversikt (refereegranskat)abstract
- Background. In general practice, dysfunctions within the locomotor system are a recurring health issue. Most frequently, diagnoses and treatments relate to pain syndromes of the backbone, the shoulder girdle or the pelvic girdle. The authors believe that physiotherapy, along with other clinical disciplines, should be regarded as an important factor which influences the effectiveness of the therapeutic process in this area. In primary care, treatment of musculoskeletal disorders – especially at the stage of early clinical symptoms – should incorporate basic physiotherapy methods, e.g., massage, physical procedures, kinesiotherapy and the underrated education of the patient. Restoring appropriate spatial arrangement of tissues provides the right conditions for the regeneration and repair of muscles, ligaments and tendons, although it is a process that requires a long time. Therefore, it can be very important to introduce self-therapy in the form of systematically repeated, easy-to-replicate procedures in the scope of self-massage and self-kinesiotherapy. Objectives. This paper presents the impact of physiotherapy in treating selected disorders and pain syndromes of the locomotor system with particular attention to the role of massage. Emphasis is placed on the meaning of self-massage in the process of restoring structural balance of tissues. The model of active inclusion of the patient in the treatment process as preparation for self-therapy is presented. This paper aims to justify the need to reorganize health services provided through general practicioners within the National Health Fund network by incorporating physiotherapy in primary care.
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| 2. |
- van der Ploeg, Milly A., et al.
(författare)
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Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients : a Survey Study Across 30 Countries
- 2019
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Ingår i: Journal of general internal medicine. - : Springer. - 0884-8734 .- 1525-1497. ; 34:9, s. 1751-1757
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Tidskriftsartikel (refereegranskat)abstract
- Background Statins are widely used to prevent cardiovascular disease (CVD). With advancing age, the risks of statins might outweigh the potential benefits. It is unclear which factors influence general practitioners' (GPs) advice to stop statins in oldest-old patients. Objective To investigate the influence of a history of CVD, statin-related side effects, frailty and short life expectancy, on GPs' advice to stop statins in oldest-old patients. Design We invited GPs to participate in this case-based survey. GPs were presented with 8 case vignettes describing patients > 80 years using a statin, and asked whether they would advise stopping statin treatment. Main Measures Cases varied in history of CVD, statin-related side effects and frailty, with and without shortened life expectancy (< 1 year) in the context of metastatic, non-curable cancer. Odds ratios adjusted for GP characteristics (ORadj) were calculated for GPs' advice to stop. Key Results Two thousand two hundred fifty GPs from 30 countries participated (median response rate 36%). Overall, GPs advised stopping statin treatment in 46% (95%CI 45-47) of the case vignettes; with shortened life expectancy, this proportion increased to 90% (95CI% 89-90). Advice to stop was more frequent in case vignettes without CVD compared to those with CVD (ORadj 13.8, 95%CI 12.6-15.1), with side effects compared to without ORadj 1.62 (95%CI 1.5-1.7) and with frailty (ORadj 4.1, 95%CI 3.8-4.4) compared to without. Shortened life expectancy increased advice to stop (ORadj 50.7, 95%CI 45.5-56.4) and was the strongest predictor for GP advice to stop, ranging across countries from 30% (95%CI 19-42) to 98% (95% CI 96-99). Conclusions The absence of CVD, the presence of statin-related side effects, and frailty were all independently associated with GPs' advice to stop statins in patients aged > 80 years. Overall, and within all countries, cancer-related short life expectancy was the strongest independent predictor of GPs' advice to stop statins.
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