Demographic and clinical characteristics of patients with low back pain in primary and secondary care settings in Southern Denmark.

Objective: To describe and compare the demographic and clinical characteristics of patients with acute or chronic low back pain across all health care settings treating this condition. Concurrent prospective survey registration of all consecutive consultations regarding low back pain at general practitioners, chiropractors, physiotherapists, and the secondary care spine centre in Southern Denmark.

Subjects: Patients ≥16 years of age with low back pain.

Defensive medicine in Danish general practice. Types of defensive actions and reasons for practicing defensively.

Objective: To examine the occurrence of and types of defensive medicine (DM), and the reasons for practicing DM in general practice.

Design: Prospective survey registration of consecutive consultations regarding defensive medicine defined as: Actions that are not professionally well founded but are carried out due to demands and pressure. The GPs registered the degree of defensiveness, the type(s) of defensive action(s) and the reason(s) for acting defensively.

Introducing teledermoscopy of possible skin cancers in general practice in Southern Denmark.

Background: The increasing incidence of skin cancers poses a burden to health care systems. General practitioners (GPs) play an important role in triaging these diseases and referring relevant patients to specialists. It is challenging to distinguish benign from malignant skin lesions, and GPs may benefit from diagnostic support from teledermoscopy (TD).

Prescribing of proton-pump inhibitors: auditing the management and reasons for prescribing in Danish general practice.

Background: Prescribing of proton-pump inhibitors has substantially increased. Information from clinical settings is warranted to gain insight into reasons for prescribing.

Aim: To investigate Danish General Practitioners' management and reasons for prescribing of proton-pump inhibitors and to identify areas for quality improvement.

How is defensive medicine understood and experienced in a primary care setting? A qualitative focus group study among Danish general practitioners.

Objectives: Recent years have witnessed a progressive increase in defensive medicine (DM) in several Western welfare countries. In Danish primary and secondary care, documentation on the extent of DM is lacking. Before investigating the extent of DM, we wanted to explore how the phenomenon is understood and experienced in the context of general practice in Denmark.

General practitioners' attitudes towards and experiences with referrals due to supplemental health insurance.

Background: Supplemental health insurances (SHI) cover 38% of the Danish population. SHI can give faster access to, and additional treatment from, private health providers. However, this is contingent on a referral from the general practitioner (GP), further complicating clinical decision-making.

Tuberculosis screening in patients with HIV: use of audit and feedback to improve quality of care in Ghana.

Background: Tuberculosis screening of people living with HIV (PLHIV) can contribute to early tuberculosis diagnosis and improved patient outcomes. Evidence-based guidelines for tuberculosis screening are available, but literature assessing their implementation and the quality of clinical practice is scarce.

Objectives: To assess tuberculosis screening practices and the effectiveness of audit and performance feedback to improve quality of tuberculosis screening at HIV care clinics in Ghana.

Appropriateness of antibiotic prescribing for upper respiratory tract infections in general practice: Comparison between Denmark and Iceland.

Objective: To compare the appropriateness of antibiotic prescribing for upper respiratory tract infections (URTIs) in two countries with different prevalence of antimicrobial resistance: Denmark and Iceland.

Design: A cross-sectional study.

Settings And Subjects: General practitioners (GPs) in Denmark (n = 78) and Iceland (n = 21) registered all patients with URTI according to the Audit Project Odense (APO) method during a three-week period in the winter months of 2008 and 2009.

Access to point-of-care tests reduces the prescription of antibiotics among antibiotic-requesting subjects with respiratory tract infections.

Background: General practitioners (GPs) often feel uncomfortable when patients request an antibiotic when there is likely little benefit. This study evaluates the effect of access to point-of-care tests on decreasing the prescription of antibiotics in respiratory tract infections in subjects who explicitly requested an antibiotic prescription.

Methods: Spanish GPs registered all cases of respiratory tract infections over a 3-week period before and after an intervention undertaken in 2008 and 2009.

Low back pain in primary care: a description of 1250 patients with low back pain in danish general and chiropractic practice.

Study Design. Baseline description of a multicenter cohort study. Objective.

Effectiveness of two types of intervention on antibiotic prescribing in respiratory tract infections in Primary Care in Spain. Happy Audit Study.

Objective: To evaluate the effectiveness of two types of intervention in reducing antibiotic prescribing in respiratory tract infections (RTI).

Design: Before-after audit-based study.

Setting: Primary Care centres in Spain.

Quality of life in children with otitis media--a cohort study.

Background: Studies about health-related quality of life (HRQOL) in children with otitis media have primarily focused on short-term effects of the disease, and how treatment with insertion of ventilation tubes (VTs) affects the HRQOL. More knowledge is needed about how long-term HRQOL is associated with different factors like insertion of VT and use of antibiotics.

Objective: We aimed to analyse HRQOL in children with otitis media 1 year after inclusion and to what extent insertion of VT, use of antibiotics, diagnoses, symptoms in the children, day-care attention, parental absence from work and parental smoking were associated with the long-term HRQOL in children with otitis media.

Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice.

Background: The aim of this study was to describe the antibiotic prescribing rate in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), to analyse predictors for antibiotic prescribing and to explore the influence of the use C-reactive protein (CRP) rapid test.

Methods: A cross-sectional study was carried out in January and February 2008 in primary care. General practitioners (GPs) from six countries (Denmark, Sweden, Lithuania, Russia, Spain and Argentina) registered all patients with AECOPD during a 3-week period.

Factors associated with antibiotic prescribing in children with otitis media.

Background. Acute otitis media (AOM) is often treated with antibiotics. However, initial observation is recommended.

Violence- and alcohol-related acute healthcare visits in Greenland.

Aims: The aim of this study was to describe emergency admissions in Greenland's healthcare system, and the extent to which admissions were associated with alcohol abuse or violence. Furthermore, we aimed to test whether data on emergencies in Greenland could be registered in a reliable way by simple means.

Methods: Registration of all emergencies presented in 15 out of 17 of Greenland's health districts in the period 21 May to 7 June 2010.

Associations between symptoms, clinical findings and the short-term prognosis among children with otitis media: a cohort study.

Objective: Otitis media (OM) is a common childhood disease and a frequent reason for seeking medical care in general practice. Only few studies have focused on what happens after diagnosis and initial treatment of OM. In particular, there is a lack of research on how different patient- and disease-related factors influence the course of OM.

Quality indicators for treatment of respiratory tract infections? An assessment by Danish general practitioners.

Background: In 2008, a set of 41 quality indicators for antibiotic treatment of respiratory tract infections (RTIs) in general practice were developed in an international setting as part of the European project HAPPY AUDIT.

Objectives: To investigate Danish general practitioners' (GPs') assessment of a set of internationally developed quality indicators and to explore if there is an association between the GPs' assessment of the indicators and their practice characteristics as well as their antibiotic prescription pattern.

Methods: A total of 102 Danish GPs were invited to assess the 41 quality indicators.

Tympanometry in general practice: use, problems and solutions.

Objectives: The diagnosis in children with middle ear symptoms is often difficult. Tympanometry is recommended as a supplementary diagnostic tool with a high predictive value for fluid or no fluid in the middle ear. The aim of this study was to examine how tympanometry was used in Danish general practice in 2009, to report common problems general practitioners (GPs) and GP nurses encounter in tympanometry and to evaluate the effect of a practical and theoretical course.

Is a targeted intensive intervention effective for improvements in hypertension control? A randomized controlled trial.

Background: High blood pressure (BP) is one of the most important risk factors for stroke, and antihypertensive therapy significantly reduces the risk of cardiovascular morbidity and mortality. However, achieving a regulated BP in hypertensive patients is still a challenge.

Objective: To evaluate the impact of an intervention targeting GPs' management of hypertension.

[Rational antibiotic treatment can be achieved through audits and teaching].

A prerequisite for rational antibiotic treatment is the suspicion that the disease is caused by bacteria and that treatment will reduce symptoms and complications. In primary health care most infections are caused by bacteria. The European project HAPPY AUDIT found that an intervention targeting doctors and patients in primary care led to a considerable decrease in antibiotic prescribing.

Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice.

Background: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values <0.90 are considered pathological, indicating peripheral arterial disease.

Treatment of acute otitis media in general practice: quality variations across countries.

Background: Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged <2 years or if AOM is accompanied by discharging ear.

Objectives: To investigate the quality of treatment of AOM in general practice and to explore the influence of selected GP and patient characteristics on antibiotic prescribing.

Health Alliance for prudent antibiotic prescribing in patients with respiratory tract infections (HAPPY AUDIT) -impact of a non-randomised multifaceted intervention programme.

Background: Excessive use of antibiotics is worldwide the most important reason for development of antimicrobial resistance. As antibiotic resistance may spread across borders, high prevalence countries may serve as a source of bacterial resistance for countries with a low prevalence. Therefore, bacterial resistance is an important issue with a potential serious impact on all countries.