Contraceptive use and pregnancy outcomes among opioid drug-using women: a retrospective cohort study.

Objective: The contraceptive needs of illicit opioid users differ from non-drug users but are poorly understood. The aim of this study was to describe contraceptive use and pregnancy outcomes in opioid-using women, and to examine their association with a range of risk factors.

Method: This retrospective cohort study used UK general practice records, Treatment Outcomes Profile and National Drug Treatment Monitoring System data, and a nested data validation exercise.

Heroin users' experiences of depression: a qualitative study.

Background: Heroin users represent a challenging group of patients for GPs, with a high morbidity including a high prevalence of depression. Compared to other groups, management of 'depression' in heroin users is likely to require different approaches. Aim.

Deep vein thromboses in users of opioid drugs: incidence, prevalence, and risk factors.

Background: Users of illicit opioids are at increased risk of hospital admission for deep vein thromboses (DVTs); however, the community prevalence, risk factors, and complications of DVTs in this group are poorly understood.

Aim: This study aimed to describe the prevalence of previous DVT for users of opioids in primary care; provide age- and sex-adjusted annual incidence rates of DVT; and explore factors associated with DVT, concordance with subsequent treatment, and complications.

Design: A retrospective analysis of DVT prevalence and incidence, and analysis of risk factors for DVT using Poisson regression of incidence rates.

Patients' explanatory models for irritable bowel syndrome: symptoms and treatment more important than explaining aetiology.

Background: Irritable bowel syndrome (IBS) is a common condition associated with no certain organic cause, though diet and stress are widely implicated. The condition is frustrating for both sufferers and doctors, and there are problems in diagnosing and treating the condition. Eliciting explanatory models (EMs) is a useful tool for understanding how individuals relate to their illnesses and their expectations for treatment, particularly for illnesses with uncertain aetiology like IBS.

GPs' explanatory models for irritable bowel syndrome: a mismatch with patient models?

Background: Inconsistencies in doctors' views about causes and treatment of irritable bowel syndrome (IBS) lead to frustration for doctors and in doctor-patient interactions. Diagnosis by GPs does not correspond well to established diagnostic criteria.

Objective: To understand GPs' explanatory models (EMs) and management strategies for IBS.

How patients with depressive symptoms view their condition: a qualitative study.

Background: Depressive symptoms are common in primary care, yet considerable professional controversy exists about appropriate management including the effectiveness of treatments. In addition, avoiding prescribing antidepressants at least initially is recommended. Views of patients themselves should therefore be particularly important in agreeing management strategies.

General Practitioners with special clinical interests: a qualitative study of the views of doctors, health managers and patients.

Background: The difficulties with under-provision of doctors mean that alternative ways of providing services need to be developed. In the UK, some primary care doctors are now providing services traditionally only obtained through secondary care. The views of health care professionals, as well as patients, about these new services are currently unexplored.

The '2-week rule' for suspected breast carcinoma: a qualitative study of the views of patients and professionals.

Background: The '2-week rule' for the referral of patients with potential cancers is an important but controversial development.

Aims: To investigate the 2-week rule for women with breast problems from the perspective of the patients and of healthcare professionals.

Design Of Study: Qualitative study using semi-structured interviews.

The 2-week rule for patients with suspected breast cancer: what can be learnt by analysing policy documents?

The '2-week rule', introduced in the UK during 1999, represents a significant organisational change for referral of patients with suspected breast cancer. From an analysis of policy documents, a mixture of influences and agendas from different interest groups are apparent in the current working of the policy. These include political/modernisation agendas with a variety of aims including: reducing variation in care, efficient administration, reassuring patients, improving public confidence, earlier referral and lowering the threshold for referral to improve mortality figures.

The prescribing and follow-up of domiciliary oxygen--whose responsibility? A survey of prescribing from primary care.

Domiciliary oxygen is expensive and is frequently used outside the prescribing guidelines, which include the need for blood oxygen measures, a hospital-based facility. Ongoing prescriptions are generally provided by general practitioners (GPs). A survey in the north-east of England found that the origin of the initial prescription was often obscure and that there was no record of the responsible clinician or of structured follow-up for the majority of patients.