Treatment strategies for insomnia in Japanese primary care physicians' practice: A Web-based questionnaire survey.

Background: It is unclear how primary care physicians manage insomnia after the introduction of novel hypnotics such as orexin receptor antagonists and melatonin receptor agonists. This Web-based questionnaire survey aimed to examine treatment strategies for insomnia in Japanese primary care practice.

Methods: One-hundred-and-seventeen primary care physicians were surveyed on the familiarity of each management option for insomnia on a binary response scale (0 = "unfamiliar"; 1 = "familiar") and how they managed insomnia using a nine-point Likert scale (1 = "I never prescribe/perform it"; 9 = "I often prescribe/perform it").

Clinical practice for unspecified anxiety disorder in primary care.

Aim: Clinicians face difficulties in making treatment decisions for unspecified anxiety disorder due to the absence of any treatment guidelines. The objective of this study was to investigate how familiar and how often primary care physicians use pharmacological and nonpharmacological approaches to manage the disorder.

Methods: A survey was conducted among 117 primary care physicians in Japan who were asked to assess the familiarity of using each treatment option for unspecified anxiety disorder on a binary response scale (0 = "unfamiliar," 1 = "familiar") and the frequency on a nine-point Likert scale (1 = "never used," 9 = "frequently used").

Mental health training in family medicine residencies: International curriculum overview.

Integration of mental health into primary care has become a global trend, and many countries have developed mental health training in primary care. However, systematic mental health training for family physicians is insufficient in Japan. The newly established Japan Primary Care Association Mental Health Committee surveyed the current status of mental health training curricula in family medicine residency internationally.

Physicians' attitudes toward hypnotics for insomnia: A questionnaire-based study.

Introduction: Benzodiazepines and non-benzodiazepines are still widely prescribed despite safety concerns and the introduction of novel hypnotics (orexin receptor antagonists [ORA] and melatonin receptor agonists [MRA]), which may be influenced by physicians' attitudes toward hypnotics.

Methods: A questionnaire survey was administered to 962 physicians between October 2021 and February 2022, investigating frequently prescribed hypnotics and the reasons for their selection.

Results: ORA were the most frequently prescribed at 84.

Management of unspecified anxiety disorder: Expert consensus.

Aims: Treatment guidelines with respect to unspecified anxiety disorder have not been published. The aim of this study was to develop a consensus among field experts on the management of unspecified anxiety disorder.

Methods: Experts were asked to evaluate treatment choices based on eight clinical questions concerning unspecified anxiety disorder using a nine-point Likert scale (1 = "disagree" to 9 = "agree").

Attitudes and Difficulties Associated with Benzodiazepine Discontinuation.

Long-term use of benzodiazepine receptor agonists (BZDs) may depend on clinicians' BZD discontinuation strategies. We aimed to explore differences in strategies and difficulties with BZD discontinuation between psychiatrists and non-psychiatrists and to identify factors related to difficulties with BZD discontinuation. Japanese physicians affiliated with the Japan Primary Care Association, All Japan Hospital Association, and Japanese Association of Neuro-Psychiatric Clinics were surveyed on the following items: age group, specialty (psychiatric or otherwise), preferred time to start BZD reduction after improvement in symptoms, methods used to discontinue, difficulties regarding BZD discontinuation, and reasons for the difficulties.

Death at home versus other locations in older people receiving physician-led home visits: A multicenter prospective study in Japan.

Background: The Japanese government is promoting physician-led home visits as well as end-of-life care at home. However, the proportion of deaths occurring at home has remained unchanged for the past 20 years.

Objectives: To report the cumulative incidence of deaths at home and to explore the factors associated with deaths at home versus other places, mainly hospitals.

Use of a 2-year continuing professional development programme to change Japanese physicians' attitudes to learning primary care: a qualitative study.

Objective: To evaluate changes in the learning attitudes of primary care physicians.

Design: Qualitative study through one focus group interview with the programme's participants. Analysis of the focus group content using the Steps for Coding and Theorization method.

Patient experience of residents with restricted primary care access during the COVID-19 pandemic.

Objectives: To evaluate primary care access for COVID-19 consultation among residents who have a usual source of care (USC) and to examine their associations with patient experience during the pandemic in Japan.

Design: Nationwide cross-sectional study.

Setting: Japanese general adult population.

Development and validation of a Japanese version of the person-centered primary care measure.

Background: Although primary care (PC) is an indispensable part of the health system, measuring its quality is challenging. A recent measure of PC, Person-Centered Primary Care Measure (PCPCM), covers 11 important domains of PC and has been translated into 28 languages. This study aimed to develop a Japanese version of the PCPCM and assess its reliability and validity.

Usual source of primary care and preventive care measures in the COVID-19 pandemic: a nationwide cross-sectional study in Japan.

Objectives: To assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan.

Design: Nationwide cross-sectional study.

Setting: Japanese general adult population.

Associations of primary care structures with polypharmacy and patient-reported indicators in patients with complex multimorbidity: a multicentre cross-sectional study in Japan.

Objectives: Evidence supporting the effects of primary care structures on the quality of care for patients with complex multimorbidity, which is one of the most important challenges facing primary care, is scarce internationally. This study aimed to examine the associations of the types of primary care facilities with polypharmacy and patient-reported indicators in patients with complex multimorbidity, with a focus on differences between community clinics and hospitals.

Design: Multicentre cross-sectional study.

Effect of multimorbidity patterns on the decline in health-related quality of life: a nationwide prospective cohort study in Japan.

Objectives: Longitudinal studies, which consider multimorbidity patterns, are useful for better clarifying the effect of multimorbidity on health-related quality of life (HRQoL) and for identifying the target population with poorer clinical outcomes among patients with multimorbidity. This study aimed to examine the effects of different multimorbidity patterns on the decline in HRQoL.

Design: Nationwide prospective cohort study.

Overall mortality in older people receiving physician-led home visits: a multicentre prospective study in Japan.

Background: Japan has the most rapidly ageing population in the world. The Japanese government has, therefore, promoted physician-led home health care for frail and disabled people.

Objectives: To describe mortality among older people receiving physician-led health care at home or at a nursing home in Japan and to identify risk factors.

Perspectives on expert generalist practice among Japanese family doctor educators: a qualitative study.

Background: Expert generalist practice (EGP) is increasingly being viewed as the defining expertise of generalist care. In Japan, several prominent family doctors consider it important and relevant in the Japanese context. However, no study has examined Japanese family doctor educators' perceptions of EGP.

Development and validation of a Japanese version of the Patient Centred Assessment Method and its user guide: a cross-sectional study.

Objectives: The primary objective of this study was to develop the Japanese version of the Patient Centred Assessment Method (PCAM) and its user guide. The secondary objective was to examine the validity and reliability in the primary care setting.

Design: Cross-sectional study.

The need for home care physicians in Japan - 2020 to 2060.

Background: Japan faces the most elderly society in the world, and the Japanese government has launched an unprecedented health plan to reinforce home care medicine and increase the number of home care physicians, which means that an understanding of future needs for geriatric home care is vital. However, little is known about the future need for home care physicians. We attempted to estimate the basic need for home care physicians from 2020 to 2060.

How a problem-based learning approach could help Japanese primary care physicians: a qualitative study.

Objectives: This study aimed to identify training needs among primary care physicians in Japan who had no formal primary care training.

Methods:  We conducted a focus group interview with seven Japanese primary care physicians who had not previously undergone specialist training in primary care and had been recruited to a family medicine training program that used a problem-based learning approach. At the start of the program, the physicians attended the interview.

Correlation of patient complexity with the burden for health-related professions, and differences in the burden between the professions at a Japanese regional hospital: a prospective cohort study.

Objectives: An ageing society includes high patient complexity. Various biopsychosocial problems result in a high burden for health-related professionals. The direct relationship between the burden and patient complexity, however, has not been reported.

Combining Scores Based on Compensatory and Noncompensatory Scoring Rules to Assess Resident Readiness for Unsupervised Practice: Implications From a National Primary Care Certification Examination in Japan.

Purpose: Competence decisions in health professions education require combining scores from multiple sources and identifying pass-fail decisions based on noncompensatory (required to pass all subcomponents) and compensatory scoring decisions. This study investigates consequences of combining scores, reliability, and implications for validity using a national examination with subcomponent assessments.

Method: National data were used from three years (2015, 2016, and 2017) of the Japan Primary Care Association Board Certification Examination, with four subcomponent assessments: Clinical Skills Assessment-Integrated Clinical Encounter (CSA-ICE), CSA-Communication and Interpersonal Skills (CSA-CIS), Multiple-Choice Questions (MCQ), and Portfolio.

Social Isolation and Patient Experience in Older Adults.

Purpose: Social isolation has been identified as a major health problem, particularly in the elderly. In the present study, we examine the association between social isolation and patient experience in elderly primary care patients.

Methods: This cross-sectional study was conducted in a primary care practice-based research network (28 clinics) in Japan.

Effect of Patient Experience on Bypassing a Primary Care Gatekeeper: a Multicenter Prospective Cohort Study in Japan.

Background: To discuss how best to implement the gatekeeping functionality of primary care; identifying the factors that cause patients to bypass their primary care gatekeepers when seeking care should be beneficial.

Objective: To examine the association between patient experience with their primary care physicians and bypassing them to directly obtain care from higher-level healthcare facilities.

Design And Methods: This prospective cohort study was conducted in 13 primary care clinics in Japan.

Influence of overstated abstract conclusions on clinicians: a web-based randomised controlled trial.

Objectives: To investigate whether overstatements in abstract conclusions influence primary care physicians' evaluations when they read reports of randomised controlled trials (RCTs) DESIGN: RCT setting: This study was a parallel-group randomised controlled survey, conducted online while masking the study hypothesis.

Participants: Volunteers were recruited from members of the Japan Primary Care Association in January 2017. We sent email invitations to 7040 primary care physicians.

Validity and reliability of the Patient Centred Assessment Method for patient complexity and relationship with hospital length of stay: a prospective cohort study.

Objectives: Several instruments for evaluating patient complexity have been developed from a biopsychosocial perspective. Although relationships between the results obtained by these instruments and the length of stay in hospital have been examined, many instruments are complicated and not easy to use. The Patient Centred Assessment Method (PCAM) is a candidate for practical use.