Tag Archives: #NAPCRG2015

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Greiver_photoMichelle Greiver is a family physician with the North York Family Health Team in Toronto

 

As a family doctor, I sometimes wonder if I provide too much care for some patients in my practice. Do my elderly patients with diabetes need very low A1Cs? What about the risk of falls and fractured hips due to hypoglycemia associated with enthusiastic use of diabetic medications? Should patients over the age of 90 really be on a statin? Should they be on anything that does not improve their quality of life? Perhaps I should be asking them what they would like? ...continue reading

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Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Some sessions just stand out. Dee Mangin's stunning distinguished presentation of her research into whether iron deficiency without anaemia in infants affected their long term developmental outcomes. They had, incredibly, 100% recruitment with blood tests in infants, and they followed the kids meticulously for 6 years with validated outcomes for intellectual and psychomotor ability. There was no loss to follow up with only minimal data loss e.g. 5% missing blood data blood at age 6 years. Dee’s presentation kicked off a superb afternoon on Tuesday at NAPCRG 2015 of ground-breaking trials asking important clinical questions... Do steroids help in chronic cough? What's the effectiveness of maintenance SSRI (and what happens with antidepressant withdrawal)? It would be unfair to release any of these findings in a blog and we all look forward to publication of the papers. Suffices to say, they will be practice-changing. ...continue reading

Domhnall_MacDomhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK

 

Health care has three components, according to Michael LeFevre (University of Missouri) who gave the opening keynote address at #NAPCRG2015. They are: to relieve suffering, to prevent future illness and to prolong life. Most of his career focused on prevention through his work with the US Preventive Services Task Force which was at the cutting edge of using science to inform clinical decisions. His involvement came during period of evolution from traditional consensus guidelines developed by experts to creating of evidence based guidelines based on formal evaluation of the literature. Difficulties arose when the evidence didn’t fit with established clinical practice ...continue reading

Scott MurrayProfessor Scott A Murray is the St Columba’s Hospice Chair of Primary Palliative Care Research Group at The University of Edinburgh in Scotland, UK

 

We live in exciting times for palliative care in general and for palliative care in primary care and family medicine in particular. The World Health Assembly (WHO's resolution-making body) in May 2014 passed its first ever resolution about palliative care. It called for palliative care to be integrated into health care in all settings, especially in the community, and countries will be answerable to this resolution in May20161.

Ten years ago Professor Geoff Mitchell, a speaker in today's NAPCRG 2015 plenary session, and I decided on his patio, one warm evening in Brisbane, Australia, that it was high time to re-emphasise the potential of palliative care in the community. That night the International Primary Palliative Care Network was born. ...continue reading

Dees_MMarianne Dees is a family physician and academic researcher at Radboud University Medical Centre in the Netherlands

 

Let's take a look at appropriate end of life care.

The case of Mr. Jones

Mr. Jones, aged 88, was referred to the hospital for the fourth time that year with dyspnoea. He was diagnosed with pneumonia. His medical history mentioned myocardial infarction, chronic heart failure, and a pacemaker. Two years earlier he had made a written will with a non-resuscitation and non-intensive care statement. The next day he became progressively dyspnoeic and developed kidney failure. He was transferred to the ICU ...continue reading

DFM_Burge_IMG_0633Fred Burge is a Professor in the Department of Family Medicine at Dalhousie University, Nova Scotia.

 

Finally, a plenary session at NAPCRG on dying. For over twenty years I’ve come to this annual meeting as ‘the’ place to be nurtured as that oddest of breeds in medical research, a family doctor. Early in my academic life I thought I wanted to be a full time palliative care doctor. But over time I realized I loved long relationships with patients, sharing their experience with illness, helping them stay healthy and most compelling to me was being with them at life’s tough moments. What I call the transitions. New heart attacks, the diagnosis of multiple sclerosis, cancer diagnoses, depression, relationship challenges and so much more. Being a palliative care doc seemed only to work at the end of all of this. So, I moved back to being and loving family medicine. ...continue reading

Imagen_CarmenCarmen García-Peña is a Mexican family physician who is currently Head of the Research Division at the National Institute of Geriatrics. She is a keynote speaker at the forthcoming NAPCRG Annual meeting

 

Family physicians are involved in countless daily activities ranging across a spectrum that may include treating patients with chronic or acute diseases, advising a mother with her first child, trying to coordinate care, providing emotional support, monitoring compliance of preventive programs, resolving administrative problems and, educating future family physicians. Many of these actions are based on clinical judgment, common sense, intuition, a framework that has been built up over the years of practice and, unfortunately, frequently, based on limited evidence and scientific research.

While it is widely accepted that family medicine is a fundamental pillar of any health system, that family physicians and primary care systems improve the health of societies compared to other schemes and that they also increase and promote equity and solidarity, the scientific potential of the specialty has not yet been realized. ...continue reading