52 Assessing chronic pain in general practice: are guidelines relevant? A cluster randomised controlled trial
Many guidelines on pain management urge the use of pain assessment scales but these scales are still not necessarily used in routine clinical practice. Huas and colleagues in a large multi-centre trial in France compared outcomes for patients’ pain relief between patients whose GPs used such scales and those who did not. They found, somewhat surprisingly, that patients of GPs who used the scales had somewhat better pain relief than those whose GP did not.
58 Diabetes mellitus in Irish general practice: level of care as reflected by HbA
The routine care of patients with diabetes mellitus increasingly takes place mainly or, sometimes, exclusively, in general practice. However, not all practices manage to achieve the same outcomes for their patients with diabetes. O'Connor and colleagues have examined the characteristics of Irish general practices with the best outcomes for diabetes care as judged by HbA1c values.
66 Experience of intimate partner violence among women and men attending general practices in Dublin, Ireland: a cross sectional survey
Intimate partner violence is an increasingly widely recognised problem. General practitioners are well placed to detect this problem and patients attending general practice have been shown to find it acceptable to be asked about the issue by their GP. Paul and colleagues have surveyed patients attending six general practices in Dublin, Ireland. They found intimate partner violence to be very common and, surprisingly, men were slightly more likely to have experienced it than women. Women, however, were more often victims of more serious degrees of violent behaviour while men were more often subjected to ‘controlling behaviour’.
BACKGROUND ARTICLE
70 Cluster randomized controlled trials in primary care: an introduction
When conducting randomized controlled trials in primary care contamination, whereby interventions directed at one patient have an impact on others in the same community, can be a problem. One solution is to randomise by practice rather than by patient. This is cluster randomisation. While to may help resolve potential contamination problems, it is a technique that brings its own issues and problems that are discussed by Murphy and colleagues.
RESEARCH LETTERS
74 This issue contains research letters on recording of risk factors for long lasting sickness absences in Dutch general practice; the impact on healthcare system resources of the marketing of a new non-sedating antihistamine in Israel; what happens patients with poorly controlled diabetes once oral therapy is optimised; levels of healthcare utilization of patients with type 2 diabetes in Sweden; the failure of elderly Hungarian patients with diabetes to achieve desired weight loss; and on the prevalence of irritable bowel syndrome in Swedish primary care.