Family Medicine

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World Book of Family Medicine – European Edition 2015 Ready” (RR) practices (http://www.rcgp.org.uk/clinical-and-research/research-opportunities-and-awards/researchready-self-accreditation.aspx). The scheme was initially commissioned by the Department of Health and developed in conjunction with the NIHR Clinical Research Network (NIHR CRN). The RR programme comprises five core competencies that cover the essential knowledge needed to safely and effectively undertake research in primary care. More than 1,000 practices in the UK have already been successful in achieving RCGP accreditation to undertake research by measurement against core competencies of the scheme which includes providing evidence of good clinical practice in research. General Practice, of course, is “where the patients are” and GP electronic patient records offer an unparalleled opportunity for high-quality epidemiological and clinical research. This is exemplified by RCGP Research and Surveillance Centre (http://www.rcgp.org.uk/clinical-and-research/research-and-surveillance-centre.aspx). The incidence data provided through consultation data from over 100 practices in England and Wales provides the early warning of changes in the incidence of common illnesses such as influenza like-illness and incidence rates for acute illnesses, as detailed in the RCGP’s weekly Communicable and Respiratory Disease Report for England and Wales. The RCGP also provides recognition to an individual or group of researchers who have undertaken and published an exceptional piece of research relating to general practice or primary care, through its Research Paper of the Year award, now in its 18th year. There is a formal presentation of the winning paper at the annual RCGP Conference and an award of £1,000 to the authors. The most recent award was presented at the 2014 RCGP annual conference to Dr Joe Gallagher on behalf of the authors of the winning paper (*). Exceptional individuals involved in research are recognised by the RCGP through other awards. The RCGP Discovery prize for the most sustained contribution to GP research have included such luminaries as Julian Tudor-Hart of “Inverse Care Law” fame. More recently the Yvonne Carter award, in memory of Professor Yvonne Carter, is presented jointly by the RCGP and the Society for Academic Primary Care (SAPC) and aims to support the career developments of a promising new researcher in primary care, particularly by facilitating international research links. The most recent recipient is a primary care scientist, Dr Helen Atherton. In terms of potential new awards, an appeal has recently been launched by the RCGP to support primary care mental health researchers through the Helen Lester Appeal for Mental Health Research. Helen Lester was a GP champion of patients with mental health problems. Finally the academic hub of the RCGP, the Clinical Innovation and Research Centre (CIRC, currently chaired by Dr Imran Rafi) provides a link with external organisations to develop joint collaborative working. An example of this is the submission of research topics by key RCGP clinical champions to the NIHR designed to lead onto ‘fully developed’ research funding opportunities. A further example is a recent RCGP-NIHR Multimorbidity workshop which brought together key academics in Multimorbidity research with representatives from key organisations such as the National Institute for Health and Care Excellence to reflect the importance of translatable research. Take home messages General Practitioners organisations have important roles in facilitating research by their members, building primary care research capacity and capability, and working closely with the academic community. There are considerable benefits to GPs themselves in engaging in research. Original abstract http://www.woncaeurope.org/content/3505-role-royal-college-general-practitioners-developing-research-capacity-and-capability References: Ledwidge M, Gallagher J, Conlon C, Tallon E, O'Connell E, Dawkins I, Watson C, O'Hanlon R, Bermingham M, Patle A, Badabhagni MR, Murtagh G, Voon V, Tilson L, Barry M, McDonald L, Maurer B, McDonald K. Natriuretic peptide-based screening and collaborative care for heart failure: the STOP-HF randomised trial. JAMA. 2013. 310(1):66-74. DOI: 10.1001/jama.2013.7588 242
World Book of Family Medicine – European Edition 2015 Tonka Poplas Susič, MD, PhD tonka.poplas-susic@mf.uni-lj.si Care 79 – From Familygram to Personalised Medical Tonka Poplas Susič, MD, PhD Assist. Prof. Health Centre Ljubljana, Ljubljana, Slovenia WONCA Europe 5 Star Doctor 2014 Familygram As a profession, family medicine has a myriad of specific tools designed for assessing every single patient in the context of his/her family and its psycho-sociological and health circumstances. Even though many modern techniques have been introduced into clinical care, family physicians continue to use tools deeply rooted in simple family assessment techniques, considering them a unique privilege of the profession. Patient/family assessment is provided by the Family Apgar, Family profile and Family history. Through analysis, a family tree and family genogram can be established. Connection and assessment is made of all obtained data results in a familygram profile, which is recognised as an integral presentation of the entire family and its social and health record, including personal comments. Family Apgar is designed to test five areas of family function (Adaptability, Partnership, Growth, Affection, Resolve). Every question is scored as 2 (almost always), 1 (sometimes) and 0 (hardly ever). A total score of 7-10 presents a highly functional family and 0-3 a severely dysfunctional family. Family profile comprises of different assessments. Family structure and family form show a large variety of different, nationally or regionally specific patterns, often strongly connected to different cultural backgrounds or family policy models. Some new types of families represent different environments that affect family members and their attitude to social and health-related behaviour. Family history (FH) has become evident as the gateway to medical genetics (recognizing inherited disorders). Creating a FH involves several steps, the family medical history questionnaire often being the first step in this process. Patients may be encouraged to contact relatives to obtain or confirm information. The face-to-face interview is a critical part of eliciting family history, with the ultimate goal to obtain a pedigree that includes at least 3 generations (age or year of birth, age and cause of death, ethnic background of each grandparent, relevant health information -e.g., height and weight-, illnesses and age at diagnosis, information regarding prior genetic testing and information regarding pregnancies). Family history plays an important role in identifying patients who may benefit from predictive genetic testing. A positive FH has been recognized as a risk factor for the development of cardiovascular diseases (CVD), diabetes (DM) and various cancers, moreover, it has been identified as an independent risk factor for the development of CVD and DM. It is known that family history of common chronic disease is associated with a 2- to 5-fold relative risk of developing the condition, and this increases with the number of affected relatives. IT supporting systems (ITSS) 243
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