Araştırma Çıktıları
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Item The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: Person centred care, comprehensive and holistic approach(TAYLOR \& FRANCIS LTD, 2010-01-01) Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, EvaThe recently published `Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies `primary care management' and `community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. `person centred care', `comprehensive approach' and `holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.Item Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 6: Reaction on commentaries - how to continue with the Research Agenda?(TAYLOR \& FRANCIS LTD, 2011-01-01) Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, EvaThe Research Agenda should be used as a key reference point to which new research should relate its usefulness and added value. Primary care evolves towards more interdisciplinary care, and research should focus more on the core competency of person-centred team care. There is an urgent need to develop clear definitions and appropriate research instruments for this domain. It will be a particular challenge to study comprehensive approaches in primary-care patients with multi-morbidity. The Research Agenda and the commentaries on it show future directions for primary care research. There are challenges related to a changing society, the shared responsibility and guidance of research by professionals and citizens (patients), and the need to fully integrate research as part of primary healthcare provision. There will be a need for a prioritization of spearheads to guide primary care research for the next decade: translational research, research on equity and health differences, on chronic disease and health systems research. This can not be realized without the development and maintenance of a solid research infrastructure: easily maintained and accessed observational databases, helpful information technology, strategies and techniques for patient involvement, advanced research training possibilities, and the development and validation of appropriate research instruments and outcome measures to capture the different challenges. Worldwide, primary care not only is a priority for health care policy, but it needs to become a research priority as well.Item Residents' views about family medicine specialty education in Turkey(BMC, 2010-01-01) Uzuner, Arzu; Topsever, Pinar; Unluoglu, Ilhami; Caylan, Ayse; Dagdeviren, Nezih; Uncu, Yesim; Mazicioglu, Mumtaz; Ozcakir, Alis; Ozdemir, Hakan; Ersoy, FusunBackground: Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods: This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27) and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11) by e-mail and by personal contact. Results: A total of 191 questionnaires were returned. The female/male ratio was 58.6\%/41.4\%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29\%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8\%Item Deintensification in older patients with type 2 diabetes: A systematic review of approaches, rates and outcomes(WILEY, 2019-01-01) Seidu, Samuel; Kunutsor, Setor K.; Topsever, Pinar; Hambling, Clare E.; Cos, Francesc X.; Khunti, KamleshAim To assess deintensification approaches and rates and evaluate the harm and benefits of deintensification with antidiabetic medication and other therapies among older people (>= 65 years) with type 2 diabetes with or without cardiometabolic conditions. Methods We identified relevant studies in a literature search of MEDLINE, Embase, Web of Science and Cochrane databases to 30 October 2018. Data were extracted on baseline characteristics, details on deintensification and outcomes, and was synthesized using a narrative approach. Results Ten studies (observational cohorts and interventional studies) with data on 26 558 patients with comorbidities were eligible. Deintensification approaches included complete withdrawal, discontinuation, reducing dosage, conversion, or substitution of at least one medication, but the majority of studies were based on complete withdrawal or discontinuation of antihyperglycaemic medication. Rates of deintensification approaches ranged from 13.4\%-75\%. The majority of studies reported no deterioration in HbA1c levels, hypoglycaemic episodes, falls or hospitalizations on deintensification. On adverse events and mortality, no significant differences were observed among the comparison groups in the majority of studies. Conclusion Available but limited evidence suggests that the benefits of deintensification outweigh the harm in older people with type 2 diabetes with or without comorbidities. Given the heterogeneity of patients with diabetes, further research is warranted on which deintensification approaches are appropriate and beneficial for each specific patient population.Item Patient Satisfaction by Family Health Unit Infrastructure(IGITUR, UTRECHT PUBLISHING \& ARCHIVING SERVICES, 2013-01-01) Eker, Aysen; Celik, Burak Erdi; Cindemir, Firat; Altun, Oguzhan; Hayret, Tugce; Topsever, PinarItem The Effect of Two Types of Informing Methods Over Medical Student's Hypertension Knowledge Level(IGITUR, UTRECHT PUBLISHING \& ARCHIVING SERVICES, 2013-01-01) Cadirci, Sena; Yilmaz, Can; Usta, Abdul Samed; Cengiz, Turgut Bora; Toto, Omer Faruk; Topsever, Pinar