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Article ; Online: Non-acute heart failure management in primary care.

Roskvist, Rachel / Eggleton, Kyle / Arroll, Bruce / Stewart, Ralph

2024 Volume 385, Page(s) e077057

MeSH term(s)	Humans ; Hospitalization ; Heart Failure/diagnosis ; Heart Failure/therapy ; Primary Health Care
Language	English
Publishing date	2024-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj-2023-077057
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Burns Depression Scale Today (BDST): A validation study of BDST against the reference standard of PHQ-9.

Matthew, Carolyn / Dahle, Nina / Roskvist, Rachel / Moir, Fiona / Arroll, Bruce

Journal of family medicine and primary care

2023 Volume 12, Issue 7, Page(s) 1367–1370

Abstract: Background: Case finding for low mood is essential in primary care, but it is time-consuming using current depression inventories. The Burns Depression Scale Today (BDST) is a short, simple inventory which assesses mood for today, and we aimed to ... ...

Abstract	Background: Case finding for low mood is essential in primary care, but it is time-consuming using current depression inventories. The Burns Depression Scale Today (BDST) is a short, simple inventory which assesses mood for today, and we aimed to validate it in this study. Materials and methods: Consecutive patients with emotional distress seen in a single primary care clinic by one of the authors over 22 months were eligible for this retrospective audit ( Results: The median age of patients was 35 years, and 63% of the cohort were women. The median BDST score was 8, indicative of moderately low mood, and the median PHQ-9 score was 15, indicative of moderately severe depression. For patients with a BDST score ≥6, the likelihood ratio of a positive test was 2.67. The sensitivity was 85% (95% confidence interval [CI]: 89%-96%) and the specificity was 68% (95% CI: 60%-76%). The area under the curve was 84% (95% CI: 80%-87%). Conclusion: This audit validates BDST against PHQ-9 and finds it an excellent case-finding tool compared to PHQ-9. This is the first validation study of BDST.
Language	English
Publishing date	2023-07-14
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_9_23
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Antidepressants in primary care: limited value at the first visit.

Arroll, Bruce / Roskvist, Rachel / Moir, Fiona / Harwood, Matire / Eggleton, Kyle / Dowrick, Christopher / Cuijpers, Pim

World psychiatry : official journal of the World Psychiatric Association (WPA)

2023 Volume 22, Issue 2, Page(s) 340

Language	English
Publishing date	2023-05-09
Publishing country	Italy
Document type	Letter
ZDB-ID	2236130-3
ISSN	2051-5545 ; 1723-8617
ISSN (online)	2051-5545
ISSN	1723-8617
DOI	10.1002/wps.21057
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Article ; Online: Emoqol-100: Development and validation of a single question for low mood in primary care. A retrospective audit.

Dahle, Nina Edel / Matthew, Carolyn / Roskvist, Rachel Petronella / Moir, Fiona / Arroll, Bruce

BJGP open

2023 Volume 7, Issue 3

Abstract: Background: Patients with depression need to be diagnosed and managed effectively in primary care. However, current inventories for case-finding low mood are time-consuming when considering the limited time available during appointments.: Aim: To ... ...

Abstract	Background: Patients with depression need to be diagnosed and managed effectively in primary care. However, current inventories for case-finding low mood are time-consuming when considering the limited time available during appointments. Aim: To validate the diagnostic accuracy of a single question on the emotional quality of life (Emoqol-100) as a measure of depression in symptomatic patients. Design & setting: A retrospective clinical audit, validating the Emoqol-100 compared with the 9-item Patient Health Questionnaire (PHQ-9) and Burns Depression Scale Today (BDST) in South Auckland, New Zealand. Method: Consecutive patients with suspected low mood, seen over 22 months in a single primary care clinic by one of the authors, were eligible for this retrospective audit ( Results: The Emoqol-100 range 0-20 had a likelihood ratio (LR) of 25.2 for low mood compared with the BDST as the reference standard; and for Emoqol-100 scores of 21-40, 41-60, 61-80, and 81-100 the LRs were 3.6, 1.7, 0.35, and 0.09, respectively. For the PHQ-9, these were 10.1, 2.9, 1.3, 0.40, and 0.2, respectively. Any score ≤60 was associated with a low mood. Conclusion: The Emoqol-100 appears to have high validity, so when it is low (≤60), it is suggestive of a high PHQ-9 or BDST score, and a mood issue probably exists. Emoqol-100 could be helpful for busy primary care professionals and other clinicians.
Language	English
Publishing date	2023-09-19
Publishing country	England
Document type	Journal Article
ISSN	2398-3795
ISSN (online)	2398-3795
DOI	10.3399/BJGPO.2023.0011
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Article ; Online: Teaching medical students in general practice when conducting remote consults: a qualitative study.

Roskvist, Rachel / Wearn, Andy / Eggleton, Kyle / Gauznabi, Shomel / Goodyear-Smith, Felicity

Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors

2023 Volume 34, Issue 4, Page(s) 204–210

Abstract: Background: Telehealth involves real-time communication (telephone or video-call) between patients and health providers. The COVID-19 pandemic propelled general practitioners to conduct most consultations remotely, seeing patients face-to-face only when ...

Abstract	Background: Telehealth involves real-time communication (telephone or video-call) between patients and health providers. The COVID-19 pandemic propelled general practitioners to conduct most consultations remotely, seeing patients face-to-face only when required. Placement opportunities and experience for medical students were reduced. Initially online learning programmes replaced clinical attachments. Subsequently, clinical teachers supervised students to engage in remote consultations, either in clinics or from their homes. This study aimed to explore the experience of New Zealand general practitioners undertaking clinical teaching with medical students when telehealth consulting. Methods: Semi-structured interviews with general practitioners who had taught medical students whilst consulting remotely. General inductive thematic analysis of transcribed interviews. Results: Six female and four male participants aged 40 to over 65 years. Participants often focused on general practicalities of telehealth consultations and effects on the patient-doctor relationship, and needed direction to consider remote consultations with students, which added to the interactions. Four themes were identified: changes needed in teaching delivery format; direct comparison with face-to-face; challenges and advantages to remote teaching, each with subthemes. Discussion: Clinicians needed to determine practical logistics and develop skills for both remote consulting and teaching. New format and structures of consultations needed planning. Differences from face-to-face teaching included scene-setting for the consultation and supervision factors. Telehealth teaching conferred new opportunities for learning but also challenges (e.g. consent, cues, uncertainty). Remote consultations are likely to remain a significant mode for doctor-patient interactions. Preliminary guidelines for teaching and learning using telehealth need to be developed and embedded into medical programmes and then evaluated.
MeSH term(s)	Humans ; Male ; Female ; Students, Medical ; Pandemics ; General Practice/education ; Family Practice ; Remote Consultation
Language	English
Publishing date	2023-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2074818-8
ISSN	1475-990X ; 1473-9879
ISSN (online)	1475-990X
ISSN	1473-9879
DOI	10.1080/14739879.2023.2243597
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Article ; Online: Provision of e-learning programmes to replace undergraduate medical students' clinical general practice attachments during COVID-19 stand-down.

Roskvist, Rachel / Eggleton, Kyle / Goodyear-Smith, Felicity

Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors

2020 Volume 31, Issue 4, Page(s) 247–254

Abstract: Senior medical students at the University of Auckland, New Zealand spend most of their learning time in clinical attachments. Experiential apprentice-style training is traditionally recognised as an important aspect of obtaining competency. In March 2020 ...

Abstract	Senior medical students at the University of Auckland, New Zealand spend most of their learning time in clinical attachments. Experiential apprentice-style training is traditionally recognised as an important aspect of obtaining competency. In March 2020 they were stood down from their general practice placements in the context of a national response to the COVID-19 pandemic. Acute conversion of their general practice education from experiential clinical exposure to online and offsite learning was required. This paper describes the steps taken and the underlying theoretical foundations for our expediently developed online course. Our online learning programme has three online components, reflecting the domains of educational environment theory: asynchronous discussion forums; a symposium facilitating social interactions and teacher presence, and a portfolio facilitating personal goal aspects. The latter is underpinned by a multi-theories model of adult learning, built upon the scaffolding framework that supports our entire medical curriculum. Within this theory, we propose a five-stage model of learning. Learning from this experience contributes to the body of knowledge around online education, particularly in meeting the needs of a clinical attachment traditionally grounded in experiential learning. It is hoped that the mechanisms described here might be useful to other educators facing similar challenges.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Clinical Competence ; Coronavirus Infections ; Curriculum ; Education, Distance ; Education, Medical, Undergraduate/methods ; General Practice/education ; Humans ; New Zealand ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Students, Medical
Keywords	covid19
Language	English
Publishing date	2020-05-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2074818-8
ISSN	1475-990X ; 1473-9879
ISSN (online)	1475-990X
ISSN	1473-9879
DOI	10.1080/14739879.2020.1772123
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Zs.A 3195: Show issues

Location:
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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Emoqol 100, an ultra ultra-brief mood case-finding tool: A diagnostic accuracy study.

Arroll, Bruce / Mulcahy, Connor F / Roskvist, Rachel P / Mount, Vicki

Journal of family medicine and primary care

2021 Volume 10, Issue 10, Page(s) 3590–3594

Abstract: Background: Case-finding for low mood in primary care can be time-consuming using current depression inventories.: Aim: To assess the diagnostic accuracy, of a single verbally administered question on the emotional quality of life (Emoqol 100), for ... ...

Abstract	Background: Case-finding for low mood in primary care can be time-consuming using current depression inventories. Aim: To assess the diagnostic accuracy, of a single verbally administered question on the emotional quality of life (Emoqol 100), for low mood in patients with symptoms of distress in an ambulatory care setting. Design and setting: Eligible patients were consecutive patients seen by one of the authors over 13 months with possible distress/low mood. The index test was the verbally asked Emoqol 100, which is the patient's emotional quality of life now, with 100 being perfect emotional health and 0 being the worst imaginable. The reference standard is the written version of the PHQ-9 with a cut point of ≥10. Methods: A retrospective audit of consecutive consultations in a single primary care clinic. Results: One hundred two patients were seen during the study period, of which 76 met the eligibility criteria for this audit, and there were 215 test results. For a cut point of <50 on the Emoqol 100 and the PHQ-9 ≥10 the sensitivity was 47% (95% CI 39-54), and the specificity was 93% (95% CI 86-100). The positive predictive value was 95%, and the negative predictive value was 37%. Conclusion: This is the first accuracy estimation of the Emoqol 100. It appears to have a high specificity which means when it is positive (<50) it is a good estimate of a high PHQ-9, i.e. a mood issue probably exists. The test will be helpful for busy primary care clinicians as it takes less than 15 seconds to verbally administer.
Language	English
Publishing date	2021-11-05
Publishing country	India
Document type	Journal Article
ZDB-ID	2735275-4
ISSN	2278-7135 ; 2249-4863
ISSN (online)	2278-7135
ISSN	2249-4863
DOI	10.4103/jfmpc.jfmpc_40_21
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Psychological treatment of adult depression in primary care compared with outpatient mental health care: A meta-analysis.

Cuijpers, Pim / Miguel, Clara / Ciharova, Marketa / Harrer, Mathias / Moir, Fiona / Roskvist, Rachel / van Straten, Annemieke / Karyotaki, Eirini / Arroll, Bruce

Journal of affective disorders

2023 Volume 339, Page(s) 660–675

Abstract: Background: It is not yet known whether psychological treatments of depression in primary care have comparable effects to treatments in specialized mental health care. We conducted a meta-analysis comparing randomized controlled trials in primary and ... ...

Abstract	Background: It is not yet known whether psychological treatments of depression in primary care have comparable effects to treatments in specialized mental health care. We conducted a meta-analysis comparing randomized controlled trials in primary and specialized care. Methods: We selected studies from an existing database of randomized trials of psychological treatments of depression in adults, which was built through searches in PubMed, PsychINFO, Embase and the Cochrane Library. Random effects meta-analyses were conducted to examine the effects of therapies and mixed effects subgroup analyses were used to compare the effects in primary and specialized care. Results: We included 52 trials (7984 patients) in primary care and compared them with 50 trials (3685 patients) in specialized care. The main effect of therapies in primary care was g = 0.43 (95 % CI: 0.32; 0.53; PI: -0.18; 1.03). The overall effects were significantly smaller than those in specialized care (p = 0.006), but this was no longer significant after adjustment for differences between the two settings. The proportion of patients responding to treatment was comparable in primary (0.38; 95 % CI: 0.33; 0.43) and specialized care (0.34; 95 % CI: 0.28; 0.41; p = 0.41), but higher in control conditions in primary care (0.25; 95 % CI: 0.22; 0.28) compared to specialized care (0.16; 95 % CI: 0.12; 0.20; p < 0.001). Discussion: Psychological treatments are effective in primary care, but somewhat less than in specialized care. Response rates in control conditions in primary care are higher than in specialized care, which may point at a transient nature of depression in primary care.
MeSH term(s)	Adult ; Humans ; Psychotherapy ; Depression/therapy ; Outpatients ; Mental Health ; Primary Health Care
Language	English
Publishing date	2023-07-17
Publishing country	Netherlands
Document type	Meta-Analysis ; Journal Article
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.07.011
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Article ; Online: Emoqol 100, an ultra ultra-brief mood case-finding tool

Bruce Arroll / Connor F Mulcahy / Rachel P Roskvist / Vicki Mount

Journal of Family Medicine and Primary Care, Vol 10, Iss 10, Pp 3590-

A diagnostic accuracy study

2021 Volume 3594

Abstract: Background: Case-finding for low mood in primary care can be time-consuming using current depression inventories. Aim: To assess the diagnostic accuracy, of a single verbally administered question on the emotional quality of life (Emoqol 100), for low ... ...

Abstract	Background: Case-finding for low mood in primary care can be time-consuming using current depression inventories. Aim: To assess the diagnostic accuracy, of a single verbally administered question on the emotional quality of life (Emoqol 100), for low mood in patients with symptoms of distress in an ambulatory care setting. Design and setting: Eligible patients were consecutive patients seen by one of the authors over 13 months with possible distress/low mood. The index test was the verbally asked Emoqol 100, which is the patient's emotional quality of life now, with 100 being perfect emotional health and 0 being the worst imaginable. The reference standard is the written version of the PHQ-9 with a cut point of ≥10. Methods: A retrospective audit of consecutive consultations in a single primary care clinic. Results: One hundred two patients were seen during the study period, of which 76 met the eligibility criteria for this audit, and there were 215 test results. For a cut point of <50 on the Emoqol 100 and the PHQ-9 ≥10 the sensitivity was 47% (95% CI 39-54), and the specificity was 93% (95% CI 86-100). The positive predictive value was 95%, and the negative predictive value was 37%. Conclusion: This is the first accuracy estimation of the Emoqol 100. It appears to have a high specificity which means when it is positive (<50) it is a good estimate of a high PHQ-9, i.e. a mood issue probably exists. The test will be helpful for busy primary care clinicians as it takes less than 15 seconds to verbally administer.
Keywords	clinical audit ; depression ; primary health care ; sensitivity and specificity ; Medicine ; R
Subject code	150
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Provision of e-learning programmes to replace undergraduate medical students’ clinical general practice attachments during COVID-19 stand-down

Roskvist, Rachel / Eggleton, Kyle / Goodyear-Smith, Felicity

Education for Primary Care

2020 Volume 31, Issue 4, Page(s) 247–254

Keywords	Public Health, Environmental and Occupational Health ; covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ZDB-ID	2074818-8
ISSN	1475-990X ; 1473-9879
ISSN (online)	1475-990X
ISSN	1473-9879
DOI	10.1080/14739879.2020.1772123
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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