BACKGROUND: General practitioners play a fundamental role in combatting the current epidemic of physical inactivity, and pedometer-based walking interventions are able to increase physical activity levels of their patients. Supplementing these interventions with email counseling driven by feedback from the pedometer has the potential to further improve their effectiveness but it has to be yet confirmed in clinical trials. Therefore, the aim of our pilot randomized controlled trial is to evaluate the feasibility and potential efficacy of future trials designed to assess the additional benefit of email counseling added to a pedometer-based intervention in a primary care setting. METHODS: Physically inactive patients were opportunistically recruited from four general practices and randomized to a 12-week pedometer-based intervention with or without email counseling. To explore the feasibility of future trials, we assessed the speed and efficiency of recruitment, adherence to wearing the pedometer, and engagement with email counseling. To evaluate the potential efficacy, daily step-count was the primary outcome and blood pressure, waist and hip circumference, and body mass were the secondary outcomes. Additionally, we conducted a qualitative analysis of structured interviews with the participating general practitioners. RESULTS: The opportunistic recruitment has been shown to be feasible and acceptable, but relatively slow and inefficient; moreover, general practitioners selectively recruited overweight and obese patients. Patients manifested high adherence, wearing the pedometer on 83% (± 20) of days. All patients from the counseling group actively participated in email communication and responded to 46% (± 22) of the emails they received. Both groups significantly increased their daily step-count (pedometer-plus-email, + 2119, p = 0.002; pedometer-alone, + 1336, p = 0.03), but the difference between groups was not significant (p = 0.18). When analyzing both groups combined, there was a significant decrease in body mass (- 0.68 kg, p = 0.04), waist circumference (- 1.73 cm, p = 0.03), and systolic blood pressure (- 3.48 mmHg, p = 0.045). CONCLUSIONS: This study demonstrates that adding email counseling to a pedometer-based intervention in a primary care setting is feasible and might have the potential to increase the efficacy of such an intervention in increasing physical activity levels. TRIAL REGISTRATION: The trial was retrospectively registered at ClinicalTrials.gov (ID: NCT03135561 , date: April 26, 2017).

• MeSH
• aktigrafie přístrojové vybavení   MeSH
• chůze fyziologie   MeSH
• dospělí MeSH
• elektronická pošta statistika a číselné údaje   MeSH
• hodnocení programu MeSH
• lidé středního věku MeSH
• lidé MeSH
• pilotní projekty MeSH
• podpora zdraví metody   MeSH
• poradenství statistika a číselné údaje   MeSH
• praktické lékařství * MeSH
• senioři MeSH
• studie proveditelnosti MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

U Hrvatskoj je obiteljska medicina bila prvi privatizirani segment sustava zdravstvene zaštite. Zasad je privatizirano oko 84 % ordinacija obiteljske medicine dok je preostalih 16 % ostalo u sastavu domova zdravlja. Da bismo procijenili status informatizacije ordinacija obiteljske medicine, anketirali smo liječnike na specijalizaciji iz obiteljske medicine za vrijeme njihovog poslijediplomskog studija na Medicinskom fakultetu Sveučilišta u Zagrebu u školskoj godini 2004/05. Uzorak se sastojao od 159 liječnika. Pokazalo se da neki oblik informacijskog sustava postoji u 62 % ordinacija u zakupu, 42 % ordinacija u domovima zdravlja te 91 % potpuno privatnih ordinacija obiteljske medicine. Svoj postojeći informacijski sustav liječnik obiteljske medicine prvenstveno upotrebljava za administrativne svrhe: izvještavanje, preskripcije, bolovanja, uputnice i račune. Što se tiče medicinskog dijela rada, elektronički medicinski zapis koristi oko 50 % liječnika, istraživanja, koja se temelje na podacima pohranjenim u e-formatu, provodi oko 31 % liječnika, dok oko 35 % koristi podatke iz sustava za evaluaciju svog rada. Bibliografske baze podataka i elektroničke časopise čita 86 % liječnika iz privatnih ordinacija, 79 % onih koji rade u ordinacijama obiteljske medicine unutar domova zdravlja te 60 % liječnika u ordinacijama u zakupu. Zadovoljstvo s postojećim informacijskim sustavima nije veliko (19 %). Informacijski sustavi naime samo parcijalno zadovoljavaju informacijske potrebe liječnika. 32 % smatra da uz pomoć postojećeg informacijskog sustava dobiva dovoljno informacija, 40 % smatra da im je posao postao učinkovitiji, a 25 % da su i njihovi pacijenti zadovoljniji što njihov liječnika ima kompjutorizirani informacijski sustav u svojoj ordinaciji. S obzirom na tri tipa prakse može se reći da su mlađi doktori, koji rade unutar domova zdravlja, manje zadovoljni svojim informacijskim sustavom nego li doktori iz privatnih ordinacija ili ordinacija u zakupu. Zaštita podatka u sustavu se provodi pomoću zaporke, fizičkom zaštitom računala te svakodnevnim arhiviranjem podatka.

Family practice was the first privatized part of the health care system in Croatia. Recently, 84 % of family practices are privatized. Other 16% of them left within health centers. In order to assess current status of use of the information and communication technology (ICT) in family practice, physicians specializing in the family medicine, being also the postgraduate students of the University of Zagreb, School of Medicine in the year 2004/05, have been surveyed. The sample consisted of 159 physicians. Some kind of information system (IS) exists in 62 % of family practices under lease, 42 % within health centers, and 91 % of completely private offices. Having IS in their offices, physicians use it primarily for administration: reporting, prescriptions, sick leaves, referrals and for billing. Usage of ICT in medical work, electronic medical records, was found at about 50 % of physicians. Doing research based on information stored in e-format, is conducting by 31 % of physicians. Based on e-information 35 % of physicians evaluate their work. About using e-sources of medical knowledge (bibliographic data bases, e-journals): 86 % physicians from private offices, 79% physicians working within health centers, 60 % physicians from offices under lease. Satisfaction with current information system is small (19 %). Their information needs are covered partially. 32 % of physicians said they can get enough information by using their information system. 40 % of physicians feel that ICT gave more efficiency to their work, and 25 % of physicians feel their patients are more satisfied since the IS was put into function. Considering different types of practices – young physicians working in health centers are less satisfied with their ISs than the other two groups of physicians coming from private practice. Data security was practiced by using a password, physical protection, and by daily archiving of data .

• MeSH
• chorobopisy - počítačové systémy statistika a číselné údaje   využití   MeSH
• elektronická pošta statistika a číselné údaje   využití   MeSH
• internet statistika a číselné údaje   využití   MeSH
• lidé MeSH
• počítače statistika a číselné údaje   využití   MeSH
• počítačová gramotnost MeSH
• postoj k počítačům MeSH
• rodinní lékaři statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Chorvatsko MeSH