Prevalence of cramps in patients over the age of 60 in primary care : a cross sectional study.

BACKGROUND: Cramps are involuntary painful muscle contractions that mainly affect older people. Cramps may cause severe pain and sleep disturbance. Little information exists on the prevalence and the main features of cramps in primary care settings. The objective of this study was to estimate the prevalence and the main features of cramps among primary care patients aged 60 years and older. METHODS: We prospectively enrolled 516 patients aged 60 years and older in a cross-sectional study at 25 general practices in Alsace - France between October 2011 and March 2012. Questionnaires were used to obtain information about demographics, cramp presence and main features, medical history, and treatment. RESULTS: The adjusted prevalence was 46 % (95 % CI: 38-53 %). Thirty-one per cent of the study sample reported being woken up by cramps, 15 % had cramps more than 3 times a month. Logistic regression revealed a slightly higher prevalence in the age group 65-69 years compared to 60-64 years. No significant association was observed between other age groups and prevalence, or between gender and prevalence. The main localization of cramps was in the calves (80 %). The duration since onset was 5 years or more for 58 %. CONCLUSIONS: Cramps are common in primary care, and although only a minority of patients report suffering from cramps more than once a week, many patients report cramp-related sleep disturbance. Further studies are needed to assess risk factors and therapeutic options for patients suffering from cramps in primary care.

[Cancer screening by primary care physicians: a chart audit]. / Dépistage des cancers: auto-évaluation des dossiers médicaux de 37 médecins généralistes.

BACKGROUND: Cancer screening requires identification of individuals at high risk for cancer, mainly through an adequate family history, and documentation of dates and results of past screening examinations. By asking general practitioners (GPs) to audit their charts, we sought to encourage them to enhance chart quality and their involvement in colorectal, breast and cervical cancer screening. METHODS: Chart audit of data on family cancer history and past screening examinations. Volunteer GPs, working in groups, self-audited the completeness of their charts of 20 (10 women, 10 men) consecutive patients not seen for the first time and aged 40-74 years for colorectal, breast and cervix cancer. RESULTS: In all, 37 GPs participated, analyzing 736 charts. Family history of cancer was documented in half the charts. A fecal occult blood test was mentioned in 51.2%, with a date in 40.2%. Mammograms were mentioned in 62.7% of women's charts, but only 27.9% contained complete information (family history, date and result of mammogram documented). Similarly, 44.2% of women's charts mentioned pap smears but only 25.9% contained complete information. The rates of complete charts ranged from 0 to 100% and varied with cancer and GP. CONCLUSION: Quality of charts in primary care is globally poor but very heterogeneous, ranging from bad to excellent according to GP. The collection of updated information on family history and past screening examinations must be improved in primary care.