Family practice最新文献

{"title":"Guideline adherence for the management of cardiovascular disease in primary care: a scoping review.","authors":"Elena Zink, Pia Traulsen, Christoph Strumann, Jost Steinhäuser","doi":"10.1093/fampra/cmag061","DOIUrl":"10.1093/fampra/cmag061","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, cardiovascular diseases (CVDs) persist as a leading cause of mortality. Clinical practice guidelines (CPGs) aim to support evidence-based decision-making and improve outcomes in primary care. However, application of these guidelines is often inconsistent, raising concerns about potential unconsidered barriers to implementation.</p><p><strong>Objectives: </strong>This review aimed to assess the extent to which CVD-related CPGs are followed in general practice and factors influencing the application.</p><p><strong>Methods: </strong>A structured literature review was conducted in August 2025 in accordance with the PRISMA-ScR guidelines, using MEDLINE (PubMed), Cochrane Library, and Web of Science. The inclusion criteria comprised original studies in English or German that focused on CPG adherence in primary care related to CVDs.</p><p><strong>Results: </strong>After screening 791 studies, 37 were included. Most of these studies had a cross-sectional design and were conducted in Europe. Reported CPG application varied considerably, ranging from 4% to 100% depending on the disease area and evaluation method. Factors influencing CPG application included time constraints, systemic factors, and limitations within the guidelines themselves. Especially complex cases led to concerns about side effects and to deviations from the guideline.</p><p><strong>Conclusion: </strong>Despite high awareness, the adherence to cardiovascular guidelines in general practice has a high variance. As patients in primary care are often multimorbid, evidence-based recommendations often need to be tailored to the patient's needs. Guideline enhancement should therefore emphasize practicality, comprehensibility, and the incorporation of general practitioners' viewpoints.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are general practitioners less likely to recommend treatment when given absolute data on its risks and benefits? A web-based randomized survey.","authors":"David F Harris, Kenneth A Eaton","doi":"10.1093/fampra/cmag064","DOIUrl":"10.1093/fampra/cmag064","url":null,"abstract":"<p><strong>Background: </strong>Doctors need to balance benefits and harms of treatments to advise patients and enable shared decision-making, yet studies indicate general practitioners (GPs) may not be familiar with treatment effect sizes. In atrial fibrillation, national guidelines on anticoagulation recommend risk scoring tools, which do not provide details of the absolute effects.</p><p><strong>Objectives: </strong>To determine if presenting absolute data on benefits and risks of anticoagulation in atrial fibrillation influences GPs' treatment recommendations.</p><p><strong>Methods: </strong>One hundred and fifty-nine GPs and 93 GP trainees in South East England were recruited from conferences and via email invitations. Participants completed a questionnaire with three clinical scenarios of progressively lower stroke risk. They were randomized to receive either guideline recommended risk scores, or descriptions of absolute risk, then asked for their anticoagulation recommendation and to self-rate their recommendation strength.</p><p><strong>Results: </strong>In this study, doctors were less likely to recommend anticoagulation when given absolute data compared to risk scores in all three scenarios (P < .0077, P < .0001, P < .0001). In scenario one and two, even those who recommended treatment rated their recommendation strength lower (P < .0001, P < .012). In scenario two and three, qualified GP's decisions were more likely to concord with guidelines than trainees when given risk scores (P < .0072, P < .023), but no significant differences were seen if informed of absolute risk.</p><p><strong>Conclusion: </strong>Doctors should have ready access to both guidelines and absolute data to tailor their advice to individual patients. Care is needed in how information is presented to avoid discouraging evidence-based practice.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of 6-minute walk test and pulmonary function testing in patients with post COVID-19 condition: a systematic review and meta-analysis.","authors":"Jana Khawandi, Khushi Patel, Muayad Azzam, Jamil Nazzal, Grace Y Lam, Aseel Al Khader, Hassan Kawtharany, Mohammad Amin Al Zabibi, Jood Ahmad, Husam Kivan, Sahar Al Hussein, Aqeeb Ur Rehman, Alain Piché, Andrea Vasquez Camargo, Candace McNaughton, Gavin Y Oudit, Rejina Kamrul, Samia Afzal, Holger Schunemann, Wojtek Wiercioch, Robby Nieuwlaat, Romina Brignardello-Petersen, Emilia Liana Falcone, Reem A Mustafa","doi":"10.1093/fampra/cmag074","DOIUrl":"10.1093/fampra/cmag074","url":null,"abstract":"<p><strong>Background and objective: </strong>Post-COVID-19 condition (PCC) is a complication of acute COVID-19 infection, which often presents with respiratory symptoms. This review aimed to assess the prevalence of abnormal pulmonary function test (PFTs) and 6-minute walk test (6MWT) with oximetry findings, and their respective prevalence and magnitude of abnormalities in patients with PCC, compared to patients without PCC.</p><p><strong>Methods: </strong>We searched three databases. Two reviewers independently screened articles using LASER Al and extracted relevant data using a piloted Excel sheet. We performed meta-analysis using OpenMeta and RevManWeb and a subgroup analysis based on patients' settings during acute COVID-19. We assessed the risk of bias using the Hoy et al. tool and the certainty using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>We included 30 studies that reported on the prevalence of abnormal PFTs and/or 6MWT in patients with PCC. Outcomes within PFTs and 6MWT showed that patients with PCC have a higher probability of having abnormal tests, with those hospitalized during their acute COVID-19 infection showing a higher probability of having abnormal tests. The overall certainty of the evidence was very low due to the high risk of bias, indirectness, and imprecision.</p><p><strong>Conclusion: </strong>This review provides insight into the utilization of PFTs and 6MWT and the frequency of test abnormalities in patients with PCC. Despite existing evidence, there is a need for future studies to assess the diagnostic test accuracy of these tests in PCC.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing mutual trust in interprofessional partnerships within primary care settings: a systematic review.","authors":"Amary Mey, Miaoyin Guo, Hannah Warriner, Kylie Vuong","doi":"10.1093/fampra/cmag060","DOIUrl":"10.1093/fampra/cmag060","url":null,"abstract":"<p><strong>Background: </strong>Trust between healthcare providers is important in facilitating collaborative practices, especially in primary care, where disciplines collaborate across communities to deliver patient-centred care.</p><p><strong>Objective: </strong>To identify the facilitators and barriers that influence trust in interprofessional partnerships within primary care settings.</p><p><strong>Methods: </strong>We searched PubMed, PsycInfo, Embase, and CINAHL using key words to identify articles published up to 16 August 2023. Facilitators and barriers to trust were mapped onto the Consolidated Framework for Implementation Research (CFIR). Quality assessment utilized the Mixed Methods Appraisal Tool (MMAT).</p><p><strong>Results: </strong>From 5750 screened articles, 11 studies were included. Sixteen facilitators and seven barriers were identified. Facilitators included co-location, familiarity, competence, professional identities, and effective communication. Barriers included perceived conflicts of interest, lack of familiarity, and transgressions of professional boundaries. Trust was often unbalanced, with a perception among non-medical healthcare professionals that they need to earn trust from medical healthcare professionals.</p><p><strong>Conclusions: </strong>Formation and nurturing of interprofessional trust is the foundation for building strong partnerships between healthcare professionals that promote collaborative practice in primary care. Future research should include non-English and grey literature and focus on the unequal trust dynamics.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-based automated scoring of the Clock Drawing Test in older adults in primary care: association with Mini-Mental State Examination scores, discriminative performance, and agreement with clinician rating.","authors":"Öztürk G Tutu, Veli Bilen, Zeynep Ziroğlu","doi":"10.1093/fampra/cmag051","DOIUrl":"10.1093/fampra/cmag051","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is common in older adults, and its early detection in primary care remains challenging. The Clock Drawing Test (CDT) is a practical tool, but variability in its scoring limits standardization.</p><p><strong>Objective: </strong>To evaluate artificial intelligence (AI)-based automated CDT scoring in primary care by examining its association with Mini-Mental State Examination (MMSE) scores, discriminative performance for cognitive impairment, and agreement with clinician rating.</p><p><strong>Methods: </strong>In this cross-sectional study, 207 adults aged ≥65 years were assessed in a primary care setting. CDT drawings were scored manually by a neurologist and automatically using a multimodal generative AI system based on the Manos and Wu 10-point method. Associations with MMSE were analyzed, and discriminative performance was assessed using receiver operating characteristic analysis. Agreement was evaluated using intraclass correlation coefficient and Bland-Altman analysis.</p><p><strong>Results: </strong>AI-based CDT scores demonstrated a moderate positive correlation with MMSE (ρ = .437, P < .001). Both methods significantly discriminated MMSE-defined cognitive impairment, although manual scoring yielded a significantly higher area under the receiver operating characteristic curve than AI-based scoring (.779 vs .715; DeLong P = .028). AI-based scoring provided higher sensitivity but lower specificity. Agreement between methods was good (intraclass correlation coefficient = .721), with AI tending to assign slightly higher scores (mean difference: 1.13).</p><p><strong>Conclusion: </strong>AI-based CDT scoring is associated with global cognitive performance and offers meaningful discrimination of cognitive impairment in primary care. However, given lower accuracy and individual-level variability, it should be considered a supportive tool rather than a replacement for clinician assessment.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing patients with mental health conditions in family medicine: a qualitative study exploring the experiences of general practitioners' experiences in Switzerland.","authors":"Juliane Messer, Konstantinos Tzartzas, Nguyen-Toan Tran, Christine Cohidon","doi":"10.1093/fampra/cmag024","DOIUrl":"10.1093/fampra/cmag024","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) frequently serve as the first or only point of contact for patients with mental health disorders, playing crucial roles in detection, prevention, and management. Despite this, many GPs feel poorly prepared to address mental health issues, often citing the barriers of limited time, heavy workloads, and insufficient training.</p><p><strong>Objectives: </strong>The present study's main objective was to make an in-depth exploration of the potential difficulties encountered by GPs as they manage and follow up with patients with mental health problems.</p><p><strong>Methods: </strong>Our qualitative approach involved semi-structured individual interviews with 17 GPs from French-speaking Switzerland. Interviews were transcribed and analysed using reflexive thematic analysis within an inductive theoretical framework. Once the most important themes and subthemes had emerged, we externally and internally validated them.</p><p><strong>Results: </strong>Four principal themes emerged. GPs reported that: (i) they enjoyed caring for patients with mental health issues, valuing their unique position in providing comprehensive, long-term support; (ii) they faced significant systemic barriers, including frustration with limitations related to Switzerland's health assurance scheme; (iii) collaboration with psychiatrists was lacking and resources were insufficient; and (iv) they required help and new ideas to improve the quality of their care.</p><p><strong>Conclusion: </strong>GPs' experiences revealed a mixed reality: their dedication to patient care existed alongside their frustration with systemic constraints, highlighting the complexity of mental health management in primary care. Sustainable improvements would require addressing gaps in caregivers' training, greater interprofessional collaboration, and more public health initiatives to mainstream mental health care into society.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal-offer HIV testing amongst patients undergoing blood tests in primary care: results from a multi-centre study.","authors":"Rhys D Wenlock, Sean Perera, Jaime H Vera, Gillian Dean","doi":"10.1093/fampra/cmag038","DOIUrl":"10.1093/fampra/cmag038","url":null,"abstract":"<p><strong>Background: </strong>The 2016 NICE guidelines recommend offering HIV testing alongside routine blood tests in areas of high HIV prevalence (>2 per 1000 adults aged 18-59). Despite this, implementation in primary care has been limited.</p><p><strong>Method: </strong>A universal-offer HIV testing intervention was implemented across seven general practices in Brighton and Hove. Data were collected on all blood test appointments between June 2022 and February 2024, including demographics, whether an HIV test was offered, patient acceptance, and test results. Mixed-effects logistic regression was used to assess factors associated with test offer and uptake. An electronic survey was disseminated to staff to gather views on feasibility and acceptability.</p><p><strong>Results: </strong>Seven sites were recruited, although only four successfully engaged and provided complete data. A total of 6105 HIV tests were conducted, with one new diagnosis identified. HIV testing was offered to 45% of eligible patients, with 74% accepting. Older adults were significantly less likely to be offered a test [aOR 71-80: 0.79 (95% CI: 0.69-0.91); 81+: 0.50 (0.42-0.60)]. Amongst those offered testing, patients aged over 50 were less likely to accept [aOR: 0.72 (0.57-0.91)], with the lowest uptake amongst those aged 81+ [aOR: 0.44 (0.32-0.61)]. Staff reported no barriers to feasibility or patient acceptability.</p><p><strong>Conclusion: </strong>Routine HIV testing in primary care is well-accepted and can identify new cases. However, site engagement can be challenging, with closer monitoring, support, and rigorous on-boarding processes required.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Amapola Test: description of a novel screening tool for visual alterations in primary care.","authors":"Albert Arnaiz-Camacho, Marta Castany-Aregall, Armand Pairó-Salvador, Sara García-Hidalgo, Tatiana Pablos-Jiménez, Yann Bertolani, Sílvia Alarcón-Portabella, Miguel-Ángel Zapata","doi":"10.1093/fampra/cmag034","DOIUrl":"10.1093/fampra/cmag034","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a novel screening tool for the detection of visual alterations in primary care.</p><p><strong>Methods: </strong>A prospective study was conducted in order to assess concordance and feasibility of the Amapola Test. In patients with a visual complaint, a primary care resident physician identified the visual symptom using the Amapola Test and the results were then compared with an expert history-taking conducted by an ophthalmologist.</p><p><strong>Results: </strong>The Amapola Test was administered to 350 patients with visual disturbances. Of these, 321 patients identified the symptom on the visual charts. The test showed a high concordance rate, with a usability of 89.4% (95% CI: 86.2%-92.6%). The most frequently identified visual symptoms were blurred vision (109), isolated floaters (75), floaters combined with photopsia (23), and isolated photopsia (20). The most common diagnoses were posterior vitreous detachment (100), migraine visual aura (28), and exudative age-related macular degeneration (19).</p><p><strong>Conclusion: </strong>The Amapola Test allows for correct identification of visual symptoms. This study demonstrates a high level of concordance between patient-reported symptoms using the test and expert clinical history, and indicates potential application as a supportive tool in primary care. However, further studies in real-life settings are needed to demonstrate its usefulness and to evaluate its diagnostic performance.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal changes in chronic disease management in primary care in relation to telehealth policy changes: Australian whole-of-population interrupted time-series analysis.","authors":"Danielle C Butler, Nina Lazarevic, Grace Joshy, Christine Phillips, Sally Hall Dykgraaf, Jennifer Welsh, Kirsty A Douglas, Hsei Di Law, Emily Banks, Jane Desborough, Tsheten Tsheten, Jason Agostino, Susan Trevenar, Rosemary J Korda","doi":"10.1093/fampra/cmag042","DOIUrl":"10.1093/fampra/cmag042","url":null,"abstract":"<p><strong>Background: </strong>Universal telehealth aims to support access to timely coordinated chronic disease care. Large-scale evidence on the extent to which this occurs to guide telehealth policy is limited.</p><p><strong>Objective: </strong>To examine temporal changes in uptake and timeliness of general practitioner chronic disease management (GP-CDM) services in Australia following universal telehealth introduction (March 2020) and removal of subsidized telephone (but not video) GP-CDM services (July 2021).</p><p><strong>Methods: </strong>Whole-of-population cohort study of linked national claims and death data, 2018-2022. Interrupted time-series analyses quantified temporal changes in GP-CDM service uptake and timeliness following telehealth policy changes.</p><p><strong>Results: </strong>From 2018 to 2022, each month an average of 568 858 GP-CDM services were delivered, with 25-43 users and 44-76 services per 1000 population aged 45-<85 per month. After universal telehealth introduction, GP-CDM uptake remained stable, with similar trends pre- and early-pandemic. Monthly uptake decreased substantially following the removal of telephone GP-CDM services [decrease of 4.0 users (95%CI -6.3, -1.7) and 6.9 services (-10.5, -3.3) per 1000 population]. In the first month of telehealth, 38.7% of people using GP-CDM services used telehealth (37% telephone, 1.7% video), declining to 2.2-5.4%/month after removal of telephone GP-CDM services. Small improvements in GP-CDM timeliness stalled once telephone services were no longer available. Patterns were similar across population subgroups.</p><p><strong>Conclusions: </strong>Telehealth policies in Australia sustained access to chronic disease care during the pandemic. Limiting access to these services to video alone was associated with a greater than expected decline in use had the pandemic and introduction of telehealth not occurred.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13296993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148327852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creation and interprofessional collaborative practice for the local management of osteoporosis: a qualitative study in primary healthcare.","authors":"Jenny Nilsson, Helena Salminen, Eva Toth-Pal, Hans Ranch Lundin","doi":"10.1093/fampra/cmag045","DOIUrl":"10.1093/fampra/cmag045","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional collaborative practice (ICP) benefits patients with complex conditions such as osteoporosis that require care from multiple professions. ICP is not consistently applied in osteoporosis management in primary healthcare today.</p><p><strong>Objectives: </strong>To explore how an ICP intervention promoting co-creation of osteoporosis management was conducted and how it was experienced by nurses and physicians in primary healthcare.</p><p><strong>Methods: </strong>The intervention part was guided by participatory health research approach. In total, 12 nurses and physicians from five primary healthcare centres participated in three workshops aimed at supporting co-creation of local osteoporosis management. The evaluation part consisted of group and individual interviews and surveys capturing self-reported experiences. Data were analysed using qualitative content analysis with inductive approach.</p><p><strong>Results: </strong>Participants reviewed local osteoporosis management and co-created work procedures tailored to their settings. The analysis generated three categories with seven subcategories. The categories were innovative learning processes, perceived effects, and factors influencing changes in work procedures. Innovative learning processes described shared learning, reflection, and adaptation in developing work procedures. Perceived effects included expected benefits for patients, changes in professional roles, and increased interprofessional collaboration. Participants described a strengthened role for nurses in osteoporosis management. Factors influencing changes in work procedures included organizational, professional, and resource-related conditions. The survey findings supported those from the interviews.</p><p><strong>Conclusion: </strong>A participatory approach facilitated collaborative revision of osteoporosis management by leveraging local knowledge and promoting interprofessional learning. Participatory health research appears useful for developing ICP in managing complex conditions such as osteoporosis in primary healthcare.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"43 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}