Family practice最新文献

{"title":"Australian practice nurses' perspectives on integrating specialist diabetes care with primary care: a qualitative study.","authors":"Rachael M Taylor, Shamasunder H Acharya, Martha E Parsons, Ushank P Ranasinghe, Deniz O Kuzulugil, Kerry C Fleming, Melissa L Harris, Julie E Byles, Annalise N Philcox, Meredith A Tavener, John R Attia, Johanna Kuehn, Sharon N Ross-Evans, Alexis J Hure","doi":"10.1093/fampra/cmaf020","DOIUrl":"https://doi.org/10.1093/fampra/cmaf020","url":null,"abstract":"<p><strong>Background: </strong>In 2015, the Australian Diabetes Alliance Program (DAP) was implemented in the Hunter New England Local Health District, New South Wales as a collaboration with the Hunter Medicare Local. DAP integrates specialist teams within primary care practices, delivering case conferencing, practice performance reviews, and education sessions.</p><p><strong>Objective: </strong>To report on practice nurses (PNs) perspectives on the impact of the DAP on their skills, knowledge, and approach in delivering care for adults with type 2 diabetes.</p><p><strong>Methods: </strong>Three primary care practices with high rates of monitoring haemoglobin A1c (HbA1c) levels (> 90% of patients annually) and three practices with lower rates of monitoring HbA1c levels (< 80% of patients annually) from DAP provided the sampling frame. Interviews were conducted with six PNs, which were transcribed and analysed using codebook thematic analysis.</p><p><strong>Results: </strong>Overall, DAP was viewed favourably by PNs. Significant improvements in knowledge and skills were reported relating to administering antihyperglycemic agents, insulin, and other injectable therapy, as well as dietary modifications for diabetes management. PNs transferred this knowledge and skills to other patients not participating in DAP. An improvement in the delivery of diabetes care, rather than a change in approach, was also reported by PNs. However, the amount of preparation required for case conferencing in the program was identified as a burden to PNs.</p><p><strong>Conclusions: </strong>PNs were supportive of DAP and identified knowledge gains that were transferable to other patients. The administrative burdens on PNs need to be considered for scalability of the program.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980233","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":"Statins for primary prevention in multimorbid patients: to prescribe or not to prescribe? A qualitative analysis of general practitioners' decision-making processes.","authors":"Racha Onaisi, Anaïs Bezzazi, Thomas Berthouin, Justine Boulet, Jennifer Hasselgard-Rowe, Hubert Maisonneuve","doi":"10.1093/fampra/cmad068","DOIUrl":"10.1093/fampra/cmad068","url":null,"abstract":"<p><strong>Introduction: </strong>A better understanding of the determinants involved in general practitioners' (GPs) decision-making processes when it comes to prescribing statins as primary prevention in patients with multimorbidity could provide insights for improving implementation of primary prevention guidelines.</p><p><strong>Methods: </strong>We conducted a qualitative study using a deductive framework-based and inductive analysis of GPs' semi-structured interviews verbatim, from which expertise profiles of prescribers were also drawn. The analytical framework was built from a pragmatic synthesis of the evidence-based medicine, Modelling using Typified Objects (MOT) model of clinical reasoning processes, Theoretical Domains Framework, and shared decision-making frameworks.</p><p><strong>Results: </strong>Fifteen GPs were interviewed between June 2019 and January 2020. Diabetes seemed to represent a specific motivation for deciding about statin prescription for primary prevention purposes; and in situations of multimorbidity, GPs differentiated between cardiovascular and non-cardiovascular multimorbidity. Expert prescribers seemed to have integrated the utilisation of cardiovascular risk calculation scores throughout their practice, whereas non-expert prescribers considered them difficult to interpret and preferred using more of a \"rule of thumb\" process. One interviewee used the risk calculation score as a support for discussing statin prescription with the patient.</p><p><strong>Conclusion: </strong>Our results shed light on the reasons why statins remain under-prescribed for primary prevention and why non-diabetic multimorbid patients have even lower odds of being prescribed a statin. They call for a change in the use of risk assessment scores, by placing them as decision aids, to support and improve personalised shared decision-making discussions as an efficient approach to improve the implementation of recommendations about statins for primary prevention.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9831704","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":"A new community-based cardiopulmonary resuscitation training program for primary care: needs assessment, development, and pilot testing.","authors":"Sandra Paredes-García, Nuria López-Batet, Francesc Carmona, Antoni Sisó-Almirall, Luis González-de Paz","doi":"10.1093/fampra/cmaf019","DOIUrl":"https://doi.org/10.1093/fampra/cmaf019","url":null,"abstract":"<p><strong>Objective: </strong>The general population's interest in cardiopulmonary resuscitation (CPR) remains largely unknown. Fewer than one-third of individuals are familiar with CPR, and there are no comprehensive training programs available. This study aimed to examine CPR interest among patients visited in the primary care setting, design a new program, and assess the feasibility and efficacy of the training initiative.</p><p><strong>Methods: </strong>This two-phase project aimed to (i) examine patients' knowledge and interests and (ii) design and evaluate a training program within the PC setting. Knowledge and interests were assessed using a survey. The training program design adhered to European guidelines. The pilot study assessed effectiveness through self-administered tests, instructor evaluation of the chain of survival, correct use of an automated external defibrillator (AED), and a manikin capable of measuring chest compression.</p><p><strong>Results: </strong>A total of 243 patients participated. Among them, 26.16% had received prior CPR training, only 5% knew how to perform CPR maneuvers, and 84.8% were interested in learning. A 90-min training program was designed. After the training session (N = 50), all participants reported feeling capable of performing CPR techniques using the AED; 94% demonstrated proficiency in AED use, and 20% performed high-quality chest compressions (correct release, depth, and rate).</p><p><strong>Conclusion: </strong>The general population had limited knowledge about CPR but was highly interested in acquiring CPR skills. The PC-based training program enabled bystanders to perform CPR and use AEDs, potentially improving survival rates in out-of-hospital cardiac arrests.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960311","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":"Does pay for performance promote inverse inequality in chronic disease management?","authors":"Sarah Linnane, Sarah Mullarkey, Eoin Kyne, Maeve Healy, John Fallon, Santosh Sharma, Ailish Hannigan, Andrew O'Regan, Ray O'Connor","doi":"10.1093/fampra/cmaf025","DOIUrl":"https://doi.org/10.1093/fampra/cmaf025","url":null,"abstract":"<p><strong>Background: </strong>In Ireland, a mixed public-private system exists, whereby some patients receive state-funded general practice (GP) care under the General Medical Services (GMS), while private patients (PPs) pay fees. In 2020, the chronic disease management programme was introduced at the practice level to enhance the management of eight conditions. This pay for performance (P4P) programme incentivises GPs to review GMS patients regularly using a structured protocol. It is hypothesized that ineligible PPs receiving 'routine care', receive a poorer standard of care.</p><p><strong>Objective: </strong>To investigate the effect of P4P on the standard of care between PPs and GMS patients.</p><p><strong>Methods: </strong>Retrospective cross-sectional study involving 11 GP practices in the Midwest of Ireland. Clinical parameters recorded for the previous 12 months on 25 GMS patients and 25 PPs, matched by age group, sex, and one clinical condition, were collected from each practice. Parameters included vaccination status, and recording of: blood pressure, smoking status, renal function, glycosylated haemoglobin, and lipids.</p><p><strong>Results: </strong>Data from 550 patients showed that GMS patients were more likely than PPs to have received/been offered vaccinations (influenza (66% vs 26%), COVID-19 (69% vs 23%), pneumococcal (59% vs 15%)). GMS patients were more likely than PPs to have other parameters measured: blood pressure (92% vs 54%); smoking status (84% vs 24%); renal function (90% vs 59%); glycated haemoglobin (87% vs 56%); lipids (89% vs 57%) (P < .001 for all parameters).</p><p><strong>Conclusion: </strong>Significant disparities exist in the management of chronic disease in Ireland between GMS patients and PPs. Limiting P4P programmes to GMS patients promotes inequality.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981710","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":"Does father involvement affect attachment and maternal depression and quality of life?: a randomized controlled trial.","authors":"Fatma Yıldırım, Ebru Şahin","doi":"10.1093/fampra/cmaf024","DOIUrl":"https://doi.org/10.1093/fampra/cmaf024","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the effects of father involvement on father-infant bonding, postpartum depression in mothers, and quality of life.</p><p><strong>Materials and methods: </strong>The research involved randomized, controlled experimental design and was conducted from September 2021 to June 2023 with 63 mothers and fathers (31 in the experimental group and 32 in the control group). Fathers in the experimental group were given infant care training within the first 1-4 h after birth. The fathers were called with telephone in the 2nd, 3rd, 4th, 8th, and 12th weeks and participation in infant care was monitored. Data were collected using Personal Information Forms for Mother-Father, Baby Care Participation Chart, the Father-Infant Attachment Scale (FIAS), the Edinburgh Postpartum Depression Scale (EPDS), and the Maternal-Postpartum Quality of Life Scale (MPQOLS). Data analysis was done with SPSS and t-test, Mann-Whitney U, and Cohen's d were used.</p><p><strong>Results: </strong>Fathers in the experimental group displayed significantly higher mean FIAS scores (83.79 ± 5.89) and subscales compared to those in the control group (P < .05). Mothers in the experimental group exhibited lower mean EPDS scores in the 4th, 8th, and 12th weeks (2.74 ± 2.07; 1.71 ± 3.51; 1.71 ± 3.43), along with higher MPQOLS mean scores (26.46 ± 2.11; 27.62 ± 1.55; 27.83 ± 1.41), as compared to the control group, with these differences being statistically significant (P < .05).</p><p><strong>Conclusion: </strong>Father involvement strengthens father-infant bonding, reduces maternal postnatal depression risk, and improves postnatal quality of life. Healthcare providers, in postpartum care settings, could integrate father-focused education and support into routine care protocols.</p><p><strong>Clinical trial registration: </strong>This study was prospectively registered at NCT05588089.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984845","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":"Epidemiology of invasive meningococcal disease and its sequelae: a population-based study in Italian primary care, 2000-2019.","authors":"Francesco Lapi, Ettore Marconi, Davide L Vetrano, Alessandro Rossi, Erik Lagolio, Vincenzo Baldo, Claudio Cricelli","doi":"10.1093/fampra/cmad062","DOIUrl":"10.1093/fampra/cmad062","url":null,"abstract":"<p><strong>Background: </strong>Invasive meningococcal disease (IMD) is a severe infectious disease. Although effective preventive and therapeutical strategies are available, the fatality rate remains high in the general population, with an occurrence of meningococcal-related severe sequelae involving 10-20% of survivors. Given the crucial role of general practitioners in recognizing and preventing IMD and its related sequelae, we aim to assess the burden of these conditions in primary care.</p><p><strong>Methods: </strong>Using an Italian primary care database, the incidence rate of IMD was calculated in the period 2000-2019 by capturing the first diagnosis registered during follow-up. As far as meningococcal-related sequelae are concerned, we identified and clinically evaluated each potential sequela during the first 3 months, from 3 to 12 months, and up to 36 months.</p><p><strong>Results: </strong>Among 508 patients diagnosed with IMD, 403 (incidence rate: 0.24 per 10,000 person-years) comprised those diagnosed with IMD in patients aged 15 years or older. We ascertained 104 sequelae (20.4%); 76% of them occurred in those aged 25 or older; 42, 27, and 35 were assessed as short-, medium-, or long-term sequelae, respectively. Overall, 4.7% of IMD patients reported physical sequelae, while 12.2% and 5.7% of patients reported neurological and psychological sequelae, respectively.</p><p><strong>Conclusion: </strong>Our study showed that a substantial proportion of IMD and related sequelae occur in individuals aged over 25, with a non-negligible burden for healthcare systems. As for the paediatric population, effective communication on the relevance of meningococcal vaccination in adults should be proficiently fostered.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9553869","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":"Breast cancer screening among individuals with a substance use disorder: a retrospective cohort study.","authors":"Kento Sonoda, Timothy Chrusciel, Jennifer K Bello, Sarah C Gebauer, Richard Grucza, Jeffrey F Scherrer","doi":"10.1093/fampra/cmaf018","DOIUrl":"https://doi.org/10.1093/fampra/cmaf018","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited evidence about whether a substance use disorder (SUD) is a barrier to breast cancer screening. Because SUDs are highly prevalent in the USA, it is important to establish whether this patient population is less likely to obtain screening.</p><p><strong>Methods: </strong>This retrospective cohort study included 220 227 patients, with 209 132 having no SUD and 11 095 (5.0%) with SUD based on electronic health record data in a multi-state, Midwestern healthcare system (1 January 2018-31 December 2022). The outcome was the receipt of a mammogram in the 5-year follow-up period. Patients were women aged 40-69 years as of 1 January 2018, with ≥ 2 in-person primary care visits between 2018 and 2022. Covariates included demographics, health services utilization, and physical/psychiatric conditions.</p><p><strong>Results: </strong>Mean age of the sample was 54.7 (± 8.3) years old. After controlling for confounding, women without any SUDs had more than twice the odds of mammogram receipt compared to those with stimulant use disorder (odds ratio [OR] 2.06; 95% confidence interval [CI]: 1.83-2.33). Women with no SUDs had 89% higher odds of mammogram receipt compared to those with opioid use disorder (OR 1.89; 95% CI: 1.76-2.03), followed by \"other\" SUDs (OR 1.86; 95% CI: 1.69-2.06), sedative use (OR 1.70; 95% CI: 1.43-2.04), cannabis use (OR 1.58; 95% CI: 1.44-1.74), and alcohol use disorders (OR 1.49; 95% CI: 1.41-1.58).</p><p><strong>Conclusions: </strong>Despite the high prevalence of SUDs, evidence of preventive service delivery among individuals with SUDs is still lacking. Further research is needed to investigate other healthcare disparities in preventive service delivery among individuals with SUDs.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005448","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":"Effect of 2-week postpartum check-ups on screening positive for postpartum depression: a population-based cohort study using instrumental variable estimation in Japan.","authors":"Naoko Nakamura, Toshiharu Mitsuhashi, Yasuko Nakashima, Naomi Matsumoto, Takashi Yorifuji","doi":"10.1093/fampra/cmad074","DOIUrl":"10.1093/fampra/cmad074","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression is experienced by approximately 10% of women and affects the health and development of their children. Although it is recommended that all mothers have the opportunity for early detection and intervention for postpartum depression, it is unclear whether early postpartum check-ups help to reduce postpartum depression.</p><p><strong>Objective: </strong>The aim of this study was to assess the effect of 2-week postpartum check-ups on screening positive for postpartum depression in Japan.</p><p><strong>Methods: </strong>This was a population-based cohort study that used the administrative database of Tsuyama, Japan. Participants were women who received postpartum home visits from a public health nurse in Tsuyama during the fiscal years 2017-2019. Data were obtained on participant's attendance at a 2-week postpartum check-up and their responses on the Edinburgh Postpartum Depression Scale. Owing to the initiation of a publicly funded postpartum check-up programme, participants were pseudo-randomly assigned to receive/not receive a 2-week postpartum check-up. We conducted instrumental variable estimation to assess the causal effects of the check-up on screening positive for postpartum depression.</p><p><strong>Results: </strong>The characteristics of the 1,382 participants did not differ by fiscal year of childbirth. We found a 6.7% (95% confidence interval 2.2-11.2) reduction in the prevalence of screening positive for postpartum depression as an effect of 2-week postpartum check-ups among women received 1-month postpartum home visits.</p><p><strong>Conclusion: </strong>The results suggest that 2-week postpartum check-ups are effective in reducing the prevalence of screening positive for postpartum depression among 1-month postpartum women. Despite some limitations, early postpartum care could reduce postpartum depression.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10214089","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":"Development of a scale for defensive medicine practices in primary care.","authors":"Mehmet Demir, İrfan Yurdabakan, Oğulcan Çöme, Tolga Günvar","doi":"10.1093/fampra/cmaf023","DOIUrl":"https://doi.org/10.1093/fampra/cmaf023","url":null,"abstract":"<p><strong>Background: </strong>Defensive medicine, characterized by the avoidance of high-risk patients or the overuse of diagnostic and therapeutic interventions due to fear of litigation or complaints, poses significant challenges in primary care. Existing scales primarily focus on hospital settings, limiting their applicability to family physicians. This study aimed to develop and validate a scale tailored to measure defensive medicine behaviors in primary care contexts.</p><p><strong>Methods: </strong>Scale development involved reviewing the literature, conducting focus group discussions with family physicians, and consulting with experts. An initial 37-item draft was pilot-tested for clarity, resulting in a refined instrument. Data were collected from family physicians in two phases: exploratory factor analysis (EFA) with 252 participants and confirmatory factor analysis with 266 participants. Criterion validity was assessed by correlating the new scale with a previously validated defensive medicine scale. Reliability was evaluated using Cronbach's alpha and McDonald's omega.</p><p><strong>Results: </strong>EFA supported a five-factor structure: referral, complaint, e-report, verbal/physical violence, and interventional procedure dimensions. After item removal, the final 21-item scale demonstrated acceptable goodness-of-fit indices (χ²/df = 2.43, root mean square error of approximation (RMSEA) = 0.07, comparative-fit index (CFI) = 0.93). Criterion validity was evidenced by a moderate positive correlation (r = 0.350, P < .01) with an existing scale. Internal consistency was high, with both Cronbach's alpha and McDonald's omega at 0.92 for the total scale.</p><p><strong>Conclusions: </strong>The Primary Care Defensive Medicine Practices Scale is a valid and reliable instrument specifically tailored for primary care settings. It offers a more nuanced understanding of defensive behaviors, guiding targeted interventions to enhance care quality, patient safety, and resource utilization.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062406","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":"Palliative care consultation needs of certified primary care physicians in Japan: nationwide observational study.","authors":"Naoto Ishimaru, Yoko Nakazawa, Shunsuke Oyamada, Jun Hamano, Yoshiyuki Kizawa","doi":"10.1093/fampra/cmaf009","DOIUrl":"10.1093/fampra/cmaf009","url":null,"abstract":"<p><strong>Purpose: </strong>Japan has insufficient palliative care specialists, so there are calls for a palliative care consultation system to aid primary care physicians. Community-based palliative care may require clarification on the division of tasks and responsibilities. Primary care physicians' needs specific to palliative care are also ambiguous. We therefore aimed to elucidate the consultation needs of primary care physicians particular to palliative care in Japan.</p><p><strong>Methods: </strong>This analysis of a nationwide observational study was conducted between December 2023 and January 2024. We sent questionnaires to 1,100 Japanese board-certified primary care physicians based on the Palliative Care Difficulties Scale (range: 1-4). Comparisons were made by unpaired Student's t test and with a multivariate linear regression model according to workplace type (clinics and hospitals).</p><p><strong>Results: </strong>We obtained 548 replies (response rate: 50%), of which 540 had analyzable data. Primary care physicians in clinics required less consultation than those in hospitals on the choice of medication (P = .019), opioids switching (P = .018), prognosis estimates (P < .001), decision support (P = .016), and grief care (P = .009). Those in clinics were less likely to have palliative care support from non-physician palliative care specialists (P < .001) and information support (P = .003). In multivariable analysis, being a clinic-based physician was inversely associated with the functioning of a decision-making support counseling system (R2 = 0.527).</p><p><strong>Conclusions: </strong>The specific consultation needs of primary care physicians in Japan specific to palliative care differ by workplace. Our data suggest the need for clear national-level supporting guidelines and training toward primary care physicians' involvement in palliative care and individualized end-of-life management.UMIN trial ID: UMIN000054985.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604444","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}