Family practice最新文献

{"title":"From guidelines to practice: general practitioners' consensus on indicators for managing selected multimorbidity in primary care in Western Australia.","authors":"Sage M C Ishimwe, Timothy A Carey, Jacquita S Affandi, Ninh Thi Ha, Amna Mushtaq, Sayyida Anees, Christopher M Reid, Dan Xu, Delia Hendrie","doi":"10.1093/fampra/cmag055","DOIUrl":"10.1093/fampra/cmag055","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is rising in primary care, yet adherence to guidelines is hindered by fragmented, disease-specific recommendations. This study sought to establish consensus among general practitioners (GPs) on indicators of adherence to Australian guidelines in managing five common chronic conditions [type 2 diabetes mellitus (T2DM), obesity, hypertension, cardiovascular disease, and chronic kidney disease (CKD)], aiming to develop a unified tool for holistic care.</p><p><strong>Methods: </strong>A two-round reactive Delphi survey was conducted with 21 GPs in Western Australia, following RAND methodology. Indicators were drawn from the Royal Australian College of General Practitioners' guidelines and covered biophysical markers, lifestyle risks, and pharmacological management. Participants rated indicators for relevance and clarity on a 4-point Likert scale without a neutral option. Consensus was defined as ≥70% of GPs rating an indicator ≥3 for mean relevance. The process ended when ≥80% of indicators reached this threshold, and no new items were proposed. Feedback refined wording and, where relevant, was reported verbatim.</p><p><strong>Results: </strong>In Round 1, 57 indicators achieved consensus on relevance, with four additional items suggested. By Round 2, consensus was reached on 61 indicators. Most were rated clear, except two addressing pharmacological management of CKD with T2DM, which require clearer guidance. Feedback emphasized the need for refined lipid management guidelines, prioritizing obesity management for prevention, and challenges in lifestyle counselling.</p><p><strong>Conclusion: </strong>This study represents the first integration of disease-specific indicators into a GP-informed tool for multimorbidity management. Strong consensus highlights its practicality, warranting piloting to evaluate effects on guideline adherence and patient outcomes.</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/PMC13390916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561149","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":"Primary care-based interventions for post-stroke follow-up for long-term care: a systematic review.","authors":"Hannah Ravenhall, Serena Sabatini, Rhiannon De Ivey, Linda Errington, Khalifa Mohammed, Rachael Raw, Emily Symington, Faye Tabone, Jacob Brain, Eugene Yee Hing Tang","doi":"10.1093/fampra/cmag058","DOIUrl":"10.1093/fampra/cmag058","url":null,"abstract":"<p><strong>Background: </strong>Life after stroke is managed by primary care to prevent recurrent stroke and ensure that stroke survivors live well within the community. Unfortunately, stroke survivors do not always receive timely follow-up from clinical services, which leads to unaddressed and hidden unmet needs. It is not clear what follow-up interventions would be helpful for stroke survivors in the community once discharged from specialist services.</p><p><strong>Aim: </strong>The aim of this systematic review was to investigate current pathways and interventions used in primary and community care to support patients in their lives after stroke.</p><p><strong>Methods: </strong>The review was registered on PROSPERO (CRD42024575490). Four databases were searched (MEDLINE, Embase, CINAHL, and The Cochrane Library) from 2008 to July 2024. All study types were eligible and included if based around a review of a stroke patient's care and delivered within primary care and community settings. The Effective Practice and Organisation of Care (EPOC) taxonomy was used to classify the interventions, and the outcomes were synthesized.</p><p><strong>Results: </strong>The initial search identified 17 893 articles; 12 articles were included. These were categorized as follows: (i) coordination of care and management of care process (shared decision making n = 4, teams n = 3, and disease management n = 1); (ii) who provides care and how the healthcare workforce is managed (self-management, n = 2); and (iii) information and communication technology (smart home technologies, n = 2).</p><p><strong>Conclusion: </strong>Despite the current evidence, more focus is required particularly to target the hidden and unmet emotional and mental health needs of stroke survivors. The multidisciplinary nature of primary care can help to provide this holistic care.</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/PMC13409119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600880","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":"Gender-based differences in colorectal cancer screening uptake in Singapore: a cross-sectional study.","authors":"Jerrald Lau, Gretel J Wong, Su-Wei Wan, Wee-Hian Tan, Ying-Xian Chua, David H Y Tan, Ker-Kan Tan","doi":"10.1093/fampra/cmag040","DOIUrl":"10.1093/fampra/cmag040","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer screening is an evidence-based preventive approach. Singapore has a national screening programme, but local studies suggest poor uptake. Gender differences in screening uptake exist in the literature, and women in Singapore are exposed to cancer screening (via breast and cervical programmes) earlier than men. This study aimed to identify gender differences, as well as analyse barriers and facilitators associated with being screen-current for colorectal cancer within the genders, using the Health Belief Model.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted in a large public primary care institution in Singapore. Using consecutive sampling, 426 colorectal cancer screening age-eligible (50 years and above) individuals (232 females, 54.5%) completed a single questionnaire measuring knowledge of colorectal cancer symptoms and prevention, Health Belief Model factors, and colorectal cancer information sources.</p><p><strong>Results: </strong>Women had higher knowledge of colorectal cancer symptoms but perceived more barriers. Fewer women were screen-current (33.6%) compared to men (43.4%). Factors associated with knowledge of colorectal cancer symptoms and prevention differed between men (F[13, 178] = 4.51, R2 = 0.138) and women (F[13, 217] = 5.18, R2 = 0.171). Knowledge of symptoms and cues to action was associated with screen-currency in men (Wald χ2 = 33.93, pseudo R2 = 0.18), but the regression model failed to reach significance for women.</p><p><strong>Conclusions: </strong>A one-size-fits-all approach to health promotion is likely insufficient in boosting compliance with colorectal cancer screening recommendations. Further work must be done to understand the more qualitative nuances surrounding women's challenges in being screen-current in Singapore.</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/PMC13255726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148224103","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":"Effect of direct access to physiotherapy on prescribing and imaging in primary care for musculoskeletal disorders: a systematic review and meta-analysis.","authors":"Matthieu Fischer, Emilie Bui, Laure Besombes, Nicolas Pinsault, Mathilde François","doi":"10.1093/fampra/cmag046","DOIUrl":"10.1093/fampra/cmag046","url":null,"abstract":"<p><strong>Background: </strong>Direct access (DA) to physiotherapy enables patients with musculoskeletal disorders (MSDs) to consult physiotherapists without prior GP referral. Despite its growing implementation, no quantitative synthesis has assessed its impact on prescribing outcomes relevant to GP workload.</p><p><strong>Objective: </strong>To estimate the pooled effect of DA versus GP-led care on medication and imaging prescriptions for adults with MSDs in primary care.</p><p><strong>Methods: </strong>This PRISMA-compliant meta-analysis, based on a registered review (OSF: 897ub), searched MEDLINE, Embase, CINAHL, Cochrane Library, and PEDro up to November 2025. Eligible studies compared DA with GP-referred care and reported medication and/or imaging prescriptions. Risk ratios (RRs) were pooled using random-effects models; shared-comparator correlation was managed by combining relevant arms, with sensitivity analyses examining them separately.</p><p><strong>Results: </strong>Four studies (2993 participants) contributed to medication outcomes. Compared with GP-led pathways, DA was associated with fewer medication prescriptions (RR 0.57, 95% CI 0.40-0.83, I2 60%; sensitivity: RR 0.56, 95% CI 0.43-0.73, I2 45%; GRADE: low certainty). Evidence for imaging was insufficient. The planned X-ray-only analysis was uninformative due to sparse, zero-event data. A multi-modality sensitivity analysis suggested reduced imaging but without statistical significance (RR 0.48, 95% CI 0.16-1.41; very low certainty).</p><p><strong>Conclusion: </strong>DA may reduce medication prescribing in MSDs, though evidence certainty remains low. Imaging results are inconclusive. Further high-quality, adequately powered trials with prespecified prescribing and imaging endpoints are warranted to guide equitable primary care workforce planning.</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":"148327806","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":"Outcomes of an opioid reduction tool among patients with chronic noncancer pain in primary care.","authors":"Loes de Kleijn, Elsemiek A W Jansen-Groot Koerkamp, Alessandro Chiarotto, Mette Heringa, Hanneke J B M Rijkels-Otters, Jeanet W Blom, Mattijs E Numans, Marcel L Bouvy, Bart W Koes","doi":"10.1093/fampra/cmag049","DOIUrl":"10.1093/fampra/cmag049","url":null,"abstract":"<p><strong>Background: </strong>In a previous study, an opioid reduction tool was designed to reduce inappropriate opioid treatment in patients with chronic noncancer pain.</p><p><strong>Objectives: </strong>This study aimed to assess whether the tool facilitated opioid tapering in patients with chronic noncancer pain and long-term opioid treatment in primary care. In addition, it evaluated the impact on pain-related outcome measures.</p><p><strong>Methods: </strong>In a cohort study, 55 general practices and 30 collaborating pharmacies were recruited to implement the tool containing six reduction measures. Patients on long-term opioid treatment (>3 months) for chronic noncancer pain received a tailored taper programme from their healthcare provider and were monitored via questionnaires. The primary outcome was reduction in oral morphine equivalent daily dose over 3 months retrieved through pharmacy dispensing data. Secondary outcomes included trends in opioid use over 9 months, pain severity, pain interference, well-being, withdrawal symptoms, discontinuation rate, and nonopioid analgesic use.</p><p><strong>Results: </strong>Of the 366 patients approached, 116 agreed to taper, of whom 27 were included in our cohort. The median oral morphine equivalent daily dose decreased significantly from 40.0 mg (interquartile range (IQR), 16.5-120.0) at baseline to 15.2 mg (IQR, 0.0-60.0) at 3 months. Opioid dose continued to decrease over 9 months, with 12 participants discontinuing completely. Pain-related outcome measures remained stable throughout the study period.</p><p><strong>Conclusion: </strong>With a significant decrease in opioid dose without negative impact on pain, this study showed promising results for an opioid reduction tool tapering long-term opioid treatment in primary care. A larger controlled trial is needed to assess the effectiveness of the tool.</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/PMC13420516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619079","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":"Pulmonary congestion assessed by lung ultrasound in stable ambulatory patients with heart failure and preserved ejection fraction in primary care.","authors":"Eva Leceaga-Gaztambide, Mar Domingo, Josep M Manresa, Maria Iniguez-Cruz, Laura Conangla-Ferrin, Carla Chacón, Galadriel Diez-Fadrique, Raquel Garcia, Hajar El Jaouhari Khlifi, Marc Juviña, Maria Alpiste, Daniel Jorba, David Jara, Pere Torán-Montserrat","doi":"10.1093/fampra/cmag050","DOIUrl":"10.1093/fampra/cmag050","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) accounts for a growing proportion of heart failure cases. Pulmonary congestion, particularly subclinical congestion, is often underestimated by symptoms and physical examination. Lung ultrasound enables detection of extravascular lung water through B-lines, even in early stages, but its role in HFpEF patients managed in primary care remains poorly defined.</p><p><strong>Methods: </strong>This prospective, multisite observational study included ambulatory HFpEF patients with a prior hospitalization for heart failure decompensation and stable New York Heart Association class over the previous 3 months. Baseline evaluation included clinical assessment, biomarkers (N-terminal pro-brain natriuretic peptide, cancer antigen 125), frailty index, HF-related quality of life, 6-minute walking test, and bed-side lung ultrasound using a 28-zone protocol. Patients with pleural effusions were excluded, and B-lines were quantified offline.</p><p><strong>Results: </strong>A total of 188 patients were analyzed (age 77.3 ± 9.9 years, 52.1% women, 46.9% obese, 81.9% New York Heart Association II, N-terminal pro-brain natriuretic peptide 974 pg/mL, 76% loop diuretic). Overall, 86.5% of patients showed at least one B-line, and one-third had ≥5 B-lines despite clinical stability. Higher B-line count was associated with higher systolic blood pressure, pulmonary crackles, and increased N-terminal pro-brain natriuretic peptide and cancer antigen 125 levels. In contrast, no significant relationship was found between B-lines and 6-minute walking test, frailty index, or HF-related quality of life.</p><p><strong>Conclusion: </strong>In stable ambulatory HFpEF patients managed in primary care, lung ultrasound frequently identifies subclinical pulmonary congestion. B-lines are associated with biomarkers of congestion, crackles, and systolic blood pressure, but not with functional capacity, frailty, or patient-reported health status.</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":"148561168","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":"Herpes zoster as a potential clinical marker of undiagnosed Type 2 diabetes in older adults: a retrospective cohort study.","authors":"Shih-Wei Lai, Kuan-Fu Liao","doi":"10.1093/fampra/cmag043","DOIUrl":"10.1093/fampra/cmag043","url":null,"abstract":"<p><strong>Objective: </strong>Herpes zoster has been associated with immune and metabolic disturbances; however, its relationship with newly diagnosed Type 2 diabetes mellitus (T2DM) remains unclear. This study aimed to investigate whether herpes zoster may serve as a clinical marker of previously unrecognized T2DM among people aged 65-84 years.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using de-identified electronic health records from TriNetX (2006-24). Patients aged 65-84 years with a diagnosis of herpes zoster (ICD-10 code B02) were compared with age-matched patients without herpes zoster. Propensity score matching was applied to balance baseline characteristics. The primary outcome was newly diagnosed T2DM. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models within the TriNetX platform.</p><p><strong>Results: </strong>After propensity score matching and exclusion of patients who developed the outcome prior to the predefined follow-up window, 16 175 herpes zoster patients and 16 336 matched controls were included. During 1 year of follow-up, the cumulative incidence of T2DM was 2.362% in the herpes zoster group and 0.343% in controls. Herpes zoster was associated with a significantly higher likelihood of newly diagnosed T2DM (hazard ratio, 6.517; 95% confidence interval, 4.923-8.627).</p><p><strong>Conclusions: </strong>Herpes zoster was associated with newly diagnosed T2DM in older people. These findings support the hypothesis that herpes zoster may serve as an early clinical marker of previously unrecognized T2DM. Prospective studies are warranted to clarify temporal relationships and to determine whether targeted glycemic evaluation is clinically beneficial.</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":"148327775","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":"Assessing the risk of drug-induced corrected QT interval prolongation in primary care.","authors":"Divya Garg, Vishal S Bhella, Trudy Huyghebaert","doi":"10.1093/fampra/cmag048","DOIUrl":"10.1093/fampra/cmag048","url":null,"abstract":"<p><strong>Background: </strong>Tisdale risk score has been validated for predicting drug-induced QTc prolongation (QTP) in cardiac care. This study aims to determine whether it can guide prescribing and monitoring of QTc-prolonging medications in primary care.</p><p><strong>Methods: </strong>A retrospective chart audit using Tisdale Risk Score was conducted. Data from 486 primary care patients from two Family Medicine Clinics, prescribed medications with known or possible risk of Torsades de Pointes (TdP) were reviewed. Eighty-five patients with pre- and post-pharmacotherapy ECGs comprised the cases. A control group of 184 patients not on QTc-prolonging medications was assessed. Patients were categorized as low, moderate, or high risk for QTP.</p><p><strong>Results: </strong>Psychotropics were the most frequently prescribed QTc-prolonging medications. Baseline QTc did not differ significantly between cases (428 ms) and controls (426 ms). Among cases, most were stratified as low risk (69.4%), with fewer in moderate (25.9%) and high-risk (4.7%) categories. Comparatively, 99.5% of control patients were at low risk. QTc prolongation occurred in 5/85 (5.9%) post-pharmacotherapy, with none in the high-risk category. Odds ratio for QTP in moderate-risk patients versus low-risk was 0.71 (95% CI: 0.07-6.98).</p><p><strong>Conclusions: </strong>Most primary care patients were at low risk for drug-induced QTc prolongation. QTP events were low with none in the high-risk category, which limited evaluation of association between risk categories and QTc prolongation. The study highlights commonly prescribed QTc-prolonging medications in family medicine and their variable QTc effects, emphasizing the need for an outpatient-tailored risk assessment tool.</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/PMC13332750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387458","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":"Deferred prescribing in practice: an observational study in community pharmacies in France during 2024-5 and feedback from pharmacists.","authors":"Justine Coudière, Céline Mongaret, Samuel Adelou, Bénédicte Pereton, Hélène Vaillant-Roussel, Amélie Richard","doi":"10.1093/fampra/cmag037","DOIUrl":"10.1093/fampra/cmag037","url":null,"abstract":"<p><strong>Background: </strong>Excessive use of antibiotics promotes antibiotic resistance. Deferred prescribing (prescriptions dispensed according to clinical progress) is a strategy to reduce this overconsumption. Recognized in some countries, this practice is poorly documented and not recommended in France.</p><p><strong>Objectives: </strong>To determine the rate of deferred outpatient prescriptions, their dispensing rate, and their characteristics.</p><p><strong>Methods: </strong>This observational study was conducted over 1 year in 20 pharmacies and focused on prescriptions with a handwritten note indicating deferred dispensing. The data collected included patient age and sex, prescriber specialty, drug class, dispensing delay, and population density. Feedback from pharmacists was also collected.</p><p><strong>Results: </strong>Of 174 deferred prescriptions (0.021% of prescriptions), 38% were dispensed immediately, 20% were dispensed later, and 42% were not dispensed. The majority were prescribed by general practitioners (84%). Dispensing was significantly more immediate in urban areas (P = 0.02). Feedback analysis showed that pharmacists had a positive perception of deferred prescribing, seeing it as a tool for empowerment, antibiotic reduction, and collaboration. However, its implementation was limited by logistical constraints and patients' perception of the prescription as a right to dispensing.</p><p><strong>Conclusion: </strong>Effectiveness of deferred prescribing in reducing antibiotic consumption appears to be limited, especially in urban areas. Deferred prescription has little effect on antibiotic consumption. It seems more important to learn not to prescribe antibiotics when infections are viral. Delaying the prescription may help, but communication between pharmacists, doctors, and patients needs to be strengthened. Harmonization of practices and patient education need to be improved in this context of cascading uncertainties.</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/PMC13332749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387411","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":"Sustainable healthcare knowledge, experience and curricular perspectives: a cross-sectional survey within the European Young Family Doctors Movement network.","authors":"Zineb Bentounsi, Ikbal Humay Arman, Carolina Cordovil, Ana Cristina Franco Spinola, Lukasz Reczek, Ozden Gokdemir","doi":"10.1093/fampra/cmag047","DOIUrl":"10.1093/fampra/cmag047","url":null,"abstract":"<p><strong>Background: </strong>The healthcare sector contributes substantially to greenhouse gas emissions, and family doctors are well placed to reduce this impact, but their preparedness depends on adequate education in sustainable healthcare.</p><p><strong>Objectives: </strong>The objective of this study was to describe self-reported knowledge of sustainable healthcare and perceived educational gaps among family doctors and trainees affiliated with the European Young Family Doctors Movement (EYFDM) network.</p><p><strong>Methods: </strong>A cross-sectional, web-based survey was distributed through EYFDM. The instrument comprised one open-ended question, five knowledge items (four single-best-answer and one multiselect), and two yes/no items. Open-ended responses were scored independently by three authors using a rubric anchored to the World Health Organization definition of environmentally sustainable health systems. Data were analysed in SPSS v27.</p><p><strong>Results: </strong>A total of 130 family doctors and trainees from 15 European countries responded; 83.8% came from three countries (the Netherlands, Türkiye, and the UK). Of those who answered, 64.7% (75/116) reported no prior experience with sustainable healthcare, and 72.5% (58/80) had received no related teaching during training. The median total knowledge score was 3/5 [interquartile range (IQR) 2]. Scores were higher in participants aged under 45 years (P < .001), in female respondents (P = .014), and in trainees (P < .001). Nearly everyone who responded agreed that planetary health should be included in the family medicine curriculum.</p><p><strong>Conclusions: </strong>Within this EYFDM sample, prior formal education in sustainable healthcare was uncommon, and interest in further training was high. Findings are exploratory and not generalizable to all European family doctors, but they support the development of validated instruments and the integration of planetary health into family medicine curricula.</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/PMC13320706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360188","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}