Scandinavian Journal of Primary Health Care最新文献

{"title":"'Shades of grey': a focus group study on diagnostic uncertainty among general practitioners using point-of-care ultrasound.","authors":"Hans-Christian Myklestul, Holgeir Skjeie, Mette Brekke, Trygve Skonnord","doi":"10.1080/02813432.2024.2423242","DOIUrl":"10.1080/02813432.2024.2423242","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) has long been a diagnostic tool in family medicine, although most Norwegian general practitioners (GPs) who use POCUS, scans infrequently. The broad scope of family medicine, the relatively low prevalence of illnesses and infrequent use of POCUS imply that GPs may experience diagnostic uncertainty regularly.</p><p><strong>Aim: </strong>To explore how GPs perceived and managed diagnostic uncertainty when using POCUS.</p><p><strong>Design and setting: </strong>A qualitative focus group study among Norwegian GPs using POCUS.</p><p><strong>Methods: </strong>Four focus group discussions were conducted. Total number of participants were 21. The interview guide was piloted, the focus group discussions were audio-recorded and transcribed, and Systematic Text Condensation, a thematic cross-case analysis, was used to analyse the data.</p><p><strong>Results: </strong>Diagnostic uncertainty using POCUS was considered as aligning to the general clinical uncertainties in family medicine, but there were also POCUS-specific uncertainties in clinical decision-making. We generated six themes: emotional, cognitive, and ethical uncertainty using POCUS, communicating uncertainty to patients, interaction with specialists when using POCUS, and coping strategies of participants. POCUS results were the only results the participants sometimes withheld when communicating with other specialists. POCUS itself stimulated a renewed interest in family medicine. Scanning enough patients was the recommended coping strategy.</p><p><strong>Conclusion: </strong>POCUS-using GPs experienced diagnostic uncertainty when using POCUS that aligned with other diagnostic uncertainties they experienced in everyday practice. However, they did not treat the results like other findings, as the GPs at times withheld their POCUS findings when interacting with secondary care specialists. This requires further investigation.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"219-229"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on multidimensional learning and person-centred care: interviews with persons living with type 2 diabetes.","authors":"Alma Dautovic, Eva Brink, Susanne Andersson, Ulla Fredriksson-Larsson","doi":"10.1080/02813432.2024.2423881","DOIUrl":"10.1080/02813432.2024.2423881","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore patients' learning and support needs within contemporary diabetes care to help them deal with daily life challenges.</p><p><strong>Design: </strong>A qualitative descriptive design was used following the Consolidated Criteria for Reporting Qualitative Studies. The 15 individual face-to-face interviews were analysed using qualitative content analysis.</p><p><strong>Setting: </strong>Participants were drawn from three healthcare centres in rural and urban regions of West Sweden.</p><p><strong>Participants: </strong>The study involved 15 patients (8 men, 7 women) with T2DM who experienced contemporary diabetes care.</p><p><strong>Results: </strong>Patients expressed a strong desire for access to person-centred, multidimensional learning, with a focus on genuine partnership, tailored education, and emotional engagement. Digital tools were seen as valuable aids in their self-care efforts. Sub-themes were '<i>Desiring genuine partnership and tailored patient education</i>' and '<i>Needing support related to altered perspectives on life and awareness of care standards but with finite care resources</i>'.</p><p><strong>Conclusion: </strong>The findings suggest that integrating person-centred, multidimensional learning strategies into diabetes care could be beneficial, particularly when addressing both practical and emotional needs. Encouraging active patient engagement through flexible digital solutions and providing support for emotional well-being may improve the overall patient experience. However, further research and practical application are needed to fully understand how these strategies could be effectively implemented to support patients with T2DM in managing their daily health challenges.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"230-240"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervention description of pharmacist-facilitated medication reviews in Nordic primary care settings: a scoping review.","authors":"Karl-Erik Bø, Kjell H Halvorsen, Elin C Lehnbom","doi":"10.1080/02813432.2024.2439909","DOIUrl":"10.1080/02813432.2024.2439909","url":null,"abstract":"<p><strong>Background: </strong>Multicomponent interventions are increasingly utilized to tackle the complexity of aging and co-morbid patients. However, descriptions of interventions are generally poor, making it difficult for healthcare providers to implement successful programs.</p><p><strong>Objectives: </strong>This study aimed to explore the completeness of intervention description of pharmacist-facilitated medication reviews (MRs) in Nordic primary care settings.</p><p><strong>Methods: </strong>We performed a scoping review of studies reporting on pharmacist-facilitated MRs in Nordic primary care settings. Medline, Embase, CINAHL and Web of Science were searched on 24 January 2024. We used Arksey and O'Mally's framework for scoping studies and applied an adapted version of the Template for Intervention Description and Replication (TIDieR) checklist to evaluate intervention reporting. The Pharmaceutical Care Network Europe (PCNE) classification of MR levels was used to identify the components of different MRs.</p><p><strong>Results: </strong>Sixteen studies were included in this scoping review. The studies were conducted in Sweden (<i>n</i> = 7), Norway (<i>n</i> = 6), Finland (<i>n</i> = 2) and Denmark (<i>n</i> = 1). Information on the participating pharmacists' expertise, qualifications and training was fully reported in only two studies. Twelve studies did not provide any information related to intervention cost, dose or duration, making it challenging to estimate the economic impact of the intervention. Only one study made an evaluation of intervention fidelity. Conversely, 15 studies lacked information on this topic which can lead to inaccurate conclusions about the program's effectiveness.</p><p><strong>Conclusion: </strong>The studies included in this scoping review do not provide sufficient MR information for intervention replication. We recommend that pharmacy trials use reporting checklists to increase the replicability and transferability of effective interventions.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"241-253"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142897173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The in- and outpatient health care use of patients with COPD before and after initiation of home care: a registry study from Norway.","authors":"Tron Anders Moger, Jon Helgheim Holte, Olav Amundsen, Silje Bjørnsen Haavaag, Øystein Døhl, Line Kildal Bragstad, Ragnhild Hellesø, Nina Køpke Vøllestad, Trond Tjerbo","doi":"10.1080/02813432.2024.2404056","DOIUrl":"10.1080/02813432.2024.2404056","url":null,"abstract":"<p><strong>Objective: </strong>Chronic obstructive pulmonary disease (COPD) is a common condition associated with age, multimorbidity and frequently involves the use of health care across levels. Understanding the factors associated with the initiation of long-term care is important when planning the future need for services. We describe healthcare use before and after the reception of any home care. We further studied the associations between healthcare use and first registered home care service and from first registered home care service to nursing home admission or death.</p><p><strong>Design and subjects: </strong>Patients residing in Oslo or Trondheim at the time of first contact with a COPD primary diagnosis, 2009-2018. Patient data were linked across national and municipal registries, covering healthcare and sociodemographics. The sample consisted of 16,738 individuals.</p><p><strong>Results: </strong>There was a marked increase in inpatient and outpatient hospital contacts in the years prior to and after the reception of any home care. Adjusted for comorbidities and sociodemographics, high numbers of GP consultations, and inpatient and outpatient hospital contacts for respiratory diagnoses were associated with a significantly higher likelihood of receiving home care the next year (hazard odds ratios > 1.3). Following the reception of home care, the type of home care service received (e.g. home nursing or short-term rehabilitation/treatment) was more important than outpatient services in predicting next-year nursing home admission or death.</p><p><strong>Conclusion: </strong>Including data on prior outpatient care when predicting future need for home care is beneficial. A high frequency (top 10%) of yearly GP, in- or outpatient hospital contacts can imply that the patient may be in need of home care in the near future.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"100-110"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing visual and automated urine dipstick analysis in a general practice population.","authors":"S M L Cox, P Hoitinga, G J Oudhuis, R M Hopstaken, P H M Savelkoul, J W L Cals, E G P M de Bont","doi":"10.1080/02813432.2024.2392776","DOIUrl":"10.1080/02813432.2024.2392776","url":null,"abstract":"<p><strong>Introduction: </strong>Urinary symptoms constitute the primary reason for female patients to consult their general practitioner. The urinary dipstick test serves as a cornerstone for diagnosing urinary tract infections (UTIs), yet traditional visual interpretation may be subject to variability. Automated devices for dipstick urinalysis are routinely used as alternatives, yet the evidence regarding their accuracy remains limited. Therefore we aimed to compare concordance between visual and automated urinary dipstick interpretation and determine their test characteristics for the prediction of bacteriuria.</p><p><strong>Material and methods: </strong>We conducted a prospective validation study including urine samples originating from adult patients in general practice that were sent to the Maastricht Medical Centre + for urinary culture. Urinary dipstick tests were performed on each sample, which were interpreted visually and automatically. We calculated Cohen's κ and percentage agreement and used 2 × 2 tables to calculate test characteristics.</p><p><strong>Results: </strong>We included 302 urine samples. Visual and automated analysis showed almost perfect agreement (κ = 0.82 and κ = 0.86, respectively) for both nitrite and leukocyte esterase, but moderate agreement for erythrocytes (κ = 0.51). Interpretation of clinically relevant (nitrite and/or leukocyte esterase positive) samples showed almost perfect agreement (κ = 0.88). Urinary dipsticks show similar test characteristics with urinary culture as gold standard, with sensitivities of 0.92 and 0.91 and specificities of 0.37 and 0.41 for visual and automated interpretation respectively.</p><p><strong>Conclusion: </strong>Automated and visual dipstick analysis show near perfect agreement and perform similarly in predicting bacteriuria. However, automated analysis requires maintenance and occasionally measurement errors can occur.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"59-65"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is general practitioner involvement in the initiation of opioids for chronic non-cancer pain associated with opioid dose and concurrent drug use?","authors":"Trond Høibø, Svetlana Skurtveit, Torgeir Gilje Lid","doi":"10.1080/02813432.2024.2404053","DOIUrl":"10.1080/02813432.2024.2404053","url":null,"abstract":"<p><p><i>Objective</i> Is the involvement of the regular general practitioner (GP) in the decision to initiate opioid treatment for chronic non-cancer pain (CNCP) associated with two main risk factors for serious adverse events: increased opioid dose and the concomitant use of prescribed benzodiazepines or benzodiazepine-related medications? <i>Design and setting</i> An anonymous web-based survey was conducted in the county of Rogaland, Norway, during the spring of 2021. <i>Subjects</i> GPs who self-reported applying at least once for reimbursement of opioids prescribed to treat CNCP. They were asked to answer the survey based on the last patient for whom they recalled submitting a reimbursement application. <i>Main outcome measures</i> 1) Total opioid dose in daily oral morphine equivalents (OMEQ). 2) Concurrent use of benzodiazepines and/or benzodiazepine-related drugs. <i>Results</i> The daily opioid dose was lower when the surveyed GPs initiated the opioid treatment (36 OMEQ, <i>n</i> = 25), than when others had initiated the treatment (108 OMEQ, <i>n</i> = 31, <i>p</i> = 0.001). For concurrent use of benzodiazepine or benzodiazepine-related drugs, no significant difference was found (33%, <i>n</i> = 9 with GP involvement <i>vs</i>. 47%, <i>n</i> = 16, <i>p</i> = 0.279 with no GP involvement). <i>Conclusions</i> GP involvement in the initiation of opioid medication for CNCP was associated with a lower opioid dose being prescribed. <i>Implications</i> GP involvement in the initiation of opioid prescriptions may facilitate safer prescribing.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"96-99"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of point-of-care tests in pharyngotonsillitis - a registry-based study in primary health care.","authors":"Jon Pallon, Katarina Hedin","doi":"10.1080/02813432.2024.2416671","DOIUrl":"10.1080/02813432.2024.2416671","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care (POC) tests, including C-reactive protein (CRP) tests and rapid antigen detection tests (RADT) for group A streptococci (GAS), are widely used in Swedish primary health care (PHC). This study quantifies their use in pharyngotonsillitis and explore their association with antibiotic prescribing.</p><p><strong>Material and methods: </strong>Retrospective data from 2012-2016 in Region Kronoberg, Sweden, included all PHC visits with a pharyngotonsillitis diagnosis. Patient characteristics, test usage and antibiotic prescriptions were linked by visit date and personal identification number. Descriptive statistics were used for POC test analysis. Logistic regression assessed the association between CRP levels and antibiotic prescribing.</p><p><strong>Results: </strong>Of 24,237 visits, 68% included RADT and 36% included a CRP test, with 89% of CRP tests performed alongside RADT. CRP testing was more frequent in patients with negative (56%) than positive RADTs (42%) (<i>p</i> < .001). Overall, 66% of RADTs were positive. Median CRP levels were 23 mg/l for positive RADT and 31 mg/l for negative RADT (<i>p</i> < .001). Antibiotics were prescribed for 95% of positive RADTs and 43% of negative RADTs (<i>p</i> < .001). In patients with negative RADTs, CRP testing was associated with higher antibiotic prescribing (57%) compared to no CRP testing (26%) (<i>p</i> < .001). Among these patients, CRP levels were associated with prescribing (aOR 1.032; 95% CI 1.029-1.035; <i>p</i> < .001), with 50% of prescriptions occuring at CRP levels ≤ 20 mg/l.</p><p><strong>Conclusion: </strong>The use of RADTs and the proportion of positive test were higher than expected, indicating inappropriate use and diagnostic bias. CRP testing, contrary to guidelines, was common and associated with increased antibiotic prescribing.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"164-172"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functioning of post-COVID-19 patients: a cross-sectional study at the outpatient clinic for long-term effects.","authors":"Sanna Stålnacke, Helena Liira, Velina Vangelova-Korpinen, Hélène Virrantaus, Mari Kanerva, Kirsi Kvarnström, Markku Sainio, Antti Malmivaara, Aki Vuokko, Mikko Varonen, Mikko Venäläinen, Jari Arokoski","doi":"10.1080/02813432.2024.2410986","DOIUrl":"10.1080/02813432.2024.2410986","url":null,"abstract":"<p><strong>Background: </strong>After COVID-19 infection, long-term impacts on functioning may occur. We studied the functioning of patients with post-COVID-19 condition (PCC) and compared them to controls without PCC.</p><p><strong>Methods: </strong>This cross-sectional study consisted of 442 patients with PCC referred to rehabilitation at the Helsinki University Hospital (HUS) Outpatient Clinic for the Long-Term Effects of COVID-19, and 198 controls without PCC. Functioning was assessed with a questionnaire including WHODAS 2.0. Patients underwent physical testing including a hand grip strength test (HGST) and a 6-minute walking test (6MWT). Lifestyle was assessed by questionnaire and comorbidities were collected as ICD-10 codes from the HUS Data Lake on the HUS Acamedic platform.</p><p><strong>Results: </strong>The WHODAS 2.0 average total score was 34 (SD 18) (moderate functional limitation) for patients with PCC and 6 (SD 8) (normal or mild limitation) for the controls. The disability was higher in all aspects of WHODAS 2.0 in patients with PCC. Bivariate binomial and multivariable regression analyses showed that the presence of comorbidities, anxiety, depression, and smoking predicted a WHODAS 2.0 score of 24 (moderate functional limitation) or above in the PCC group. The average 6MWT distance was 435 m (SD 98 m) in patients with PCC and 627 m (SD 70 m) in controls. HGST measurements showed no significant differences from controls.</p><p><strong>Conclusions: </strong>In conclusion, patients with PCC had significantly reduced functioning based on WHODAS 2.0 scores and the 6MWT results. Comorbidities, anxiety, depression, and smoking were associated with moderate or severe limitations in functioning. Findings support that PCC is multifactorial and requires a holistic approach to rehabilitation.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"155-163"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between principles and pragmatism - primary healthcare and social services professionals' experiences and perceptions of self-care for older adults with home care: a qualitative study.","authors":"Ing-Mari Dohrn, Åsa von Berens, Christina B Olsson, Elisabeth Rydwik, Elin Jakobsson, Lina Palmlöf","doi":"10.1080/02813432.2024.2389116","DOIUrl":"10.1080/02813432.2024.2389116","url":null,"abstract":"<p><strong>Objective: </strong>To explore the experiences of healthcare and social services professionals and their perceptions of using Certificate for self-care with support (CSS) for preventive self-care for older adults with home care, including the CSS process and collaborations between primary healthcare and social services.</p><p><strong>Design: </strong>An inductive qualitative study including seven focus group interviews analyzed with reflexive thematic analysis.</p><p><strong>Setting and subjects: </strong>The study was conducted in the Stockholm Region 2022/23. In total, 23 informants were recruited from four key partners involved in the CSS process: professionals from primary care rehabilitation and primary healthcare, social services officers, and home care staff.</p><p><strong>Result: </strong>The analyses resulted in five interconnected themes: 'Guidelines with scope for interpretation,' 'Support for self-care is needed, but complicated in practice,' 'To trust the other professions' competence,' 'There is a transfer of responsibility,' and 'Communication is key.' The overarching theme 'Principles or pragmatism for safe person-centered care,' anchoring the other themes, revealed a common goal of achieving safe and individualized care within available resources, but from two conflicting perspectives: the importance of following the process according to the guidelines or taking a more pragmatic approach.</p><p><strong>Conclusion: </strong>This study highlights the need to establish structures facilitating safe self-care among frail groups, such as older persons dependent on home care. Our findings emphasize that the demarcation between, and responsibilities of, organizations need to be discussed and clarified to offer person-centered support. Comprehensible guidelines and functioning communication channels must be established so that all important perspectives can be heard, not least the patient's.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"36-46"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimizing unnecessary proBNP blood tests: an evaluation of a pop-up form implementation in general practice.","authors":"Morvarid Sophia Esmaeilzadeh, Anna Elise Engell, Henrik Løvendahl Jørgensen, Bent Struer Lind","doi":"10.1080/02813432.2024.2410984","DOIUrl":"10.1080/02813432.2024.2410984","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of a compulsory pop-up form on the ordering pattern of proBNP blood tests by general practitioners in the Capital Region of Denmark.</p><p><strong>Design: </strong>A follow-up study comparing the average number of proBNP tests ordered before and after the implementation of an intervention.</p><p><strong>Setting and subjects: </strong>From 2016 to 2021, the average number of proBNP tests increased by over 300%. In March 2022, a compulsory pop-up form was introduced in the electronic request system (WebReq), requiring general practitioners to select one of three indications for ordering proBNP, as recommended by the Danish Society of Cardiology. The study included 528 general practitioners in the Capital Region of Denmark, with data available from January 2020 to 2023, encompassing 83,576 proBNP results from 56,645 patients.</p><p><strong>Main outcome measure: </strong>The average number of proBNP tests ordered per month and the median level of proBNP before and after the intervention.</p><p><strong>Results: </strong>Following the intervention, the average number of proBNP tests per month decreased by 60% over a 22-month follow-up period. The highest reduction was seen among general practitioners who previously ordered the most tests (≥3 per 1000 biochemical tests). In this group, the median proBNP level increased from 12.1 pmol/L before the intervention to 13.5 pmol/L after the intervention (<i>p</i> < 0.0001).</p><p><strong>Conclusions: </strong>This study demonstrates a significant decrease in the number of proBNP requests from general practitioners in the Capital Region of Denmark after the introduction of a pop-up form in the requisition system containing the current guidelines.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"148-154"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}