BJGP Open最新文献

{"title":"Chronic pain - prevalence, demographic inequalities and healthcare utilisation: a primary care database analysis.","authors":"Siddesh Shetty, James Scuffell, Dianne Aitken, Mark Ashworth","doi":"10.3399/BJGPO.2024.0147","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0147","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain (CP) is an ill-defined condition, often under-recorded in primary care records.</p><p><strong>Aim: </strong>To determine prevalence, evidence of health inequalities, primary care consultation rates and healthcare utilisation costs of CP.</p><p><strong>Design & setting: </strong>Cross-sectional, retrospective study using anonymised primary care data from all GP practices in one inner-city London area.</p><p><strong>Method: </strong>CP was defined on the basis of analgesic medication codes and novel inclusion of diagnostic codes for conditions known to be strongly associated with CP. CP prevalence and consultation rates were determined; comparisons were made with 31 other Long-Term Condition (LTCs). Consultation cost estimates were based on health care professional type and consultation mode.</p><p><strong>Results: </strong>358 889 adult patients were registered in sample practices, with continuous (12-month) health care records available for 327 800 (91.3%). CP prevalence was 18.6%; the second most prevalent LTC after anxiety at 21.4%. CP mean annual consultation rates were 15.3/patient, the highest LTC consultation rate. CP incurred the highest primary care consultation costs of any of the included LTCs. Age was the strongest predictor of CP, particularly in those aged≥60 years (Adjusted Odds Ratio (AOR): 9.32; 95% Confidence Interval: 8.83 to 9.84; compared to 18-39-year-olds). Much smaller AORs were found for ethnicity, social deprivation, gender and non-UK country of birth.</p><p><strong>Conclusion: </strong>CP represents the most demanding LTC, in terms of consultation rates and costs, managed in primary care. Yet there is considerable uncertainty about optimal management and alternatives to long term, high volume primary care consultation rates.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GP referral to rapid diagnostic centres for non-specific cancer symptoms: a qualitative study.","authors":"Caroline White, Spencer Robinson, Una Macleod, Charlotte Kelly","doi":"10.3399/BJGPO.2024.0179","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0179","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing cancer can be challenging, especially when patients present to General Practitioners (GPs) with serious, but nonspecific symptoms. Rapid Diagnostic Centres (RDCs) have been introduced in England as diagnostic pathways for patients with non-specific symptoms where cancer is suspected, but they do not meet existing cancer pathway criteria.</p><p><strong>Aim: </strong>To investigate GP perspectives on referral to an RDC pathway for patients with non-specific symptoms and suspected cancer.</p><p><strong>Design & setting: </strong>Semi-structured interviews with GPs within the catchment area of an acute NHS Trust METHOD: GP interviews focusing on experiences of using the RDC pathway. A thematic analysis was conducted on interview transcripts.</p><p><strong>Results: </strong>GPs reported the RDC pathway as a game changer. It offered faster referral, reduced anxiety for GPs and patients, and reduced the need for GPs to 'game the system' when patients do not meet criteria for cancer-specific pathways. The narrative required on referral appeared to legitimise GP gut feelings and expertise. RDC results (if not cancer) gave GPs space to treat patients without concern of a missed cancer, while ensuring onward referral for those with cancer or other serious conditions. Some access barriers, especially related to travel and time, were identified especially for patients in rural areas.</p><p><strong>Conclusion: </strong>This cancer pathway fills a referral gap for GPs and patients with non-specific potential cancer symptoms. It has an important signposting function, helping identify patients requiring treatment for cancer/other serious conditions, and others whose symptoms can be treated safely within primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a data-enabled nudge intervention for childhood antibiotics in primary care: a qualitative study.","authors":"Oliver Van Hecke, Aleksandra Borek, Christopher Butler, Sarah Tonkin-Crine","doi":"10.3399/BJGPO.2024.0032","DOIUrl":"10.3399/BJGPO.2024.0032","url":null,"abstract":"<p><strong>Background: </strong>Preschool children (aged ≤5 years) have the highest antibiotic prescribing rate in general practice, mostly for self-limiting acute respiratory tract infections (RTIs). Research from >250 000 UK children suggests that a child's antibiotic history for RTI may be a good predictor for re-consulting a health professional for the same illness episode and increased clinical workload.</p><p><strong>Aim: </strong>To develop a data-enabled nudge intervention to optimise antibiotic prescribing for acute RTI based on a child's antibiotic history in general practice.</p><p><strong>Design & setting: </strong>Two-phase qualitative study with parents or carers of preschool children and primary care clinicians in England.</p><p><strong>Method: </strong>In phase 1, through an initial focus group with eight parents or carers and 'think-aloud' interviews with 11 clinicians, we co-designed the intervention (computer-screen prompt and personalised consultation leaflet). In phase 2, 13 clinicians used the intervention, integrated into the GP computer software, and shared their feedback through 'think-aloud' interviews. Interviews were audio-recorded, transcribed, and analysed thematically.</p><p><strong>Results: </strong>We co-created a data-driven intervention that automatically integrates a child's antibiotic history for acute RTI and personalised leaflet into the electronic medical records. We found that parents and clinicians found this intervention, in principle, acceptable and feasible to use in primary care consultations. GP participants reflected on the prompt's novelty and its usefulness of taking stock of the number of antibiotic prescriptions a child has had in the past year.</p><p><strong>Conclusion: </strong>Delivering such interventions, integrated into practice workflow, could be efficiently scaled up to promote effective antimicrobial stewardship and reduce unnecessary antibiotic use in primary care. Further research will test this intervention in a future trial.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency admission Predictive RIsk Stratification Models: Assessment of Implementation Consequences (PRISMATIC 2): a protocol for a mixed-methods study.","authors":"Mark Kingston, Helen Snooks, Alan Watkins, Christopher Burton, Jeremy Dale, Jan Davies, Alex Dearden, Bridie Evans, Bárbara Santos Gomes, Jenna Jones, Rashmi Kumar, Alison Porter, Bernadette Sewell, Emma Wallace","doi":"10.3399/BJGPO.2024.0182","DOIUrl":"10.3399/BJGPO.2024.0182","url":null,"abstract":"<p><strong>Background: </strong>Emergency admissions are costly, increasingly numerous, and associated with adverse patient outcomes. Policy responses have included the widespread introduction of emergency admission risk stratification (EARS) tools in primary care. These tools generate scores that predict patients' risk of emergency hospital admission and can be used to support targeted approaches to improve care and reduce admissions. However, the impact of EARS is poorly understood and there may be unintended consequences.</p><p><strong>Aim: </strong>To assess effects, mechanisms, costs, and patient and healthcare professionals' views related to the introduction of EARS tools in England.</p><p><strong>Design & setting: </strong>Quasi-experimental mixed-methods design using anonymised routine data and qualitative methods.</p><p><strong>Method: </strong>We will apply multiple interrupted time-series analysis to data, aggregated at former clinical commissioning group (CCG) level, to look at changes in emergency admission and other healthcare use following EARS introduction across England. We will investigate GP decision making at practice level using linked general practice and secondary care data to compare case-mix, demographics, indicators of condition severity, and frailty associated with emergency admissions before and after EARS introduction. We will undertake interviews (approximately 48) with GPs and healthcare staff to understand how patient care may have changed. We will conduct focus groups (<i>n</i> = 2) and interviews (approximately 16) with patients to explore how they perceive that communication of individual risk scores might affect their experiences and health-seeking behaviours.</p><p><strong>Conclusion: </strong>Findings will provide policymakers, healthcare professionals, and patients, with a better understanding of the effects, costs, and stakeholder perspectives related to the introduction of EARS tools.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GPs' experience of difficult decisions in people with dementia who have an acute illness: a qualitative, semi-structured interview study.","authors":"Samuel Lassa, Chris Burton, Jon M Dickson","doi":"10.3399/BJGPO.2024.0074","DOIUrl":"10.3399/BJGPO.2024.0074","url":null,"abstract":"<p><strong>Background: </strong>GPs are often required to make decisions about the management of acute illness in people living with dementia. These decisions are often complex and involve multiple informants.</p><p><strong>Aim: </strong>We aimed to explore how GPs made decisions about acute illness in people with dementia using a micropolitics approach.</p><p><strong>Design & setting: </strong>Qualitative, semi-structured interviews with 13 GPs with a range of years of experience working in South Yorkshire, UK.</p><p><strong>Method: </strong>Interviews were conducted by phone. Interviews focused on GPs' accounts to reflect their own perceptions and choices as portrayed to the interviewer. The analysis used the lens of micropolitics in the analysis and interpretation of the themes, with a focus on decisions between GP, patient, family and carers, and other health and social care providers about the management of acute illness in a person with dementia.</p><p><strong>Results: </strong>The results showed that GPs act as street-level bureaucrats while carrying out their role, using discretion during decision-making in an environment characterised by uncertainties and work pressures. In addition, GPs use the 'soft power' skills of diplomacy, such as negotiation, persuasion, and engagement, in navigating difficult decision-making situations, while building relationships and partnerships with various actors in the health system.</p><p><strong>Conclusion: </strong>GPs possess and express power, and influence decision-making in people living with dementia when navigating biomedical, social, and psychological factors. This power comes in the form of soft power (street-level diplomacy) and the more formal power of street-level bureaucracy.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuity within a community integrated palliative care model and the influence of remote and digital approaches to care: a qualitative interview study.","authors":"Emma Ladds, Malaika Ivey, Katrina Gadsby, Elin Preest, Ffion Samuels, Victoria Bradley","doi":"10.3399/BJGPO.2024.0126","DOIUrl":"10.3399/BJGPO.2024.0126","url":null,"abstract":"<p><strong>Background: </strong>Demand for palliative care is rising. Recent UK policy approaches promote integrated care models - collaborations between GPs and multidisciplinary specialists - and remote and digital practices. The extent to which different forms of continuity are supported within this evolving context is currently unclear.</p><p><strong>Aim: </strong>To explore the experience of continuity and impact of remote and digital practices within an integrated palliative care model.</p><p><strong>Design & setting: </strong>A qualitative interview study of patients and bereaved relatives recruited from a GP practice list and healthcare professionals delivering the integrated palliative care service for that population.</p><p><strong>Method: </strong>Twenty narrative and semi-structured interviews were conducted with 22 patients, relatives, and professionals between May 2022 and November 2023. They explored how care was delivered or received, focusing on coherency and the use of remote and digital practices. Data were theorised using a novel framework that considered psychodynamic, biomedical, sociotechnical, and sociopolitical domains of continuity.</p><p><strong>Results: </strong>The need for human care and connection were of primary importance and affected by intersubjective, biomedical, sociotechnical, and sociopolitical factors that influenced continuity of care. Despite the logistical ease of remote and digital practices, professionals had to work harder or around technologies to provide a 'caring' service. This was exacerbated by a lack of co-localisation, loss of longitudinal relationships, and reduction in tacit knowledge.</p><p><strong>Conclusion: </strong>Numerous complex factors and the exacerbating effects of remote and digital practices influence continuity and coherency within an integrated palliative care model.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating primary care to telehealth: analysis of in-person paediatric consultations and role of carers.","authors":"Simon Chan, Tasneem Khandaker, Yifu Li, Tim M Jackson, Hania Rahimi-Ardabili, Annie Ys Lau","doi":"10.3399/BJGPO.2024.0030","DOIUrl":"10.3399/BJGPO.2024.0030","url":null,"abstract":"<p><strong>Background: </strong>The usage of telehealth in general practice has risen substantially since the COVID-19 pandemic. Over this time frame, telehealth has provided care for all patient demographics, including the paediatric population (aged ≤18 years). However, the translatability of telehealth (that is, whether in-person tasks can be supported remotely via telehealth) rarely considers the paediatric population or their carers.</p><p><strong>Aim: </strong>To examine the degree of translatability to telehealth for in-person GP consultations on paediatric patients with consideration of the carers' roles.</p><p><strong>Design & setting: </strong>This study screened 281 videos of in-person GP consultations set within UK general practices, and 20 of them were eligible for analysis.</p><p><strong>Method: </strong>A secondary analysis of in-person GP consultations was undertaken to examine tasks, physical artefacts, examinations, and the interaction between carer, patient, and GP. A novel scoring method revolving around two key metrics, taking into consideration the carer, was designed to analyse whether the tasks performed can be supported via telehealth.</p><p><strong>Results: </strong>Analysis of 20 eligible consultations revealed 13 distinct physical examinations, 19 physical artefacts, and 17 clinical tasks. Of these 17 clinical tasks, 41% were deemed 'easily translatable to telehealth,' 29% 'moderately translatable with patient-provided equipment', 12% 'potentially translatable', and 18% 'currently untranslatable'. The average telehealth translatability score was 6.1/10, which suggests possible challenges with telehealth support. Regarding carer involvement, 90% of consultations involved collecting patient history, 70% placation of child, and 40% had physical support during examinations.</p><p><strong>Conclusion: </strong>Tasks performed during paediatric in-person GP consultations may not be easily translatable to telehealth and caution should be exercised when considering their translatability to telehealth.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes for older people with screening-detected versus existing chronic kidney disease: a cohort study with data linkage.","authors":"Anna K Forbes, José M Ordóñez-Mena, Winnie Mei, Clare J Taylor, Nicholas Jones, Jennifer A Hirst, Fd Richard Hobbs","doi":"10.3399/BJGPO.2024.0123","DOIUrl":"10.3399/BJGPO.2024.0123","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a common health problem associated with increased risk of cardiovascular disease (CVD), end-stage kidney disease (ESKD), and premature death. It is estimated that one-third of people aged ≥70 years have CKD globally, many of whom are undiagnosed, but little is known about the value of screening.</p><p><strong>Aim: </strong>To compare the risk of adverse health outcomes between people with an existing diagnosis of CKD and those identified through screening, and identify factors associated with mortality in CKD.</p><p><strong>Design & setting: </strong>Prospective cohort study of 892 primary care patients aged ≥60 years with CKD (existing and screening detected) in Oxfordshire, with data linkage to civil death registry and secondary care.</p><p><strong>Method: </strong>Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models to compare the risk of all-cause mortality, hospitalisation, CVD, ESKD separately, and as a composite between CKD groups, as well as to identify factors associated with mortality.</p><p><strong>Results: </strong>After a median follow-up of 3-5 years, 49 people died, 512 were hospitalised, 78 had an incident CVD event, and none had an ESKD event. There was no difference in the composite outcome between those with existing CKD and those identified through screening (HR 0.94, 95% CI = 0.67 to 1.33). Older age (HR 1.10, 95% CI = 1.06 to 1.15), male sex (HR 2.31, 95% CI = 1.26 to 4.24), and heart failure (HR 5.18, 95% CI = 2.45 to 10.97) were associated with increased risk of death.</p><p><strong>Conclusion: </strong>Screening older people for CKD may be of value, as their risk of short-term mortality, hospitalisation, and CVD is comparable with people routinely diagnosed. Larger studies with longer follow-up in more diverse and representative populations of older adults are needed to corroborate these findings.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating the perimenopause in the UK Armed Forces: a mixed-methods review exploring the confidence of GPs.","authors":"Antony Sean Willman, Kate King","doi":"10.3399/BJGPO.2024.0088","DOIUrl":"10.3399/BJGPO.2024.0088","url":null,"abstract":"<p><strong>Background: </strong>Access to high quality perimenopause (PMP) care for UK Armed Forces (UKAF) personnel is crucial, given the increasing proportion of women aged 40-55 in the service. However, owing to the lack of exposure of GPs to the PMP in defence primary health care (DPHC), there are concerns about the confidence in PMP management, particularly in prescribing hormone replacement therapy (HRT).</p><p><strong>Aim: </strong>To assess the confidence of GPs working in DPHC in the management of the PMP.</p><p><strong>Design & setting: </strong>This study employed a mixed-methods approach and included all GPs (uniformed and civilian) working in DPHC.</p><p><strong>Method: </strong>A cross-sectional survey gathered quantitative data on demographics, views on PMP care, and self-rated confidence levels in managing the PMP among defence GPs (DGPs). Semi-structured interviews of purposefully sampled responders were thematically analysed to explore these issues further.</p><p><strong>Results: </strong>There were 164 responses from 542 DGPs (response rate 30.3%). The majority of responders expressed confidence in managing the PMP but reported lower confidence levels in prescribing HRT for younger women and initiating testosterone. Factors influencing confidence included recent PMP continuing professional development (CPD), GP sex, and exposure to PMP cases. Semi-structured interviews provided deeper insights into GP characteristics, CPD, and awareness of the PMP. Women's health hubs providing PMP care and experiential education were strongly supported.</p><p><strong>Conclusion: </strong>The study identified gaps in confidence among DGPs, particularly in certain aspects of PMP management, similar to those found in NHS GPs. CPD and case exposure were important predictors of confidence, with strong support for regional women's health hubs to optimise PMP care. Further research is warranted to explore strategies for bridging confidence gaps and improving PMP care delivery within the UKAF context.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences of remote consulting with chronic fatigue syndrome/myalgic encephalomyelitis and fibromyalgia: a qualitative study.","authors":"Helen Leach, Abi Eccles, Carolyn A Chew-Graham, Helen Atherton","doi":"10.3399/BJGPO.2024.0079","DOIUrl":"10.3399/BJGPO.2024.0079","url":null,"abstract":"<p><strong>Background: </strong>Remote and digital consulting in primary care has rapidly expanded since March 2020. It is important to understand patient experiences, particularly for those living with complex long-term conditions, to identify how care can best be delivered, including within the remote space.</p><p><strong>Aim: </strong>To explore the experiences of people living with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and fibromyalgia when consulting remotely in primary care.</p><p><strong>Design & setting: </strong>Semi-structured interviews with patients living with CFS/ME and fibromyalgia in general practice in England.</p><p><strong>Method: </strong>Semi-structured interviews were carried out with 13 participants. The interviews were transcribed and analysed thematically according to a Foucauldian theoretical framework.</p><p><strong>Results: </strong>All participants highlighted needing to feel believed by clinicians. Many reported difficulties with telephone and online consulting owing to the lack of physical communication. Positive outcomes were reported when there was a good relationship with a clinician. Continuity in care and recognising the complexity of these conditions were also considered important.</p><p><strong>Conclusion: </strong>This study allowed people living with CFS/ME and fibromyalgia to describe their experiences when consulting remotely. Participants highlighted needing to feel listened to and felt they benefited from an ongoing relationship with a clinician although this was difficult to achieve when consulting remotely. Some advantages of remote consulting were reported, particularly when symptoms were troublesome. Flexible access systems, with a range of consultation modalities or preferred clinician(s) availability, could improve healthcare encounters, particularly given the increased use of remote consulting in primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}