BJGP Open最新文献

{"title":"Enhancing understanding of interventions to increase relational continuity in general practice: a realist review protocol.","authors":"Serge Engamba, Jane Smith, Nada Khan, Kate Sidaway-Lee, Patrick Burch, Tom Marshall, Phil Evans, Denis Pereira Gray, Rob Anderson","doi":"10.3399/BJGPO.2025.0119","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0119","url":null,"abstract":"<p><strong>Background: </strong>Relational continuity of care (RCC), which is characterised by an ongoing therapeutic relationship between patients and their primary care providers, is critical for ensuring high-quality care in general practice. Despite its importance, challenges such as staffing shortages, policy shifts, and evolving patient needs often impede its consistent delivery. With the new GP contract in England highlighting the need for primary care providers to monitor and deliver relational continuity, it is more than ever crucial to understand how best to achieve it.</p><p><strong>Aim: </strong>This realist review aims to explore how, why, and under what conditions interventions to improve relational continuity are successfully implemented in general practice.</p><p><strong>Design & setting: </strong>The review will be supported by an expert stakeholder panel and a patient advisory group to consider the diverse and dynamic settings of general practice, and generate contexts, mechanisms and outcomes configurations exploring how interventions to enhance RCC in general practice work.</p><p><strong>Method: </strong>Through the synthesis of diverse international evidence sources, including qualitative, quantitative, mixed-methods studies, and grey literature, the review will develop an understanding of the mechanisms that produce relational continuity, the contexts in which these mechanisms operate, and the outcomes they produce for the health system, practices, practitioners, and patients.</p><p><strong>Conclusion: </strong>The findings will provide data to inform future research and refine strategies and policies that support the effective delivery of relational continuity, which in turn may lead to improved patient outcomes and enhanced care experiences.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765621","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":"Utilization of a GP-staffed emergency response unit: an observational study from Norway.","authors":"Anders Rønning, Ann-Chatrin Linqvist Leonardsen, Odd Martin Vallersnes, Magnus Hjortdahl","doi":"10.3399/BJGPO.2025.0101","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0101","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED) crowding is a growing challenge, highlighting the need for safe and effective prehospital alternatives to hospital conveyance.</p><p><strong>Aim: </strong>To investigate how a GP-staffed emergency primary care response unit (EPCRU) affects resource allocation and patient pathways.</p><p><strong>Design & setting: </strong>A prospective observational study conducted in two Norwegian municipalities served by a GP-staffed EPCRU.</p><p><strong>Method: </strong>All missions (<i>n</i> = 2950) performed by the EPCRU from April 1, 2023, to March 31, 2024, were included. Data on dispatch origin, triage (telephone and on-site), reason for dispatch, level of care, and participating services were analysed.</p><p><strong>Results: </strong>Most missions were categorized as Acute (57.6%) by the call centre and comprised a broad spectrum of conditions and severities. The EPCRU was first on scene in 44.1% of cases. In total, 44.1% of patients were treated on-site without hospital conveyance. A mismatch was observed between telephone and on-site triage: 34.2% of Acute cases were triaged as Yellow by RETTS triage on scene. The EPCRU altered expected care trajectories compared to standard ambulance response by enabling both non-conveyance and direct Emergency Department admissions.</p><p><strong>Conclusion: </strong>A GP-staffed response unit may enhance resource efficiency, patient flow, and timely care-offering potential benefits for emergency systems facing growing demand.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765622","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":"Perceptions and practices of UK general practitioners towards youth vaping: a questionnaire-based study.","authors":"Elika Najafi, Devan Wasan, Yasmin Baker, Kristian Peters, Dhruv Vasooja, Maneth Warnapala, Mario Martínez-Jiménez","doi":"10.3399/BJGPO.2025.0080","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0080","url":null,"abstract":"<p><strong>Background: </strong>E-cigarette use among adolescents and young adults is a growing public health concern. General practitioners (GPs) play a critical role in addressing health behaviours, yet there's limited research on their perceptions and practices towards vaping in young people.</p><p><strong>Aim: </strong>This study aims to explore current perceptions and practices amongst GPs concerning vaping in young people.</p><p><strong>Design & setting: </strong>A quantitative approach was employed through an online, self-administered questionnaire. Respondents included both trainee and qualified GPs from across the UK.</p><p><strong>Method: </strong>The questionnaire consisted of Likert-scale and free-text questions, covering screening, counselling, and demographic information. Participants were recruited through newsletters and social media, with 284 responses collected from March to August 2024. Data was analysed using descriptive statistics. The Kruskal-Wallis test was used to assess for significant differences based on respondents' region of work or level of experience.</p><p><strong>Results: </strong>General practitioners rarely inquire about e-cigarette use (23.9%), despite 85.6% believing it's important to do so. Lack of time, relevance to the presenting complaint, and method for quantifying and documentation were cited as significant causes. Only 27.5% of GPs provide advice to e-cigarette users, likely due to low rates of confidence (12.3%). A lack of time, understanding of health effects, training, and availability of referral services were cited as causes. There were no significant variations in responses based on respondents' location or level of experience.</p><p><strong>Conclusion: </strong>GPs recognise the importance of youth vaping but face barriers to screening and counselling, indicating the need for change in guidelines and policy.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754655","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":"Uptake of video telehealth in general practice: an Australian whole-of-population analysis.","authors":"Danielle C Butler, Hsei Di Law, Christine Phillips, Kirsty A Douglas, Sally Hall Dykgraaf, Jason Agostino, Emily Banks, Rachel Freeman-Robinson, Jane Desborough, Alana Dougherty, Grace Joshy, Nina Lazarevic, Jennifer Welsh, Muhammad-Shahdaat Bin-Sayeed, Dan Chateau, Kay Soga, Anne Parkinson, Sue Trevenar, Rosemary J Korda","doi":"10.3399/BJGPO.2025.0011","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0011","url":null,"abstract":"<p><strong>Background: </strong>Video use remains low in primary care telehealth consultations. Little is known about patterns of use, or policy levers to promote video.</p><p><strong>Aim: </strong>To investigate use of video telehealth in Australian general practice under permanent telehealth arrangements post-COVID lockdowns, and during a policy change removing reimbursement for long telephone consultations.</p><p><strong>Setting/design: </strong>Whole-of-population analysis of 2022 national healthcare claims linked to 2021 census data.</p><p><strong>Method: </strong>We quantified: proportions of telehealth consultations by video, and of patients and GPs who used video for telehealth consultations; associations between video use and patient characteristics using Poisson regression, and video use in relation to policy changes using interrupted time-series analysis.</p><p><strong>Results: </strong>Of 38 million GP telehealth consultations in 2022, 5.1% were by video; 8.6% of patients and 62% of general practitioners who used telehealth had used video. Patients most likely to use video lived remotely, were frequent GP users, or had multiple health conditions, mental health conditions or dementia. Socioeconomic disadvantage was modestly associated with lower use of video. Over 2022, use of video for telehealth decreased for consultations (6.5% of consultations in January, 4.1% in December), patients (6.7%, 4.4%) and GPs (40%, 26%). Time-series analyses showed downward trends before removal of reimbursement for long telephone consultations, small step increases immediately following, and shallower negative trends thereafter.</p><p><strong>Conclusion: </strong>Use of video telehealth consultations in general practice in Australia is low and declining, more so for disadvantaged groups. Differential financial reimbursement of video and telephone consultations has not substantively increased video use in clinical practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754658","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":"Understanding collaborative working between GPs and community pharmacists - systematic review and thematic synthesis of qualitative studies.","authors":"Grace Kng Li Lin, Aleema Sardar, David N Blane","doi":"10.3399/BJGPO.2024.0203","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0203","url":null,"abstract":"<p><strong>Background: </strong>Collaborative working between General practitioners (GPs) and Community Pharmacists (CPs) has led to improvements in management of long-term conditions, and has strong policy backing, yet such joint working remains patchy and under-developed. Understanding the perspectives of GPs and CPs regarding collaboration provides insights for more sustainable collaborative practices.</p><p><strong>Aim: </strong>To understand the perspectives of GPs and community pharmacists concerning collaborative care practices, and to develop a framework of factors that influence this collaborative working relationship.</p><p><strong>Design & setting: </strong>A systematic review of qualitative studies.</p><p><strong>Method: </strong>Five databases were searched from inception to the 22^nd of April 2023 for qualitative studies exploring GP and CP views on collaborative care services. Articles were independently screened by two reviewers at title, abstract and full-text levels. Data extracted from eligible studies were analysed and synthesised thematically.</p><p><strong>Results: </strong>Thirty-six studies met the inclusion criteria. Four main themes were identified: 1) How pre-existing relationships influence mutual understanding of roles, 2) the impact of location and communication on relationship building, 3) analysis of perceived costs and benefits, and 4) the motivation to develop collaborative care practices.</p><p><strong>Conclusion: </strong>A complex interplay of factors influences GP and CP collaborative working, including pre-existing relationships, communication and mutual understanding, and the balance of costs and benefits to further develop these relationships. When planning future collaborative care practices, stakeholders must take the time and initiative to elucidate and understand these factors within their own unique healthcare setting to form lasting working relationships.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754657","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":"Remote vs. in-person consultations for acute cystitis: antibiotic treatment and clinical outcomes, a retrospective cohort study.","authors":"Lars Emil Aga Haugom, Knut Erik Emberland, Ingrid Keilegavlen Rebnord, Guri Rørtveit, Knut Eirik Ringheim Eliassen","doi":"10.3399/BJGPO.2025.0009","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0009","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic brought a surge of remote consultations in Norwegian primary care with unknown implications for antibiotic treatment and outcomes of acute cystitis.</p><p><strong>Aim: </strong>To examine whether there were differences in antibiotic treatment or repeat contacts for acute cystitis between remote and in-person consultations.</p><p><strong>Design & setting: </strong>Retrospective cohort study. For the 4-year period 2018-2021, we linked individual registry data on all contacts for cystitis by women aged 16 years and up in general practice and out-of-hours services in Norway with registry data on dispensed antibiotics.</p><p><strong>Method: </strong>Index consultations for cystitis episodes were identified when there had been no urinary tract infection related contacts or antibiotics dispensed at least two weeks before the consultation. We compared index remote vs. index in-person consultations by antibiotic treatment within three days and repeat contacts within 14 days. Remote consultations were defined as consultations by text, telephone or video.</p><p><strong>Results: </strong>Remote consultations for acute cystitis increased markedly, from 0.5% of acute cystitis consultations in 2018 to 15.2% in 2021. Index remote consultations were associated with more second line antibiotic treatment (adjusted relative risk (aRR) 1.05, 95% CI, 1.03 - 1.07, <i>P</i><0.001), and more repeat contacts (aRR 1.11, 95% CI, 1.09-1.13, <i>P</i><0.001) than in-person consultations.</p><p><strong>Conclusions: </strong>For acute cystitis, index remote consultations are associated with more second line antibiotic treatment and more repeat contacts. The unique time-period of the COVID-19 pandemic and the regular general practitioner scheme in Norwegian primary care must be considered when interpreting these findings.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754656","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":"Characteristics of patients with frequent contact with general practice: a retrospective study.","authors":"Jesper B Nielsen, Helene S Andersen","doi":"10.3399/BJGPO.2024.0195","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0195","url":null,"abstract":"<p><strong>Background: </strong>Frequent attenders (>11 annual contacts) use more resources than most other patients in general practice.</p><p><strong>Aim: </strong>To study what characterises frequent attenders in relation to age, sex, mode of contact (face to face, email, or phone), and patient contact (GP or GP staff).</p><p><strong>Design & setting: </strong>A retrospective analysis of Danish patient datasets in general practice.</p><p><strong>Method: </strong>We used patient data from 11 Danish GP clinics and 38 874 patients covering a 12-month period. Bivariate as well as regression analyses of patient data were used.</p><p><strong>Results: </strong>Frequent attenders exist in all age groups, but with different frequencies. In the age group 55-64 years, 25% of patients were frequent attenders, this increased to 33% in the next age decade from age 65-74 years and reached 48% among those aged ≥75 years. Frequent attenders have a different user pattern related to physical visits, phone consultations, or email consultations than other patients. In their contact to the GP clinic, the frequent attender is relatively more often in contact with the practice staff than a GP compared with other patients.</p><p><strong>Conclusion: </strong>Within our Danish patient population, 22% had >11 annual contacts to their GP clinic. These frequent attenders are in general terms characterised by being female, aged >65 years, having 20 annual contacts to the GP clinic, and having ≥10 diagnoses. For the entire patient population, the GP handles 36% of the patient contacts (64% by other staff members), and this percentage is lowest among frequent attenders. Email contact is used more often among frequent attenders than other patients.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745372","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":"Patients' reasons for declining a primary care trial online therapy: a mixed-methods study.","authors":"Fiona Fox, Debbie Tallon, Roz Shafran, Paul Lanham, Christopher Williams, Berry Jude, Nicola Wiles, David Kessler, Katrina Turner","doi":"10.3399/BJGPO.2024.0272","DOIUrl":"10.3399/BJGPO.2024.0272","url":null,"abstract":"<p><strong>Background: </strong>Integrating therapist-led sessions and cognitive behavioural therapy (CBT) materials within one online platform may be effective for people with depression. A trial evaluating this mode of delivering CBT is being conducted. To maximise future trial recruitment and understand patients' views of health interventions, it is important to explore reasons for declining to participate.</p><p><strong>Aim: </strong>To explore patients' reasons for declining to participate in a trial of integrated online CBT for depression.</p><p><strong>Design & setting: </strong>A mixed-methods study collecting data from patients via questionnaires and telephone interviews at three UK trial sites.</p><p><strong>Method: </strong>Individuals completed a short questionnaire about their reasons for not taking part in the trial. Telephone interviews further explored these reasons with a subgroup. Quantitative data were summarised using descriptive statistics. Qualitative interviews were analysed thematically.</p><p><strong>Results: </strong>Of 1799 patients who responded to an invitation to participate in the trial, 40.3% declined contact. The most common reasons were not wanting: to take part in research (<i>n</i> = 387); therapy provided online (<i>n</i> = 284); to receive CBT (<i>n</i> = 262). Qualitative interviews with 15 'decliners' highlighted that decisions related to perceptions of eligibility, previous experiences of CBT, and uncertainty about receiving CBT online. Personal circumstances, depressive symptoms, or other mental health issues were also barriers to participation.</p><p><strong>Conclusion: </strong>Reasons given by primary care patients for not taking part in a trial of integrated online CBT suggest that, at the point of recruitment, it is important to discuss the patient's perceptions of their eligibility and whether they would accept the intervention being evaluated.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030017","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":"Patterns and indications for quetiapine prescribing in Dutch primary care: a retrospective database study.","authors":"Büsra G Cinar, Suzanne A Ligthart, Hugo Ajm de Wit, Arnt Fa Schellekens, Hanneke Hwa Fleuren, Cornelis Kramers, Albert Batalla, Gerard A Kalkman","doi":"10.3399/BJGPO.2024.0219","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0219","url":null,"abstract":"<p><strong>Background: </strong>Quetiapine, an antipsychotic, is registered for schizophrenia, bipolar disorder, and as an add-on therapy for major depressive disorder. Its anxiolytic and sedative effects make it attractive for off-label uses like insomnia, despite cardiovascular and metabolic side effects. The global increase in quetiapine use over the past decade warrants an examination of its prescribing patterns, especially off-label.</p><p><strong>Aim: </strong>This study investigated quetiapine prescribing trends in Dutch primary care, with a focus on off-label use.</p><p><strong>Design & setting: </strong>A retrospective database study using national and regional prescribing data from the Netherlands.</p><p><strong>Method: </strong>National prescribing trends from 2003-2022 were analysed using data from the Drug Information Project database, focusing on the top 10 antipsychotics. Regional data from the Radboud University Medical Centre (UMC) Technology Centre Health Database provided detailed quetiapine prescribing patterns from 2012-2021, categorised by daily dose. Indications for quetiapine prescriptions from 2020-2022 were derived from the detailed Radboud UMC Technology Centre patient records, including free-text portions, with specific attention for use in sleep problems.</p><p><strong>Results: </strong>Antipsychotic use increased from 1510 to 2061 per 100 000 population from 2003-2022, largely due to a 13-fold increase in quetiapine (66 to 870 per 100 000 population). Detailed regional data revealed a 3.3-fold increase in quetiapine use from 2012-2021, particularly at doses <100 mg/day. Among new quetiapine users in 2020-2022 from a subset of practices, 76.6% were for off-label indications, and sleep problems were the primary reason for starting quetiapine in 46.9% of cases.</p><p><strong>Conclusion: </strong>Off-label quetiapine prescribing, particulary for sleep problems, is rising in the Netherlands, despite guideline warnings. Further research on the drivers and long-term effects of this practice is needed.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745373","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":"General practice specialty decision making: a system-level Australian qualitative study.","authors":"Faith R Yong, Priya Martin, Katharine A Wallis, Jordan Fox, Sneha Kirubakaran, Riitta L Partanen, Srinivas Kondalsamy-Chennakesavan, Matthew R McGrail","doi":"10.3399/BJGPO.2024.0218","DOIUrl":"10.3399/BJGPO.2024.0218","url":null,"abstract":"<p><strong>Background: </strong>Ensuring sufficient supply of GPs is critical for servicing increasing healthcare demands. Heightened by pandemic conditions, chronic shortages of GPs persist globally. While many factors reinforcing the choice of general practice as a specialty are known, system-level understanding of factors that influence GPs' career decision making during their medical training requires investigation.</p><p><strong>Aim: </strong>To explore the reasons for specialty choice through career selection narratives of recently registered Australian GPs, using a system-level perspective.</p><p><strong>Design & setting: </strong>Semi-structured interviews were selected for in-depth explorations of the rationale for choosing general practice as a specialty. Within Australia, medical specialty training choices are typically made after both university medical education and mandatory 1-2 year pre-vocational (hospital-based) training have been completed.</p><p><strong>Method: </strong>Interviews were conducted online with GPs who had completed all training in the last 10 years. De-identified and verified transcripts underwent participant checking. Deductive framework analysis, using career counselling constructs, and inductive thematic analysis were performed.</p><p><strong>Results: </strong>There were 25 participants. Career counselling constructs provided system-level understanding of GP specialty decision-making processes. Many participants highlighted that there were large gaps in information about a GP career throughout medical training. Overcoming negative medical narratives about general practice was necessary for most in choosing a GP career. However, positive experiences with GP communities or work gave insights into the broad flexibility of their person-specialty fit with general practice.</p><p><strong>Conclusion: </strong>GP work experiences and personal GP connections could counteract prominent negative narratives about GP careers. However, lack of systemic and regular exposure to GPs throughout medical training is a critical barrier that should be addressed through sustained policy and professional interventions.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469387","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}