BJGP Open最新文献

{"title":"Effectiveness of the positive nursing practice environment promotion program in improving patient safety in primary health care: study protocol for a randomized controlled clinical trial.","authors":"Soraia Pereira, Eduardo Jf Santos, Cíntia S Fassarella, Olga Mpl Ribeiro","doi":"10.3399/BJGPO.2025.0025","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0025","url":null,"abstract":"<p><strong>Background: </strong>In the past decade, interest in researching nursing practice environments has significantly increased. Multiple studies have highlighted that enhancing these environments offer substantial benefits. A strong association has been established between the nursing practice environment and key factors such as professional satisfaction, safety climate, staff retention, and the quality and safety of care delivered.</p><p><strong>Aim: </strong>This randomized clinical trial aims to evaluate the effectiveness of the Positive Nursing Practice Environment Promotion Program in Improving Patient Safety in Primary Health Care DESIGN & SETTING: A randomized clinical trial will compare changes in nurses' perceptions of the safety climate and nursing practice environment in primary healthcare units. The sample will include at least 34 nurses participating in the program and currently working in primary healthcare units. The sociodemographic and professional characteristics of the participants will be analyzed, and stratified randomization will be conducted.</p><p><strong>Method: </strong>The intervention group will participate in the Program for Promoting Positive Nursing Practice Environments (PPAPEP), consisting of six training sessions, each lasting three hours. The program's goal is to empower nurses by providing knowledge about what constitutes a Positive Nursing Practice Environment and equipping them with tools to improve their practice environment. The outcomes of the intervention will be assessed both at the end of the program and three months after its conclusion.</p><p><strong>Conclusion: </strong>We anticipate that this study will provide valuable insights into the effectiveness of a capacity-building program targeted at nurses and its impact on their perceptions regarding the safety climate and nursing practice environment.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235455","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":"Efficacy of Orlistat in type 2 diabetes - a systematic review and meta analysis.","authors":"Shraboni Ghosal, Neil Heron, Kayleigh Mason, Kelvin Jordan","doi":"10.3399/BJGPO.2025.0058","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0058","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a common comorbidity of Type 2 Diabetes mellitus (T2DM), a chronic metabolic condition affecting millions worldwide. Orlistat may be used to reduce weight as an adjunct to diet/lifestyle changes.</p><p><strong>Aim: </strong>To assess the evidence of orlistat on weight loss in adults with T2DM/high risk of T2DM and obesity.</p><p><strong>Design & setting: </strong>Systematic review and meta-analysis of randomised controlled trials (RCTs) in clinical settings.</p><p><strong>Method: </strong>Articles were searched in ten databases including Medline, Embase and PsycInfo. RCTs of orlistat in adults with T2DM/at high risk and a body mass index (BMI)≥25 kg/m², with≥12 weeks of follow-up and reported change in weight/BMI were included. A random effects meta-analysis model was used to pool mean differences, <i>I²</i> statistics to assess heterogeneity, and a funnel plot to assess publication bias.</p><p><strong>Results: </strong>Thirty RCTs compared orlistat with a comparator, in conjunction with a weight loss diet. All trials showed statistically significant greater weight loss for the orlistat group. A meta-analysis of 22 studies (<i>n</i>=5,921) showed that the overall weight loss for orlistat was a mean 2.40 kg (95% CI: 2.08, 2.72) greater than in controls. Weight difference was statistically significant between subgroups at 3 months (2.74 kg, 95% CI: 1.20, 4.27), 6 months (2.13 kg, 95% CI: 1.61, 2.66) and 12 months (2.49 kg, 95% CI: 1.89, 3.09).</p><p><strong>Conclusions: </strong>Orlistat resulted in statistically significant greater weight loss in overweight adults with T2DM/high risk compared with controls. Orlistat can be considered an adjunct in T2DM/high risk of T2DM for weight loss along with diet/lifestyle modifications.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235456","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":"A UK-based semi-structured interview study exploring two-step and one-step urgent care telephone triage.","authors":"Vanashree Sexton, Jeremy Dale, Carol Bryce, Helen Atherton","doi":"10.3399/BJGPO.2024.0270","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0270","url":null,"abstract":"<p><strong>Background: </strong>There are two models of urgent care telephone triage in the UK: one-step triage that is conducted by a clinician, and two-step triage involving an initial triage by a non-clinical call advisor followed by a secondary clinician triage. Both models may involve digital triage (computerised decision support). Little is known about patient experiences of receiving two-step triage.</p><p><strong>Aim: </strong>We aimed to explore patients' and carers' experiences of two-step triage in relation to experiences of one-step triage.</p><p><strong>Design & setting: </strong>Semi-structured interviews were conducted with patients and carers that had undergone one-step or two-step urgent care triage in England or Northern Ireland.</p><p><strong>Method: </strong>Data were thematically analysed; Oben's conceptual framework of patient experience was used to interpret findings. Findings were reported in line with Standards for Reporting Qualitative Research (SPQR) framework.</p><p><strong>Results: </strong>25 patients/carers were interviewed. Complexity, delays and frustration were described in relation to two-step triage. Communication with non-clinicians was often experienced as scripted and inflexible, whilst communication with clinicians was described as more natural and empathetic. Reassurance experienced during triage enabled some patients to stay home without seeking further care.</p><p><strong>Conclusions: </strong>Minimising the complexity experienced by patients should be factored into planning two-step triage services. Further research should explore how digital triage can be adapted to promote more natural flow of communication and how empathetic communication during triage may enable self-care. Training for clinicians should emphasise such communication and the importance of giving sufficient time to patients during triage.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227012","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":"The impact of physician associates in primary care in the UK: a systematic review.","authors":"Susan Willacy, Umaiyal Ravindran, Oyinlola Oyebode","doi":"10.3399/BJGPO.2025.0026","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0026","url":null,"abstract":"<p><strong>Background: </strong>The UK healthcare system has a growing workforce crisis which is felt especially acutely in primary care. A prospective solution is the use of physician associates (PAs). In recent times, this has generated some controversy.</p><p><strong>Aim: </strong>There is a sparsity of synthesised evidence around the use of PAs in the UK, particularly their implementation in primary care. This review aims to look at the impact PAs have on workload, safety, efficacy and cost-effectiveness in delivering UK primary care.</p><p><strong>Design & setting: </strong>Systematic review of peer-reviewed literature including qualitative and quantitative studies of PAs in UK primary care PA.</p><p><strong>Method: </strong>Cochrane and PRISMA guidelines were followed. PubMed, EMBASE, The Cochrane Library, Web of Science and CINAHL were searched from 2011-2024. Covidence was used for data management. Narrative synthesis was performed based on the four primary aims.</p><p><strong>Results: </strong>16 studies were deemed to meet the inclusion criteria for data extraction and synthesis. 13 commented on workload, 8 commented on safety, 13 on efficacy and 8 studies discussed cost-effectiveness. Results showed that PAs were considered clinically safe but impacts on workload and efficacy were less clear. Cost-effectiveness assessment was limited by inability to calculate full costs or benefits.</p><p><strong>Conclusion: </strong>This review found that there is limited evidence available in the published literature to demonstrate the impact on PAs in primary care. While there were some positive studies, a clear need for further research was demonstrated. An additional pathway to explore, comparing PAs with the non-GP primary care workforce, was also noted.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227013","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":"'Stuck or unstable' - partnerships between GPs and patients with complex chronic conditions: A qualitative study.","authors":"Mads Aage Toft Kristensen, Mette Bech Risør, Andreas Søndergaard Heltberg, Tora Grauers Willadsen, Ann Dorrit Guassora","doi":"10.3399/BJGPO.2024.0146","DOIUrl":"10.3399/BJGPO.2024.0146","url":null,"abstract":"<p><strong>Background: </strong>In chronic care, patient-GP collaboration is essential, but might be challenging if patients have complex health problems because of multimorbidity, psychosocial predicaments, and addiction problems. To understand and manage these challenges, it is important to explore how patients and GPs attempt to collaborate, to maintain and achieve an alliance in order to gain good quality of care.</p><p><strong>Aim: </strong>To explore how dyads of GPs and patients, who GPs deem have complex health problems and difficulties following treatment, perceive and manage challenges in their chronic care partnership.</p><p><strong>Design & setting: </strong>This was a qualitative study from Danish general practice in deprived, rural areas.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with 12 dyads of GPs and patients with doctor-assessed complex chronic conditions and difficulties following treatment. The principles of systematic text condensation were used in the analysis.</p><p><strong>Results: </strong>Overall, the patient-GP collaboration could be characterised as either 'stuck' or 'unstable'. In both types, the challenges were identified as pointless consultations, conflicts about lifestyle, resignation, concealment of information, and hopelessness. These challenges could be managed by solving conflicts, adjusting to the patient's needs, accommodating the challenges in the relationship, and offering continued emotional support even with unsolved medical problems.</p><p><strong>Conclusion: </strong>Care of patients with complex health problems may present several challenges. In this study, patients and GPs experienced the relational dimension as crucial for collaboration. A robust therapeutic alliance, incorporating the patient's agenda, offers an essential foundation for enhancing care in individuals with complex health problems.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956291","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":"Diabetes complications in people with alcohol use disorder and type 2 diabetes.","authors":"Sarah Cook, Sonia Saxena, Rohini Mathur, Thomas Beaney, Shamini Gnani, Ana Luisa Neves, Arti Maini, Ravi Parekh, Kate Walters, David Osborn, Jennifer K Quint","doi":"10.3399/BJGPO.2024.0133","DOIUrl":"10.3399/BJGPO.2024.0133","url":null,"abstract":"<p><strong>Background: </strong>People living with alcohol use disorder (AUD) who develop type 2 diabetes (T2DM) may be at higher risk of diabetes complications.</p><p><strong>Aim: </strong>Our aim was to compare diabetes monitoring and incidence of diabetes complications between people with and without AUD prior to T2DM diagnosis attending primary care in England.</p><p><strong>Design & setting: </strong>We used the Clinical Practice Research Datalink Aurum linked with Hospital Episode Statistics and Office for National Statistics mortality data. The target population was people with incident T2DM diagnosed between 2004 and 2019.</p><p><strong>Method: </strong>We defined AUD from codes indicating i) clinical diagnosis; ii) alcohol withdrawal; or iii) chronic alcohol-related harm. Outcomes were end-stage renal disease (ESRD), lower limb amputation, myocardial infarction (MI), stroke, cardiovascular disease (CVD) mortality, and all-cause mortality. We compared yearly HbA1c, creatinine, and cholesterol monitoring activities for the first 5 years post T2DM diagnosis.</p><p><strong>Results: </strong>The study population was 543 509 people, of whom 15 237 (2.8%) had a code for AUD. Adjusting for measured confounders, people with AUD had higher rates of ESRD ( incidence rate ratio [IRR] 1.95, 95% confidence intervals [CI] = 1.71 to 2.23), lower limb amputation (IRR 1.78, 95% CI = 1.50 to 2.21), stroke (IRR 1.36, 95% CI = 1.25 to 1.47), CVD mortality (IRR 1.74, 95% CI = 1.63 to 1.86), and all-cause mortality (IRR 2.10, 95% CI = 2.04 to 2.17) but not MI (IRR 0.91, 95% CI = 0.82 to 1.00) compared with people without AUD. Laboratory diabetes monitoring was high in people with (83.5-91.1%) and without (83.7-92.4%) AUD.</p><p><strong>Conclusion: </strong>People with AUD had nearly double the rates of most of the diabetes complications investigated compared with people without AUD.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013406","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":"'The doctors were more knowledgeable about what I had': patient views on the value of point-of-care tests for managing respiratory infections. A qualitative study in European primary care.","authors":"Marta Wanat, Melanie Eugenie Hoste, Marilena Anastasaki, Femke Böhmer, Annelies Colliers, Maria Gkamaletsou, Christin Löffler, Christos Lionis, Lile Malania, Mala Shah, Anja Wollny, Akke Vellinga, Christopher C Butler, Alike W van der Velden, Sibyl Anthierens, Sarah Tonkin-Crine","doi":"10.3399/BJGPO.2024.0139","DOIUrl":"10.3399/BJGPO.2024.0139","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care tests (POCT) can support diagnosis of patients with community-acquired acute respiratory tract infections (CA-RTI) in primary care and thereby reduce uncertainty whether antibiotics may benefit patients. However, successful roll out of POCTs need to be built on a deep understanding of patients' perspectives on the place of POCTs in patient-centred care.</p><p><strong>Aim: </strong>To explore patients' perceptions of the value of POCTs during consultations for CA-RTI.</p><p><strong>Design & setting: </strong>A qualitative study using semi-structured interviews in Belgium, Republic of Ireland, Georgia, Germany, Greece, and the UK with patients who consulted for CA-RTI in primary care.</p><p><strong>Method: </strong>Interviews were audio recorded, transcribed, and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Interviews with 56 participants revealed that in the process of a GP making a diagnosis and treatment decision, patients valued several components, such as a physical examination, their GP enquiring about and listening to concerns, and a POCT. Yet, the visibility and relative importance of each of these components varied in the four main ways in which patients perceived the value of POCTs, including 1) test as objective evidence compared to 'subjective' clinical judgment; 2) test as providing more precision; 3) test as inferior to clinical judgment; 4) test as one of the tools in the GP's toolbox.</p><p><strong>Conclusion: </strong>The wide variation in patient perceptions about POCT for CA-RTI underscores the importance of recognising patient preferences regarding the diagnostic process. This understanding is important to ensure that POCT results optimally influence treatment decision-making, patient satisfaction, and acceptance of their care plan.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773255","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":"Healthcare users' evaluations of general practice: a survey among Danish men aged 45-70 years.","authors":"Søren Birkeland, Sören Möller","doi":"10.3399/BJGPO.2024.0153","DOIUrl":"10.3399/BJGPO.2024.0153","url":null,"abstract":"<p><strong>Background: </strong>Knowledge about healthcare users' evaluations of general practice is relatively limited.</p><p><strong>Aim: </strong>We aimed to investigate Danish men's evaluations of general practice health care and different aspects of GPs' communication with patients.</p><p><strong>Design & setting: </strong>Secondary analyses of data from a web-based survey of 6756 Danish men aged 45-70 years.</p><p><strong>Method: </strong>We used municipality-level information from registries, self-reported sociodemographic data, personality characteristics, and 5-point Likert scale evaluations of health care and communication in general practice. Comparisons were made between groups using multivariable linear regression.</p><p><strong>Results: </strong>The response rate was 28%. A large majority of participants agreed or strongly agreed that their GP treatment had been 'almost perfect', with slightly fewer responding that their GP was good at showing consideration for them. The latter item was, however, reversed, making comparisons difficult and all differences were small. Older healthcare users evaluated health care higher than did younger healthcare users; higher scores on the extraversion, agreeableness, and conscientiousness personality dimensions generally were associated with higher evaluation scores, whereas the opposite tended to be true for responders with higher neuroticism scores. When not controlling for multiplicity, participants in rural areas tended to evaluate the explanation of medical procedures with lower scores; participants with cerebrovascular disease and those residing in higher tax income areas tended to evaluate GP care less positively in general.</p><p><strong>Conclusion: </strong>Despite an overall high evaluation of GP care, evaluations may vary, including among different groups of healthcare users.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928420","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":"Could a behaviour change intervention be used to address under-recognition of work-related asthma in primary care? A systematic review.","authors":"Gareth Iestyn Walters, Harriet Foley, Christopher Charles Huntley, Anadil Naveed, Kimberley Nettleton, Christopher Reilly, Maximillian Thomas, Claire Walker, Kyrie Wheeler","doi":"10.3399/BJGPO.2024.0094","DOIUrl":"10.3399/BJGPO.2024.0094","url":null,"abstract":"<p><strong>Background: </strong>Work-related asthma (WRA) is prevalent yet under-recognised in UK primary care.</p><p><strong>Aim: </strong>To identify behaviour change interventions (BCIs) intended for use in primary care to identify WRA, or any other chronic disease (that could be adapted for use in WRA).</p><p><strong>Design & setting: </strong>A systematic review was conducted using narrative synthesis.</p><p><strong>Method: </strong>We searched Cochrane Central Register of Controlled Trials, Embase, PsycINFO, and Ovid MEDLINE databases (1946-2023) for studies describing development and/or evaluation of BCIs for case finding any chronic disease in primary care settings, aimed at either healthcare professionals and/or patients. Two blinded, independent reviewers screened abstracts and assessed full-text articles. We undertook narrative synthesis for outcomes of usability and effectiveness, and for BCI development processes.</p><p><strong>Results: </strong>We included 14 studies from 768 retrieved citations, comprising three randomised controlled trials, one uncontrolled experimental study, and 10 studies employing recognised multi-step behaviour change (BC) methodologies. None of the studies were concerned with identification of asthma. BCIs had been developed for facilitating screening programmes (five studies), implementing guidelines (three studies), and individual case finding (six studies). Five studies measured effectiveness, in terms of screening adherence rates, pre- or post-intervention competency, and satisfaction and usability, for clinicians, although none measured diagnostic rates.</p><p><strong>Conclusion: </strong>No single or multi-component BCIs have been developed specifically to aid identification of asthma or WRA, although other chronic diseases have been targeted. Development has used BC methodologies that involved gathering data from a range of sources, and developing content specific to defined at-risk populations, so are not immediately transferable. Such methodologies could be used similarly to develop a primary care-based BCI for WRA.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683011","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":"Cardiovascular risk estimation and statin adherence: a historical cohort study protocol.","authors":"Samuel Finnikin, Brian Willis, Rani Khatib, Tim Evans, Tom Marshall","doi":"10.3399/BJGPO.2024.0258","DOIUrl":"10.3399/BJGPO.2024.0258","url":null,"abstract":"<p><strong>Background: </strong>Adherence to statins for the primary prevention of cardiovascular disease (CVD) is low. There is evidence that some facets of the initiation consultation, or the initiating clinician, are associated with adherence. CVD risk estimation is fundamental to statin initiation and shared decision making (SDM), because the benefits of statins are proportional to CVD risk. Absence of a recorded CVD score before statin initiation therefore indicates that SDM is unlikely.</p><p><strong>Aim: </strong>To investigate whether SDM, using the CVD risk score as a proxy measure, is associated with adherence to statins and CVD outcomes.</p><p><strong>Design & setting: </strong>A retrospective cohort study using a database of English primary care records.</p><p><strong>Method: </strong>The cohort will include statin-naïve patients aged 40-84 years initiated on statins for primary prevention between 2017 and 2020, categorised by the presence or absence of a CVD risk score at statin initiation. Statin adherence and persistence will be determined from subsequent statin prescriptions. Multivariable modelling, accounting for potential confounders, will determine the association between a recorded CVD risk score and subsequent statin adherence and with statin persistence. A secondary analysis will investigate the relationship to subsequent CVD outcomes and death.</p><p><strong>Conclusion: </strong>This research uses a record of CVD risk score as a proxy for SDM, to investigate the link between SDM and medication adherence. It will shed light on the relationship between how the initiation consultation is performed and subsequent adherence and persistence with treatment.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773256","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}