BJGP Open最新文献_第2页

Correction: Healthcare costs associated with short-acting β2-agonists in asthma: observational UK SABINA study. 更正：哮喘患者使用短效 β2-激动剂的相关医疗费用：英国 SABINA 观察性研究。

IF 2.5

BJGP Open Pub Date : 2024-08-22 DOI: 10.3399/BJGPO.2024.9997

引用次数: 0

Diagnostic information in GP referral letters to a memory clinic: a cohort study. 记忆诊所全科医生转诊信中的诊断信息：一项队列研究。

IF 2.5

BJGP Open Pub Date : 2024-08-21 DOI: 10.3399/BJGPO.2024.0065

Demi Ronner, Dorien Oostra, Jurgen Claassen, Edo Richard, Marieke Perry

{"title":"Diagnostic information in GP referral letters to a memory clinic: a cohort study.","authors":"Demi Ronner, Dorien Oostra, Jurgen Claassen, Edo Richard, Marieke Perry","doi":"10.3399/BJGPO.2024.0065","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0065","url":null,"abstract":"Background: Dementia diagnostics can often be performed in primary care, yet older persons with memory complaints are frequently referred to memory clinics (MCs).Aim: To compare diagnostic information in general practitioner (GP) referral letters of patients with and without an eventual dementia diagnosis.Design & setting: Retrospective cohort study in a Dutch academic geriatric MC.Method: We collected electronic health record (EHR) data of consecutive patients aged≥65 referred by their GP between 2016-2020. EHR data included patient characteristics, diagnostic information in referral letters, ancillary investigations performed at the MC, and established diagnoses. Chi-square tests were applied to compare groups.Results: Of 651 patients included, the average age was 78.0 (SD: 6.8), and 348 (53.5%) were diagnosed with dementia. Most people with dementia were diagnosed without ancillary investigations (235/348, 67.5%). In GP referral letters of people with dementia compared with people without dementia, a collateral history, any physical examination, a differential diagnosis including dementia, an MMSE score, interference with daily functioning, and decline from previous levels of functioning were mentioned more often. Furthermore, the more diagnostic criteria mentioned in the referral letter, the more often dementia was diagnosed at the MC (no criteria: 35.4%, one criterion: 47.3%, two criteria: 53.4%, three criteria: 69.9%, four or five criteria: 83.3%).Conclusion: GPs often correctly mention diagnostic information and dementia criteria in referral letters of people with dementia, and they are often diagnosed without ancillary investigations. This suggests that referral is often unnecessary, and GPs can be empowered to diagnose dementia themselves.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019039","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}

引用次数: 0

Characteristics of women on opioid substitution therapy in primary healthcare in Tshwane (South Africa): a retrospective observational study. 南非 Tshwane 初级医疗机构中接受阿片类药物替代疗法的妇女的特征：一项回顾性观察研究。

IF 2.5

BJGP Open Pub Date : 2024-08-21 DOI: 10.3399/BJGPO.2024.0049

Daniela S Goeieman, Robert Mash, Natasha R Gloeck, Andrew Scheibe

{"title":"Characteristics of women on opioid substitution therapy in primary healthcare in Tshwane (South Africa): a retrospective observational study.","authors":"Daniela S Goeieman, Robert Mash, Natasha R Gloeck, Andrew Scheibe","doi":"10.3399/BJGPO.2024.0049","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0049","url":null,"abstract":"Background: Women who use drugs face specific challenges compared to men, such as higher rates of HIV infection, unsafe injecting practices and intimate partner violence. However, this population's access to drug dependence treatment and gender-sensitive interventions remains limited, leading to unmet needs and increased vulnerability.Aim: To investigate the characteristics of and associations with retention in care among women on opioid substitution therapy (OST) in a community based primary care setting.Design & setting: A descriptive observational study within the Community Orientated Substance Use Programme in Tshwane, South Africa.Method: Data from 199 women (>18 years) on OST was extracted from an electronic database and paper-based files. Data was analysed descriptively, and inferential analysis looked for association of variables with retention on OST for≥6 months.Results: Majority of participants were unemployed, with 44.3% falling within the 20-29 years age range. During the initiation and course of OST, 39.2% of women experienced intimate partner violence, and 19.0% were pregnant. Retention on OST was significantly associated with increasing age at initiation (p=0.047), knowledge of HIV status (p=0.029), an increase in the ASSIST score (p=0.023), and methadone dose (p<0.001). Factors such as race, employment status, health system level, pregnancy, intimate partner using substances, intimate partner violence, route of administering opioids, and having tuberculosis and/or hepatitis C exposure did not show a significant relationship with retention on OST (p>0.05).Conclusion: This study reveals specific vulnerabilities in women receiving OST, emphasising the need for the integration of interventions to address reproductive health, violence mitigation, infectious disease and polydrug use into care.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019038","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}

引用次数: 0

MoCA use in general practice for the early detection of cognitive impairment. 在全科诊疗中使用 MoCA 早期检测认知障碍。

IF 2.5

BJGP Open Pub Date : 2024-08-21 DOI: 10.3399/BJGPO.2024.0039

Cassandre Carton, Matthieu Calafiore, Charles Cauet, Nassir Messaadi, Marc Bayen, David Wyts, Wassil Messaadi, Teddy Richebe, Sabine Bayen

{"title":"MoCA use in general practice for the early detection of cognitive impairment.","authors":"Cassandre Carton, Matthieu Calafiore, Charles Cauet, Nassir Messaadi, Marc Bayen, David Wyts, Wassil Messaadi, Teddy Richebe, Sabine Bayen","doi":"10.3399/BJGPO.2024.0039","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0039","url":null,"abstract":"Background: GPs can detect cognitive impairment at a very early stage, allowing early support for people and their caregivers. The early onset of cognitive impairment is between 50 and 60 years. Currently, in France, the Mini Mental State Examination remains the most used screening test, though it has a lower sensitivity and specificity than the Montreal Cognitive Assessment (MoCA) for detecting mild cognitive impairment, taking an average of 15 minutes to complete.Aim: To investigate the feasibility of the MoCA during routine consultations in general practice for the early detection of cognitive impairment and to determine prevalence of cognitive impairment in a primary care setting.Design & setting: A quantitative, prospective feasibility study was carried out in real-life working condition during routine consultation.Method: GPs performed MoCA on adults aged 50 years and older, without suspected or confirmed cognitive impairment.Results and conclusion: 61 GPs performed 221 MoCA with a mean duration of 8 minutes and detected mild neurocognitive impairment in 62% of patients. The MoCA is feasible and easy to perform during routine consultations in general practice by trained and experienced physicians.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019040","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}

引用次数: 0

Adapting the primary care assessment tool for sub-saharan Africa. 为撒哈拉以南非洲改编初级保健评估工具。

IF 2.5

BJGP Open Pub Date : 2024-08-21 DOI: 10.3399/BJGPO.2024.0084

Robert Mash, Kefilath Bello, Innocent K Besigye, Anna Galle

{"title":"Adapting the primary care assessment tool for sub-saharan Africa.","authors":"Robert Mash, Kefilath Bello, Innocent K Besigye, Anna Galle","doi":"10.3399/BJGPO.2024.0084","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0084","url":null,"abstract":"Background: The World Health Organization's (WHO) measurement framework for primary health care includes the core functions of primary care: first contact access, comprehensiveness, coordination, continuity, and person-centredness. The Primary Care Assessment Tool (PCAT), originally developed in the United States, was adapted for use by four African countries, and can measure the core functions of primary care.Aim: To face and content validate a sub-Saharan PCAT that measures the core functions of primary care.Design & setting: Twenty countries within the Primary Care and Family Medicine (PRIMAFAMED) network for sub-Saharan Africa participated in a validation study.Method: Two stages included a PRIMAFAMED workshop to assess face validity and a Delphi study to reach consensus on content validity amongst an expert panel as well as key stakeholders.Results: Thirteen countries participated in the workshop and suggested re-phrasing 39 items, deleting 6 and adding 4. Twenty countries participated in the Delphi and all panel members reached consensus (>70%) on including the items as written. Seven experts and stakeholders reviewed the PCAT and suggested re-phrasing 23 items, deleting 1 and adding 1. The final Sub-Saharan PCAT (PCAT-SSA) consists of 85 items that measure affiliation with the primary care facility, first contact access and utilisation, comprehensiveness, continuity, coordination, and person-centredness, as well as health, demographic and socio-economic status.Conclusions: The PCAT-SSA will now be piloted in Benin, Uganda, and South Africa. Further psychometric evaluation will be possible followed by more widespread use by researchers, district managers and policymakers in the region.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019037","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}

引用次数: 0

Use of the FebriDx point-of-care test for lower respiratory tract infections in primary care: a qualitative interview study. 在初级保健中使用 FebriDx® 下呼吸道感染护理点检测：一项定性访谈研究。

IF 2.5

BJGP Open Pub Date : 2024-08-20 DOI: 10.3399/BJGPO.2024.0024

Jill Rutter, Christopher R Wilcox, Nour Odeh, Ingrid Muller, Tristan W Clark, Paul Little, Firoza Davies, John McGavin, Nick Francis

{"title":"Use of the FebriDx point-of-care test for lower respiratory tract infections in primary care: a qualitative interview study.","authors":"Jill Rutter, Christopher R Wilcox, Nour Odeh, Ingrid Muller, Tristan W Clark, Paul Little, Firoza Davies, John McGavin, Nick Francis","doi":"10.3399/BJGPO.2024.0024","DOIUrl":"10.3399/BJGPO.2024.0024","url":null,"abstract":"Background: FebriDx is a single-use, analyser-free, point-of-care test with markers for bacterial (C-reactive protein [CRP]) and viral (myxovirus resistance protein A [MxA]) infection, measured on a finger-prick blood sample.Aim: As part of a larger feasibility study, we explored the views of healthcare professionals (HCPs) and patients on the use of FebriDx to safely reduce antibiotic prescriptions for lower respiratory tract infections (LRTIs) in primary care.Design & setting: Remote semi-structured qualitative interviews were conducted in South England.Method: In total, 22 individuals (12 patients who underwent FebriDx testing and 10 HCPs from general practices that conducted testing) participated in interviews, which were analysed thematically.Results: Patients and HCPs expressed positive views about use of the test. They felt FebriDx was a useful tool to inform prescribing decisions and provided a visual aid to support shared decision making and appropriate antibiotic use. Most felt it would be feasible to integrate use into routine primary care consultations. Some practical difficulties with blood collection and interpreting results, which impacted on usability, were identified. Some patients' reactions to negative test results suggested the need for better communication alongside use of the test.Conclusion: FebriDx was perceived as a useful tool to guide antibiotic prescribing and support shared decision making. Initial practical problems with testing and communicating results are potential barriers to use. Training and practice on using the test and effective communication are likely to be important elements in ensuring patient understanding and satisfaction, and successful adoption.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872460","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}

引用次数: 0

Utilization and consequences of CRP point-of-care-testing in primary care practices: a real-world multicentre observational study with 1,740 patient cases in Germany. 初级保健实践中 CRP 护理点检测的使用情况和后果：一项针对德国 1,740 例患者的真实世界多中心观察研究。

IF 2.5

BJGP Open Pub Date : 2024-08-19 DOI: 10.3399/BJGPO.2024.0120

Robby Markwart, Lena-Sophie Lehmann, Markus Krause, Paul Jung, Liliana Rost, Susanne Doepfmer, Lisa Kuempel, Doreen Kuschick, Kahina J Toutaoui, Christoph Heintze, Jutta Bleidorn, Florian Wolf

{"title":"Utilization and consequences of CRP point-of-care-testing in primary care practices: a real-world multicentre observational study with 1,740 patient cases in Germany.","authors":"Robby Markwart, Lena-Sophie Lehmann, Markus Krause, Paul Jung, Liliana Rost, Susanne Doepfmer, Lisa Kuempel, Doreen Kuschick, Kahina J Toutaoui, Christoph Heintze, Jutta Bleidorn, Florian Wolf","doi":"10.3399/BJGPO.2024.0120","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0120","url":null,"abstract":"Background: Point-of-care tests (POCTs) for C-reactive protein can support clinical decision-making of general practitioners (GPs) but are not widely used in German general practices.Aim: To investigate the utilization of semi-quantitative CRP-POCTs in routine primary care.Design & setting: Prospective observational study in 49 general practices in Germany (Nov/2022 to Apr/2023).Method: GPs were provided with CRP-POCTs and collected data for each CRP-POCT use using standardized data collection sheets.Results: Data from 1,740 CRP-POCT uses were recorded. GPs employed CRP-POCTs mainly for patients with respiratory tract infections (RTIs, 70.9% of all cases) and to a lesser extent for gastrointestinal infections (GIs, 10.3%). In RTIs, CRP-POCTs were frequently used to distinguish between bacterial and viral aetiology (60.8%) and to guide decisions on antibiotic prescribing (62.8%). In GIs, CRP-POCTs were mainly used to rule out severe disease progressions (53.2%) and for decisions on further diagnostic procedures (45.6%). In RTIs, CRP-POCTs influenced antibiotic prescribing in 77.5 % of the cases (32.3% in favour vs. 45.2% waiver). In GIs, CRP levels mainly affected decisions on further diagnostic procedures. GPs reported that CRP-POCTs were helpful in 88.6% of all cases.Conclusions: When available, German GPs predominantly use semi-quantitative CRP-POCTs to guide decisions on antibiotic prescribing in patients with RTI. CRP-POCT use improves clinical decision-making and increases the GPs' clinical confidence.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005496","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}

引用次数: 0

Adjusting primary-care funding by deprivation: a cross-sectional study of lower-super-output-areas in England. 按贫困程度调整初级保健资金：对英格兰较低产出地区的横断面研究。

IF 2.5

BJGP Open Pub Date : 2024-08-19 DOI: 10.3399/BJGPO.2024.0185

Ian Holdroyd, Cameron Appel, Efthalia Massou, John Ford

{"title":"Adjusting primary-care funding by deprivation: a cross-sectional study of lower-super-output-areas in England.","authors":"Ian Holdroyd, Cameron Appel, Efthalia Massou, John Ford","doi":"10.3399/BJGPO.2024.0185","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0185","url":null,"abstract":"Background: Previous research has called for General Practice (GP) funding to be adjusted by deprivation data. However, there is no evidence that this would better meet clinical need.Aim: We assessed 1. how accurately the capitation formula (Carr Hill), and total GP funding predicts clinical need and 2. whether adjusting by the Index of Multiple Deprivation score (IMD), improves accuracy.Design & setting: Cross-sectional analysis of 32 844 Lower-Super-Output-Areas in England in 2021-2022. Sensitivity analysis used data from 2015-2019.Method: Weighted average Carr-Hill Index (CHI), total GP funding and five measures of clinical need were calculated for each LSOA. For both CHI and total funding, four sets of generalised linear models were calculated for each outcome measure: unadjusted; Age-adjusted; IMD-adjusted; and age and IMD adjusted. Adjusted R2 assessed model accuracy.Results: In unadjusted models, CHI was a better predictor than total-funding of Combined Morbidity Index (CMI) (R2=49.81%,29.31% respectively), combined diagnosed and undiagnosed morbidity (R2=43.52%,21.9%), emergency admissions (R2=32.75%,16.95%). Total-funding was a better predictor than capitation of GP appointments per patient (R2=28.5%, 22.5% respectively) and age and sex standardised mortality rates (R2=0.42%,0.37%).. Adjusting for age and IMD improved all ten models (R2=62.2%,53.2%,48.6%,38.5%,40.5%, 32.8%, 29.1%,34.6%, 25.2%,25.2% respectively). All age and IMD adjusted models significantly outperformed age-adjusted models (p<0.001). Sensitivity analysis confirmed findings.Conclusion: Adjusting capitation or total-funding by IMD would increase funding efficiency, especially for long term outcomes, such as mortality. However, adjusting for IMD without age could have unwanted consequences.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005494","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}

引用次数: 0

Identifying impaired mental health in diabetes: a cross-sectional study in general practice. 识别糖尿病患者受损的心理健康：全科医学横断面研究。

IF 2.5

BJGP Open Pub Date : 2024-08-19 DOI: 10.3399/BJGPO.2024.0045

Line T Jakobsen, Anne Søjbjerg, Stinne E Rasmussen, Kaj S Christensen

{"title":"Identifying impaired mental health in diabetes: a cross-sectional study in general practice.","authors":"Line T Jakobsen, Anne Søjbjerg, Stinne E Rasmussen, Kaj S Christensen","doi":"10.3399/BJGPO.2024.0045","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0045","url":null,"abstract":"Background: Type two diabetes (T2D) is linked to impaired mental health. International guidelines emphasise the importance of including psychological aspects in diabetes care. Yet, no systematic approach has been implemented to assess mental health in patients with T2D in general practice.Aim: To evaluate the mental health of patients with T2D in general practice, and to investigate the effectiveness of asking patients about their well-being by using a single-item question compared to the WHO five-item Well-being Index (WHO-5).Design & setting: Cross-sectional study, including 230 patients with T2D in Danish general practice from 1 May 2023 to 31 January 2024.Method: Eligible patients were recruited at the annual chronic care consultation. They answered a single-item question on well-being and four validated measures of general well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), and diabetes distress (PAID-5).Results: Overall, 32% of patients expressed symptoms of impaired mental health. Notably, the WHO-5 identified 53% of these patients, whereas only 12% was identified through the single-item question. Importantly, among the patients exhibiting symptoms of impaired mental health, those identified by the WHO-5 displayed statistically significantly lower mental health scores across all measures (except PAID-5) compared to those not identified by the WHO-5.Conclusion: A significant proportion of patients with T2D in general practice are affected by mental health issues. Our findings indicate that a single-item question may not sufficiently detect these issues, highlighting the importance of incorporating tools like the WHO-5 to offer a more comprehensive approach in diabetes care.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005495","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}

引用次数: 0

Patient's perspectives of epilepsy care by specialists and generalists: qualitative evidence synthesis. 患者对专科医生和普通医生提供的癫痫护理的看法：定性证据综述。

IF 2.5

BJGP Open Pub Date : 2024-08-13 DOI: 10.3399/BJGPO.2024.0072

Charlotte L Cotterill, Andrew Booth, Jon M Dickson, Daniel Hind

{"title":"Patient's perspectives of epilepsy care by specialists and generalists: qualitative evidence synthesis.","authors":"Charlotte L Cotterill, Andrew Booth, Jon M Dickson, Daniel Hind","doi":"10.3399/BJGPO.2024.0072","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0072","url":null,"abstract":"Background: In the UK, epilepsy care involves both specialists (eg, neurologists) and generalists (eg, general practitioners). Policymakers typically consider that epilepsy care should be integrated and involve both specialists and generalists. However, few understand exactly how patients view and compare specialist and generalist care.Aim: This systematic review aimed to explore patient perspectives of specialist care and generalist care for epilepsy in a qualitative evidence synthesis.Design & setting: Systematic Review, qualitative evidence synthesis using an identified framework.Method: Systematic searches in 5 databases retrieved 17 eligible studies. Data was extracted and synthesised using framework analysis informed by the 'United Model of Generalism'.Results: Three themes were developed: 'Epilepsy care can be burdensome' (eg, through care fragmentation); 'Patient's experience is that care is not always accessible' (eg, lack of a continuum between standardised and interpretive care); 'How care could change for people with epilepsy' (eg, clinicians currently have insufficient time to deviate from protocol-driven care to address psychosocial needs). People with epilepsy frequently observe that generalists lack expertise in epilepsy management.Conclusions: This synthesis of patient experiences indicates recommendations should focus on improving communication and integration between specialists and generalists for epilepsy care. Patient experiences indicate specialist care risks being burdensome and generalist knowledge insufficient, requiring enhanced primary care clinician skills and improved awareness of patient psychosocial needs. The findings argue in favour of healthcare policies, materials and tools to continually support patient perspectives in developing epilepsy services.","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976865","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}

引用次数: 0