BJGP Open最新文献

{"title":"Association between overweight and obesity and the frequency of general practice consultations among children aged 2-17 years: a French retrospective cohort study.","authors":"Theo Christophe Duguet, Mikaël Dusenne, Thibaut Sabatier, Matthieu Schuers, Kim Bonello, Julie Chastang, Saldanha Gomes Cécilia","doi":"10.3399/BJGPO.2025.0178","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0178","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity and overweight are increasing, with consequences for children and for healthcare systems. Data on how a child's Body Mass Index (BMI) is associated with primary healthcare use in children remain limited, especially in France.</p><p><strong>Aim: </strong>Exploring the association between general practice (GP) consultation rates and children aged 2-17 years living with overweight or obesity.</p><p><strong>Design & setting: </strong>A retrospective cohort study (2012-2022) was created from the PRIMEGE database, including 205 757 consultations from 10 067 children. BMI categories (underweight, normal, overweight, obesity) followed International Obesity Task Force criteria. The outcome was the age-adjusted GP consultation rates.</p><p><strong>Method: </strong>Inter-individual comparisons of mean normalized consultation rates across BMI categories were performed using linear regression models. Intra-individual interrupted time-series analysis was conducted with a negative binomial and zero-inflated mixed model to estimate the Incidence Rate Ratio (IRR) following transitions from normal BMI to overweight BMI, and from overweight BMI to obesity BMI.</p><p><strong>Results: </strong>In inter-individual analyses, children with overweight/obesity BMI had significantly higher GP consultation rates than those with normal BMI. In intra-individual analyses, transitioning from normal BMI to overweight BMI was associated with an increase consultations rate (IRR=1.49; 95% CI [1.39;1.59]; <i>P</i><0.001), and the transition from overweight to obesity BMI was associated with an increase consultation rate (IRR=1.64; 95% CI [1.37;1.96]; <i>P</i><0.001).</p><p><strong>Conclusion: </strong>This study, with inter- and intra-individual analytical approaches, shows that increases in BMI categories are associated with higher GP consultation rates. These findings highlight the need for prevention and tailored care for children with excess weight, helping adapt healthcare systems to population needs.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115979","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":"Understandability of statin patient information leaflets in the UK: a mixed-methods cross-sectional evaluation.","authors":"Diya Rao, Jon M Dickson, Mia Sudbury, William Dixon, Lennie Mcshane, Adam J Noble","doi":"10.3399/BJGPO.2026.0143","DOIUrl":"10.3399/BJGPO.2026.0143","url":null,"abstract":"<p><strong>Background: </strong>Statins are the UK's most prescribed medicine and are used more in deprived populations. Patient Information Leaflets (PILs) included in medication packaging may support safe, effective use, but only if they are understandable. Guidance states PILs should have a reading age of ≤13 years, and regulators require that ≥80% of patients answer comprehension questions correctly on them when 'user tested'.</p><p><strong>Aim: </strong>To provide the first independent evaluation of the readability and comprehension of UK statin PILs.</p><p><strong>Design & setting: </strong><i>Study 1:</i> Cross-sectional analysis of the reading age of 39/40 of the UK's approved statin PILs.<i>Study 2:</i> Cross-sectional survey with a representative sample of 517 UK adults aged 40-74.</p><p><strong>Methods: </strong><i>Study 1:</i> Reading age was assessed using four readability formulas, with additional scores calculated after adjusting for potentially familiar technical terms.<i>Study 2:</i> Two PILs (atorvastatin [MSN] and rosuvastatin [Ranbaxy]) were randomly selected and user-tested with participants. They answered eight comprehension questions per PIL; responses were double-scored.</p><p><strong>Results: </strong><i>Study 1:</i> No PIL met the recommended reading age. Median reading age was 15.9 years (15.0 after adjustment). Atorvastatin PILs were least readable.<i>Study 2:</i> Key messages were poorly understood; for atorvastatin, 5/8 items met the≥80% criterion; for rosuvastatin, 2/8 met it. Key safety and use messages were frequently misunderstood.</p><p><strong>Conclusion: </strong>UK statin PILs do not meet recommended readability or comprehension standards and are likely to be difficult to understand for many users. Improving clarity and usability is essential to support equitable understanding and safe, informed long-term statin use.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456936","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":"Testing a structured end-of-life care approach in Danish general practice settings: a cohort study.","authors":"Matilde Alida Arendt Eriksen, Dorte Melgaard, Morten Breinholt Søvsø, Janus Laust Thomsen, Morten Sig Ager Jensen, Anne Lund Krarup","doi":"10.3399/BJGPO.2025.0258","DOIUrl":"10.3399/BJGPO.2025.0258","url":null,"abstract":"<p><strong>Background: </strong>The Acute Basic Palliation Concept (ABPC) - a structured end-of-life (EoL) care model - has shown increased quality of EoL care when used in hospital settings.</p><p><strong>Aim: </strong>To measure if the use of the ABPC could increase symptom relief and user satisfaction when applied in general practice.</p><p><strong>Design & setting: </strong>This cohort study was conducted across nine general practices in Northern Denmark with 29 GPs, as well as 10 representatives from the regional out-of-hours GP service.</p><p><strong>Method: </strong>GPs received training in an adapted ABPC and subsequently reported on patient cases managed both with and without the concept. Data on symptom control and satisfaction were collected via questionnaires from relatives, municipal caregivers, and GPs.</p><p><strong>Results: </strong>A total of 74 EoL care trajectories were included in the analysis, with 51% managed using the structured concept. The mean patient age was 84 ±8.9 years; 46% were female. The median duration from EoL care initiation to death was 3.0 (interquartile range 2.0-7.0) days. When using the concept, symptom control increased for pain (97% versus 83%), agitation (93% versus 56%), and discomfort (93% versus 81%; all <i>P</i><0.05). Shortness of breath was less frequent, with a trend toward improved symptom relief using the concept (81% versus 54%). Most staff were willing to use the concept again (90% GPs and 100% municipal nurses).</p><p><strong>Conclusion: </strong>The structured ABPC model facilitated adequate symptom management and was widely accepted among GPs and municipal nurses, demonstrating promising potential for EoL care in a general practice setting.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054091","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":"Realist evaluation of multiprofessional advanced practice in primary care (REMAP): a study protocol.","authors":"Rachel King, Stefanie Williamson, Pauline Anne Nelson, Rachael Finn, Damian Hodgson, Caroline Mitchell, Julian Barratt, Michelle Horspool, Tabassum Aaishah Javeed, Emily Wood","doi":"10.3399/BJGPO.2025.0272","DOIUrl":"10.3399/BJGPO.2025.0272","url":null,"abstract":"<p><strong>Background: </strong>The introduction of advanced practitioners (APs) is one approach to addressing health and care workforce shortages, with around 6000 APs working in primary care in England. There is variation in implementation, regulation, and scope of the role, and limited knowledge on implications of their implementation on workforce organisation, staff, and patients. There is a pressing need for research to understand what works in advanced practice implementation, for whom and in which contexts.</p><p><strong>Aim: </strong>To understand the contexts and mechanisms that influence key outcomes in the implementation of multiprofessional advanced practice in primary care in England and develop recommendations to support workforce development.</p><p><strong>Design & setting: </strong>A realist evaluation using mixed methods across four work packages in primary care in England, incorporating research with advanced practice workforce leads, APs, key primary care staff (clinical and management), and patients and carers.</p><p><strong>Method: </strong>The following approaches will be taken: (i) semi-structured interviews with advanced practice workforce leads in England to inform the development of an initial programme theory (IPT) (<i>n</i> = 15); (ii) online survey of APs in England to refine IPT (<i>n</i>>300); (iii) case studies in five GP practices in England, interviewing staff members (<i>n</i> = 10), conducting interviews or focus groups with patients (<i>n</i> = 5), and gathering documentary data (to test and modify the IPT); (iv) stakeholder workshops to share findings and develop policy and practice recommendations.</p><p><strong>Conclusion: </strong>Findings will be used to inform recommendations for the implementation of advanced practice in primary care, to support workforce development, enhance patient experience, and improve health outcomes.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133211","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":"Rapid point-of-care testing for urinary tract infections: diagnostic accuracy and clinical impact.","authors":"Robby Markwart, Timo Jung, Thiên-Trí Lâm, Florian Wolf, Jutta Bleidorn, Felix Kannapin, Guido Schmiemann, Ildikó Gágyor, Peter Kurotschka","doi":"10.3399/BJGPO.2026.0044","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0044","url":null,"abstract":"<p><strong>Background: </strong>The PA-100 AST system (Sysmex®) is a point-of-care test (POCT) that tests for bacteria in urine samples using a fixed threshold and performs antimicrobial susceptibility testing (AST) within 45 minutes.</p><p><strong>Aim: </strong>To evaluate the diagnostic accuracy and perceived clinical utility of the PA-100 AST for diagnosing uncomplicated urinary tract infection (uUTI) in people assigned female at birth.</p><p><strong>Design & setting: </strong>Prospective multicentre diagnostic accuracy study in four primary care practices in Germany.</p><p><strong>Method: </strong>Urine samples from adult female patients with uUTI symptoms were tested using the PA-100 AST (index test) and standard laboratory urine culture (reference standard). General practitioners reported the perceived clinical utility.</p><p><strong>Results: </strong>Data from 109 patients (median age 59 years, interquartile range: 43 - 72) were analysed. Bacteriuria prevalence was 63%. For bacterial detection, sensitivity was 86% (95% CI 67-88) and specificity 80% (95% CI 63-93). Positive and negative predictive values were 88% (95% CI 80-96) and 76% (95% CI 46-77), respectively. For AST, overall categorical agreement across uUTI antibiotics was 84% for ciprofloxacin, 87% for fosfomycin, 94% for trimethoprim and 95% for nitrofurantoin. The overall sensitivity for identifying non-susceptible pathogens was 74% (11/15), but was particularly low for ciprofloxacin (40%, 2/5). Among the 15 resistant isolates, the PA-100 AST misclassified four (27%) as susceptible. GPs reported that results influenced prescribing in 25% of consultations, equally split between initiating antibiotics after initially withholding (\"step-up\") and withholding after initially considering treatment (\"step-down\"). GPs reported that using the PA-100 AST improved communication, increased diagnostic confidence, and that the test could be readily integrated into routine workflow.</p><p><strong>Conclusion: </strong>The PA-100 AST showed moderate diagnostic accuracy and may support management of suspected uUTI in primary care. However, its relatively low negative predictive value observed in our study population limits its ability to rule out bacteriuria. The test had a modest impact on prescribing decisions but further research is needed to determine its effectiveness in optimizing antibiotic use.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018060","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 practitioners' perspectives on implementing a self-management mobile application for musculoskeletal pain.","authors":"Eva Seerup, Nina Sjørup Simonsen, Mette Terp Høybye, Cecilie Rud Butz, Rasmus Østergaard Nielsen, Julie Sandel Jacobsen, Michael Skovdal Rathleff, David Høyrup Christiansen","doi":"10.3399/BJGPO.2026.0089","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0089","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal conditions are common, and digital self-management tools are increasingly used to support general practice. General practitioners' perceptions of digital tools are key to implementation.</p><p><strong>Aim: </strong>To interpret how general practitioners (GPs) perceive and implement a self-management exercise app for musculoskeletal pain in general practice.</p><p><strong>Design & setting: </strong>Qualitative study using semi-structured interviews with nine Danish GPs.</p><p><strong>Method: </strong>Data were analysed using reflexive thematic analysis, enabling an iterative and interpretive engagement. Themes were developed abductively informed by the Theoretical Domains Framework, which was used as an analytical lens. The analysis explored how GPs perceived the clinical value and usability of the app, focusing on factors influencing implementation.</p><p><strong>Results: </strong>GPs use of the app was influenced by the perceived compatibility with clinical workflow and clinical responsibility. Facilitators included trust in the app's quality, user-friendliness, and peer endorsement. The app was perceived as useful in remote or financially limited settings. Barriers included increased workload, limited time and familiarity. Implementation was shaped by time pressures and intuitive judgements of patients' digital literacy and adherence to exercise. The app was used as a supplementary tool, and implementation reflected pragmatic clinical reasoning rather than system-level objectives.</p><p><strong>Conclusion: </strong>Successful implementation of mHealth tools depends not only on usability but also on GPs' confidence in the quality and clinical value of the solution. A clearly defined purpose aligned with system-level objectives is essential for embedding mHealth tools as an alternative in routine care pathways rather than leaving their use to individual clinical purpose and judgement.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920404","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 quantitative analysis of resident composition within GP training practices across the UK.","authors":"Laura Jayne Emery, Michael Bride, Eleanor Hoverd, Geoff Wong, Sophie Park","doi":"10.3399/BJGPO.2026.0215","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0215","url":null,"abstract":"<p><strong>Background: </strong>Increasing workload in primary care has prompted an increase in general practice (GP) training places. These additional places have historically been filled by international medical graduates (IMGs); in 2025 52% of UK GP residents were IMGs. However, disparities in allocation to training practice may disadvantage IMGs thereby causing problems in training progression.</p><p><strong>Aim: </strong>To analyse the allocation of residents to GP training practices across the UK to determine whether this varies with socio-economic deprivation.</p><p><strong>Design & setting: </strong>A quantitative analysis of data obtained from freedom of information (FOI) requests to UK bodies governing GP training.</p><p><strong>Method: </strong>Main outcome is composition of residents within training practice; classified as IMG-only, UK medical graduate (UKMG) -only or mixed. Variable of interest is Index of Multiple Deprivation (IMD) quintile.</p><p><strong>Results: </strong>We observed a 23% increase in number of UK GP training practices from 2020-2025. In this time, composition of residents shifted from predominantly UKMG-only to more mixed and IMG-only practices. Number of training practices serving the most deprived communities varied; 15% in England to 34% in Northern Ireland (NI). In England, Scotland and NI, IMG-only training practices were significantly more likely to be in areas of higher deprivation than UKMG-only practices. Prevalence of diabetes and COPD were higher in IMG-only compared to UKMG-only practices.</p><p><strong>Conclusion: </strong>Findings highlight the substantial contribution of IMGs to the UK primary care workforce from 2020-2025; however, we must acknowledge and address disparities in the allocation of GP training placements and further investigate impact on resident progression.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913606","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":"Examining variation in general practice consultation frequencies for older adults: a nationwide register study.","authors":"Jonas Korsholm Olsen, Sonja Wehberg, Frans Boch Waldorff, Daniel Pilsgaard Henriksen, Jesper Lykkegaard","doi":"10.3399/BJGPO.2025.0113","DOIUrl":"10.3399/BJGPO.2025.0113","url":null,"abstract":"<p><strong>Background: </strong>In the Danish healthcare system, primary care for the growing population of older adults is provided by around 1600 independently owned general practices with a high degree of autonomy in service delivery.</p><p><strong>Aim: </strong>To investigate practice-level variation in consultation frequencies for older adults in Denmark and its association with practice-level factors, after adjustment for patient characteristics.</p><p><strong>Design & setting: </strong>Register-based nationwide cohort study of all Danish residents aged ≥75 years listed with a general practice in 2017-2021.</p><p><strong>Method: </strong>The practices' consultation frequencies were analysed using zero-inflated Poisson regression adjusted for patient population factors. Funnel plots assessed variation in consultations. Multinomial logistic regression was used for analysing associations between practice factors and exhibiting systematic variation in consultation frequency.</p><p><strong>Results: </strong>In 2017, the study included 468 679 older adults, rising to 569 457 in 2021. In 2021, the average consultation frequency was 10, comprising 3.7 face to face, 3.3 telephone, 2.2 email, 0.61 home visit, and 0.38 chronic care review consultations. After adjusting for the practices' patient population, 4%-9% of general practices showed greater variation in consultation frequency than could be explained by chance. No practice-level factors - number of GPs, their age, sex, or years since specialist qualification - were associated with providing more consultations than expected.</p><p><strong>Conclusion: </strong>The systematic variation in consultation frequencies between practices is notable. Further studies should explore the potential consequences for patients registered with a general practice exhibiting consultation frequencies that differ significantly from other practices beyond what could be explained by chance.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114547","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":"Checklists for emergencies in general practice: participatory design of a quick reference handbook.","authors":"Helen Higham, Anne Maloney, Paul Robert Greig, Elizabeth Shawcross, Phil Harbord, Rosie Warren, James Thomas","doi":"10.3399/BJGPO.2025.0268","DOIUrl":"10.3399/BJGPO.2025.0268","url":null,"abstract":"<p><strong>Background: </strong>Emergency presentations in general practice are increasing, yet teams may go months without managing one. Cognitive aids, such as checklists, improve in-hospital emergency care, but existing tools are poorly suited to general practice.</p><p><strong>Aim: </strong>To identify common emergency presentations in general practice and co-design bespoke checklists for safer management.</p><p><strong>Design & setting: </strong>Participatory design of general practice-specific emergency checklists and usability testing in real clinical settings with multidisciplinary general practice teams.</p><p><strong>Method: </strong>A multidisciplinary expert group used a mixed-methods participatory methodology to prioritise emergencies and develop checklists for a GP Quick Reference Handbook (GP-QRH). In-situ simulations in 29 general practices informed iterative refinement of checklist content, layout, and usability.</p><p><strong>Results: </strong>The final GP-QRH comprised 15 clinical emergency checklists, one checklist for non-clinical staff, a structured handover template, and emergency debrief guidance. Testing the final version in 11 general practices was uniformly positive and emphasised the importance of simple design, clear language, prominent prompts for escalation, and team training in checklist use.</p><p><strong>Conclusion: </strong>We have developed the first QRH for general practice specifically tailored to primary care, co-designed with intended users. Its impact will depend on commitment to consistent use, local leadership, and advocacy across GP networks. Further usability testing, evaluation of clinical impact, and development of additional checklists are needed, but the GP-QRH has the potential to enhance emergency care and patient safety in UK general practice and internationally.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012592","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":"Mapping quality indicators for primary Care-Based palliative care: a systematic review.","authors":"Vanessa Cunha, Rahat Sidhu, Karla Gonzalez Pallares, Marina Englesakis, Vilma A Tripodoro, Jose Pereira, Shrikant Atreya, Megan Doherty, Katherine Rouleau, Kirsten Wentlandt","doi":"10.3399/BJGPO.2026.0229","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0229","url":null,"abstract":"<p><strong>Background: </strong>Integrating palliative care into primary care is increasingly recognised as essential for people with life-limiting illness, yet the relevance of existing palliative care quality indicators (QIs) to primary care remains unclear.</p><p><strong>Aim: </strong>To identify, map, and appraise quality indicators (Qis) relevant to palliative care delivered in primary care.</p><p><strong>Design & setting: </strong>Systematic review of studies describing QIs applicable to primary care-based palliative care.</p><p><strong>Method: </strong>We searched MEDLINE, Embase, Cochrane databases, and Global Index Medicus (inception to July 2024). Eligible studies described QIs relevant to both palliative care and primary care. Indicators were classified using Donabedian's framework, mapped to National Consensus Project Palliative Care domains and the WHO Primary Health Care (PHC) Measurement and Improvement Framework, and appraised using the Appraisal of Indicators through Research and Evaluation instrument.</p><p><strong>Results: </strong>Twenty-two studies met inclusion criteria, yielding 381 relevant indicators. Most indicators focused on processes of care (64.8%), with fewer addressing structure (27.6%) and outcomes (7.6%). Palliative care indicators were concentrated in PHC domains related to continuity, coordination, person-centredness, and effectiveness. Psychosocial, spiritual, and cultural domains were sparsely represented. PHC structural system elements, including governance and population health approaches, were minimally captured. Methodological quality was highest for clarity of purpose, but variable for stakeholder involvement (28-94%) and low for implementation guidance (17-65%).</p><p><strong>Conclusion: </strong>Current palliative care QIs are predominantly focused on processes of care and may not fully reflect the breadth of primary care-based palliative care, particularly with respect to patient-centred outcomes and psychosocial, spiritual, and cultural domains. Further work is needed to develop and validate indicators that are specifically relevant to primary care practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913654","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}