BJGP Open最新文献

{"title":"Optimising HbA1c monitoring intervals in patients with type 2 diabetes based on glycaemic control status: a target trial emulation study.","authors":"Boyuan Wang, Emily Tsui Yee Tse, Shugang Li, Hao Wu, Celine Sze Ling Chui, Cindy Lo Kuen Lam, Eric Yuk Fai Wan","doi":"10.3399/BJGPO.2025.0020","DOIUrl":"10.3399/BJGPO.2025.0020","url":null,"abstract":"<p><strong>Background: </strong>The appropriate glycated haemoglobin (HbA1c) monitoring intervals for patients with type 2 diabetes mellitus (T2DM) remain unclear.</p><p><strong>Aim: </strong>To determine appropriate HbA1c monitoring intervals for patients with T2DM across different glycaemic control categories.</p><p><strong>Design & setting: </strong>A target trial emulation study using electronic health records obtained from the Hospital Authority of Hong Kong and death records from the Hong Kong Government Death Registry.</p><p><strong>Method: </strong>Adult patients who had T2DM between 2009 and 2012 were identified and grouped by baseline HbA1c levels as follows: <7.0% (<53 mmol/mol), 7.0%-7.9% (53-63 mmol/mol), 8.0%-8.9% (64-74 mmol/mol), and ≥9.0% (≥75 mmol/mol). A pre-specified target trial was emulated for each group to evaluate the impact of various HbA1c monitoring intervals on the risk of all-cause mortality and cardiovascular disease (CVD). For HbA1c <7.0%, the following intervals were compared: every 2-4 months, 5-8 months, 9-15 months, and 16-24 months. For HbA1c ≥7.0%, comparisons were made between intervals of 2-4 months, 5-8 months, and 9-24 months. Follow-up continued until the earliest occurrence of the outcome, death, or 31 December 2021.</p><p><strong>Results: </strong>The cohort comprised 183 078 patients. For those with HbA1c <7.0%, extending the HbA1c monitoring interval to every 16-24 months was not associated with higher risks of the assessed outcomes compared with intervals of 2-4 months. Among patients with baseline HbA1c 7.0%-7.9%, 9-24-month monitoring intervals versus 2-4-month intervals was associated with higher mortality risk: hazard ratio (HR) 1.10, 95% confidence interval (CI) = 1.05 to 1.15. Moreover, for those with HbA1c ≥8.0%, when compared with monitoring at 2-4-month intervals, monitoring every 5-8 months was associated with higher risk of mortality (HbA1c 8.0%-8.9%: HR 1.10, 95% CI = 1.04 to 1.16; HbA1c ≥9.0%: HR 1.25, 95% CI = 1.18 to 1.33). The corresponding HRs for CVD were 1.04 (95% CI = 0.98 to 1.10) and 1.09 (95% CI = 1.02 to 1.17), respectively.</p><p><strong>Conclusion: </strong>For patients with T2DM and HbA1c <7.0%, monitoring can be extended to 1.5-2 years. For those with HbA1c 7.0%-7.9% and ≥8.0%, recommended intervals are 6 months and 3 months, respectively.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439072","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 sensitivity of decision support tools for identifying patients with pancreatic cancer: an observational study.","authors":"Rachel E Neale, Susan J Jordan, Bridie Thompson, Christina M Bernardes, Judi Adams, Christopher Baggoley, Savio George Barreto, Catherine M Baxter, Daniel Croagh, Benedict Devereaux, Jon Emery, Louisa G Collins, Rajit Gilhotra, Paul Grogan, Luke Hourigan, Javiera Martinez-Gutierrez, Andrew J Metz, Stephen Philcox, Meena Rafiq, Joel Rhee, Silja Schrader, Michelle Stewart, John Windsor, John Zalcberg, Mary Waterhouse","doi":"10.3399/BJGPO.2025.0142","DOIUrl":"10.3399/BJGPO.2025.0142","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer causes non-specific symptoms, potentially leading to delays in diagnosis. Decision support tools may help primary care practitioners to triage patients for pancreatic imaging.</p><p><strong>Aim: </strong>To investigate the sensitivity of three different tools for identifying patients who may have pancreatic cancer.</p><p><strong>Design & setting: </strong>An observational study in Australia.</p><p><strong>Method: </strong>We investigated the performance of the Risk Assessment Tool (RAT) for pancreatic cancer, the QCancer^® tool, and a tool developed through a consensus process led by QIMR Berghofer (the QPaC Tool). We applied these tools to people with pancreatic cancer who were interviewed about their symptoms on first presentation to a clinician. We designated patients as 'flagged' by each tool if they met specific criteria, and calculated the percentage flagged (that is, the sensitivity). Participants with jaundice were excluded from analyses of QCancer^®.</p><p><strong>Results: </strong>We included 190 participants in analyses of the RAT and QPaC Tool (142 in analyses of QCancer^®). The sensitivity of the QPaC Tool and the RAT were 54% and 27%, respectively. QCancer^® had a sensitivity of 14%, at a probability threshold of 1%; in the same 142 participants, QPaC and the RAT flagged 44% and 7%, respectively.</p><p><strong>Conclusion: </strong>The QPaC Tool was the most sensitive, largely owing to its inclusion of severe epigastric pain and emphasis on diabetes, but it has unknown specificity. More research is needed to determine whether any tool could reduce delays in diagnosis; in the interim, the QPaC Tool may support clinicians to consider pancreatic cancer in their differential diagnoses.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524172","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":"Insights into general practice research in The Netherlands and Germany: methodological challenges and suggestions.","authors":"Aida Bedri, Henk van der Worp, Imke Aits, Michael H Freitag, Marco H Blanker, Corinna Glasner","doi":"10.3399/BJGPO.2025.0274","DOIUrl":"10.3399/BJGPO.2025.0274","url":null,"abstract":"<p><strong>Background: </strong>We conducted research on the diagnosis and treatment of urinary tract infections in general practices in the Northern Dutch-German cross-border region. The challenges that were encountered in that study are discussed in this article, including prolonged formal ethical and legal processes, data collection, and recruitment of both general practitioners (GPs) and patients.</p><p><strong>Aim: </strong>To provide recommendations for those in the early stages of planning and conducting research in general practices.</p><p><strong>Design & setting: </strong>Opinion paper based on the authors' experience conducting a cross-border prospective study.</p><p><strong>Method: </strong>An overview of the strategies used to collect data and recruit participants is presented, along with their respective advantages and disadvantages.</p><p><strong>Results: </strong>GPs were recruited by post, email, and newsletters, with varying success rates depending on the region. Overall, personal approaches fared better, leading to increased willingness to participate in the study. Two different measures were used to collect data: students in The Netherlands and practice assistants in Germany. While using student assistants alleviated the constraints associated with study participation for a general practice, their limited availability disrupted the continuity of data collection phases. Instructing practice assistants to collect data independently enhanced flexibility regarding patient recruitment, but the authors' experience revealed that this approach was more prone to errors, likely as a result of heavy workloads. Designating a contact person within the practice facilitated communication between the practice and the researchers, providing reminders for ongoing study recruitment.</p><p><strong>Conclusion: </strong>With research in general practice becoming increasingly important, it is necessary to illustrate and understand its barriers and facilitators. Data collection strategies have to be carefully assessed and selected according to the specific needs of practices (such as flexibility and time constraints) to mitigate disruption of regular care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317638","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":"2026-10-21","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":"GPs' views about opioid management and tapering before hip or knee replacement surgery: a qualitative study.","authors":"Stephen Hughes, Jennifer Stevens, Justine Naylor, Asad Patanwala, Shania Liu, Jonathan Penm","doi":"10.3399/BJGPO.2025.0168","DOIUrl":"10.3399/BJGPO.2025.0168","url":null,"abstract":"<p><strong>Background: </strong>Total hip or knee replacement (arthroplasty) is common in ageing populations, as are prescribed opioids for osteoarthritis pain while awaiting such surgeries. Opioid-related harm can be minimised through pre-surgery tapering of opioids, yet the practice is uncommon.</p><p><strong>Aim: </strong>This research sought to understand GPs' understandings, beliefs, and support needs around managing patients' pain while awaiting surgery, use of opioids, and pre-surgery tapering.</p><p><strong>Design & setting: </strong>A qualitative study with GPs in Australia.</p><p><strong>Method: </strong>Semi-structured interviews were conducted. Data were transcribed, deidentified, and reflexively analysed inductively and thematically.</p><p><strong>Results: </strong>Analysis of transcript data from GP interviews (<i>n</i> =17) revealed little knowledge of, yet positive support for, pre-arthroplasty opioid tapering as a further way to minimise opioid harm. Three themes described were: 1) feeling challenged by pre-surgery pain management and opioid prescribing; 2) optimal pain management and tapering prevented by patient-related and system-level barriers; and 3) sharing workload and perceived risk - pharmacists could provide opioid management support.</p><p><strong>Conclusion: </strong>Realisation of potential opioid tapering benefits will require addressing some personal-, patient-, and system-level barriers revealed by this study. GPs view support from pharmacists as valuable and welcomed yet the required collaborative models appear, currently, underdeveloped between these primary care professions. Implementation research is a crucial next area of inquiry.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145669395","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' experiences of phosphatidylethanol in hypertension treatment in primary care: a qualitative study.","authors":"Åsa Thurfjell, Maria Hagströmer, Johanna Adami, Jan Hasselström, Lena Lundh","doi":"10.3399/BJGPO.2025.0201","DOIUrl":"10.3399/BJGPO.2025.0201","url":null,"abstract":"<p><strong>Background: </strong>Alcohol is not routinely addressed in the management of hypertension. The use of the alcohol biomarker phosphatidylethanol (PEth) is increasing in primary care but patients' experiences of PEth in primary care are unexplored.</p><p><strong>Aim: </strong>To investigate the experiences of patients regarding PEth in the treatment of hypertension in primary care, regardless of their alcohol consumption levels.</p><p><strong>Design & setting: </strong>Qualitative interview study with 13 patients, mean age 67 years, with hypertension (ICD-10 code I10.9), in Swedish primary care, 2023-2025.</p><p><strong>Method: </strong>Semi-structured individual interviews were conducted, audio-recorded, transcribed, and analysed with Grounded Theory.</p><p><strong>Results: </strong>The final theory 'double-layered insight' consists of two categories: 'personal concern and agency' and 'trusting the healthcare system to deliver'<i>.</i> Each category illustrates barriers to and facilitators of motivation to change alcohol-related behaviours. The two additional categories 'losing trust' and 'empowered by insight' describe the emotional responses emerging in relation to the identified barriers and facilitators. Patients viewed physicians as having the mandate to address alcohol use, despite its sensitivity. They valued PEth for its objectivity and emphasised the importance of transparency and non-judgemental, person-centred dialogue. Although PEth could evoke discomfort, it was generally seen as meaningful, despite some ambivalence about whether testing should be optional.</p><p><strong>Conclusion: </strong>The results indicate that the judicious use of PEth is perceived to be of importance in preventing adverse outcomes and promoting positive change. The results also indicate that actions of both the patient and the GP may have an impact on the patient's alcohol use aligning with person-centred care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366788","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":"Experiences of older Greek patients with limited English proficiency in general practice: a qualitative study.","authors":"Isabella Joy Papadopoulos, Grant Russell, Sharon Clifford, Chris Barton","doi":"10.3399/BJGPO.2025.0193","DOIUrl":"10.3399/BJGPO.2025.0193","url":null,"abstract":"<p><strong>Background: </strong>Older adults from culturally and linguistically diverse backgrounds often face communication barriers in general practice, which compromise care quality and patient safety. Limited English proficiency (LEP) is a key determinant of these barriers, yet little is known about how older patients with LEP experience communication from general practice.</p><p><strong>Aim: </strong>To identify the experiences and preferences for communication from Australian general practice by older Greek patients with LEP.</p><p><strong>Design & setting: </strong>An exploratory, qualitative, descriptive research design was used. The study took place in a Greek community club in south-east Melbourne, Australia.</p><p><strong>Method: </strong>Ten older Greek persons with LEP and two informal carers were interviewed in a mix of both English and Greek. Interviews lasted 20-45 minutes, were audio-recorded, transcribed verbatim, and translated to English. Data were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants described diverse experiences. The following three themes emerged: 1) perceptions towards, and knowledge of, participants' doctor's clinic; 2) experiences of communication from general practice clinics; and 3) preferences for communication from general practice and what drives them.</p><p><strong>Conclusion: </strong>The preferences and needs for communication from general practice clinics among this group were influenced by age and language-related factors. It is important to consider these factors when designing and implementing communication systems in general practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468417","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":"Barriers and enablers to engagement with green social prescribing in primary care: a scoping review using the socio-ecological model.","authors":"Helen Frost, Bruce Mason, Tricia R Tooman, Beth R Bareham, Lauren Ng, Holly Haines, Stella Arakelyan, Sue Lewis, Maria K Wolters, Katie Hawkins, Margaret E Ogden, Helen G Pain, Stewart W Mercer","doi":"10.3399/BJGPO.2026.0219","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0219","url":null,"abstract":"<p><strong>Background: </strong>Green social prescribing (GSP) connects individuals with nature-based interventions (NBIs) through healthcare providers, link workers, and social and community networks. While evidence supports the health benefits of NBIs, further research is needed to understand the factors that influence engagement.</p><p><strong>Aim: </strong>To explore barriers and enablers to GSP and NBIs for prescribers, service users and community providers.</p><p><strong>Design & setting: </strong>A scoping review in primary care and community settings.</p><p><strong>Method: </strong>We systematically searched Medline, Embase, CINAHL, Web of Science, and SCOPUS from 2019. We assessed quality using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. We mapped data to the socioecological framework during synthesis.</p><p><strong>Results: </strong>Out of 4864 screened records, 45 studies from 11 countries were included. GSP and NBIs face micro-level barriers such as knowledge gaps, cultural and social issues, time and cost constraints and perceptions of adverse weather; meso-level and macro-level challenges include unequal access, underfunded NBIs, an emphasis on biomedical models, safety concerns, limited training, and insufficient policy support and leadership. Engagement was enabled by flexible, person-centred approaches, tailored NBIs with clear pathways, including link workers, strong cross-sector partnerships, community co-design, and public health campaigns.</p><p><strong>Conclusion: </strong>Promoting engagement with GSP and NBIs requires a multi-level approach that addresses systemic barriers through collaboration between prescribers, third-sector organisations and policymakers. Investment in workforce training and sustainable funding models is critical to support long-term success in primary care and community settings. Addressing health inequalities by improving access for people in areas of high socioeconomic deprivation remains a priority.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229006","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 systematic review of the perspectives of adults with type 2 diabetes mellitus or prediabetes on behavioural weight management.","authors":"Shraboni Ghosal, Neil Heron, Kayleigh J Mason, Kelvin P Jordan","doi":"10.3399/BJGPO.2025.0291","DOIUrl":"10.3399/BJGPO.2025.0291","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a major global health concern. Weight management in T2DM and prediabetes can improve quality of life (QoL) and glycaemic parameters. People with T2DM or prediabetes experience threats and barriers regarding weight management but current evidence is lacking in this area.</p><p><strong>Aim: </strong>To determine experiences, perceptions, facilitators, and barriers related to weight management in people with T2DM and prediabetes.</p><p><strong>Design & setting: </strong>Systematic review in primary care settings.</p><p><strong>Method: </strong>A systematic search of 10 databases including MEDLINE, CINAHL Plus, and Scopus, and hand searching (2015-2025), generated 5315 qualitative and mixed-methods studies. We used Braun and Clarke's thematic analysis to synthesise data, and Critical Appraisal Skills Programme (CASP) tools and Hawker's quality assessment tool to assess study quality, risk of bias, and strength of evidence. The JBI (formerly known as the Joanna Briggs Institute) standards and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were adhered to, and findings were presented using narrative synthesis.</p><p><strong>Results: </strong>Thematic analysis of the article texts of 43 studies identified five overarching themes regarding success or failure of weight management in T2DM and prediabetes: (i) nutrition, diet, and exercise; (ii) patient and healthcare professional (HCP) experience and knowledge; (iii) perceptions and behaviours; (iv) challenges, threats, and barriers; and (v) roles and responsibilities. While facilitators for people with T2DM and prediabetes included better support, education, motivation, diet and/or exercise adherence, and access to care-facilitated weight management, threats or barriers included time constraints, social pressure, inequalities, language barriers, and stigma. Clinicians and other HCPs are perceived to be supportive in weight management and could help overcome threats or barriers in T2DM and prediabetes.</p><p><strong>Conclusion: </strong>Emergent evidence on weight management in type 2 diabetes mellitus (T2DM) and prediabetes indicates that stronger support and personalised approaches are essential. Tailoring programmes could improve weight management in T2DM and prediabetes. Future interventions should address inequalities, stigma, language barriers, and misinformation, and offer tailored advice on lifestyle, diet, and exercise, and improve resources for those with T2DM and prediabetes.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356865","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":"Impact of antibiotic side effects and allergies on patient adherence and attitudes: a mixed-methods study in England.","authors":"Liam Clayton, Catherine V Hayes, Luke O'Neill, Fionna Pursey, Libby Eastwood, Jonathan At Sandoe, Donna M Lecky","doi":"10.3399/BJGPO.2024.0288","DOIUrl":"10.3399/BJGPO.2024.0288","url":null,"abstract":"<p><strong>Background: </strong>The overuse and misuse of antibiotics significantly contributes to antimicrobial resistance (AMR). Adverse reactions to antibiotics are well documented, but their impact on patients' behaviours requires further exploration.</p><p><strong>Aim: </strong>To explore how side effects and allergies influence patients' behaviours around prescribed antibiotic use.</p><p><strong>Design & setting: </strong>A mixed-methods explanatory sequential study in England.</p><p><strong>Method: </strong>A survey of 1059 adults with prior experience of antibiotic side effects was conducted. Descriptive statistics identified common side effects and behavioural responses, while χ² tests explored demographic differences. Focus groups were held with 21 participants, recruited through a research panel. Thematic analysis captured deeper insight into participants' personal experiences.</p><p><strong>Results: </strong>Many antibiotic side effects were identified, presenting shortly after consumption and affecting several aspects of patients' lives. Approximately one-third of responders (31%, <i>n</i> = 325; 95% confidence interval [CI] = 28% to 34%) were unaware of potential side effects beforehand, citing inaccessible patient information leaflets and limited communication from healthcare professionals as barriers. Almost half (42%, <i>n</i> = 440; 95% CI = 39% to 45%) did not complete their antibiotic course following the side effects, with 32% (<i>n</i> = 142; 95% CI = 28% to 37%) stopping without medical advice. Many allergy diagnoses were made in childhood without follow-up assessments.</p><p><strong>Conclusion: </strong>Antibiotic side effects can significantly disrupt patients' lives and discourage appropriate use of antibiotics. Providing accessible information before prescribing may help manage expectations and support self-management of side effects. Patients with longstanding allergy labels should be encouraged to undergo reassessment to ensure that they are not contributing to AMR by unnecessarily avoiding the use of first-line antibiotics.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776074","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}