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The PAPER Study (Prescribing Antidepressants in Primary care: Ethnic inequalities in tReatment): a study protocol. 论文研究(在初级保健处方抗抑郁药:治疗中的种族不平等)。研究方案。
IF 2
BJGP Open Pub Date : 2025-09-09 DOI: 10.3399/BJGPO.2024.0311
Lydia Poole, Amy Ronaldson, Hannah Frith, Paramjit Gill, Madiha Sajid, Rose Rickford, Andrea Martinez, Khaula Ali, Mel Ramasawmy
{"title":"The PAPER Study (Prescribing Antidepressants in Primary care: Ethnic inequalities in tReatment): a study protocol.","authors":"Lydia Poole, Amy Ronaldson, Hannah Frith, Paramjit Gill, Madiha Sajid, Rose Rickford, Andrea Martinez, Khaula Ali, Mel Ramasawmy","doi":"10.3399/BJGPO.2024.0311","DOIUrl":"10.3399/BJGPO.2024.0311","url":null,"abstract":"<p><strong>Background: </strong>South Asian people represent the largest minority ethnic group in the UK, but prior research has suggested unequal access to primary care and differences in antidepressant prescribing practices for these patients.</p><p><strong>Aim: </strong>To understand the treatment of depression in South Asian patients, with specific reference to factors affecting appropriate prescribing. The secondary aim is to understand the intersection between ethnicity, age, and financial deprivation within this context.</p><p><strong>Design & setting: </strong>A mixed-methods approach will be adopted, including primary and secondary analyses, to understand the ways in which inequalities may arise along the pathway from patient experience of symptoms to clinician decision to treat with antidepressants in UK primary care.</p><p><strong>Method: </strong>Two scoping reviews will inform our approach. Quantitative data analysis of UK Biobank will allow us to examine prevalence and heterogeneity in depressive symptoms, and antidepressant prescribing over time, stratified by ethnicity. Qualitative data will be generated through interviews and focus group discussions with patients and healthcare professionals to understand experiences of depression and document the depression management decision-making process.</p><p><strong>Conclusion: </strong>The PAPER study will produce clinically relevant findings to support the treatment and management of depression in primary care for South Asian patients. The dissemination plan will be informed by patient and public involvement (PPI) group members and engagement with stakeholders. Our main outputs will include a toolkit of resources for use in primary care as well as community-facing materials.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774551","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
Challenges in reducing the 10-item CARE measure to a two-item version: comparison of patients' preferences with psychometric evaluation in a cross-sectional survey in Scotland. 将10项CARE测量减少到两项版本的挑战:在苏格兰横断面调查中患者偏好与心理测量评估的比较。
IF 2
BJGP Open Pub Date : 2025-09-03 DOI: 10.3399/BJGPO.2025.0085
Lauren Ng, Kieran D Sweeney, Stewart W Mercer
{"title":"Challenges in reducing the 10-item CARE measure to a two-item version: comparison of patients' preferences with psychometric evaluation in a cross-sectional survey in Scotland.","authors":"Lauren Ng, Kieran D Sweeney, Stewart W Mercer","doi":"10.3399/BJGPO.2025.0085","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0085","url":null,"abstract":"<p><strong>Background: </strong>The Consultation and Relational Empathy (CARE) Measure is a widely used 10-item measure to assess patients' perceptions of physician empathy. Takahashi et al.'s (2022) recent study proposed a two-item version based on psychometric evaluation of survey responses, without considering patient preferences.</p><p><strong>Aim: </strong>To apply Takahashi et al's psychometric method to UK data, and compare findings with patients' preferences on the two most important items.</p><p><strong>Design and setting: </strong>In 2022, a cross-sectional postal survey of 6,291 Scottish adults was conducted.</p><p><strong>Method: </strong>Using Takahashi <i>et al</i>..'s method, psychometric evaluation compared correlations between all possible two-item combinations with the original 10-item CARE measure to identify the optimal two-item combination. Patients were also asked to select the two items they considered most important. Descriptive analysis examined the proportion of patients selecting each item, and level of agreement on the most popular two-item combination.</p><p><strong>Results: </strong>1053 (17%) of 6,291 patients responded. Psychometric evaluation identified items 6 (\"Showing care and compassion\") and 8 (\"Explaining things clearly\") as the optimal two-item combination (Cronbach's alpha=0.916, correlation=0.953). This differed from patient preferences, with items 3 (\"Really listening\") and 8 receiving the highest proportion of votes (19% and 17%, respectively). Preferences also varied by age, deprivation level, and consultation complexity. The most popular two-item combination (items 3 and 8) was selected by 10% of respondents, with 90% selecting other combinations.</p><p><strong>Conclusion: </strong>The psychometrically optimal two-item combination did not align with patient preferences. Given variation in patient preferences and low agreement, reducing the CARE Measure to two-items may be inadvisable.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993542","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
Has the new Scottish GP contract improved GPs' working lives in deprived areas? A secondary analysis of two cross-sectional national surveys of GPs' views in 2018 and 2023. 新的苏格兰全科医生合同是否改善了贫困地区全科医生的工作生活?对2018年和2023年两次全国全科医生观点横断面调查的二次分析。
IF 2
BJGP Open Pub Date : 2025-09-03 DOI: 10.3399/BJGPO.2025.0055
Lauren Ng, Carey J Lunan, Stewart W Mercer
{"title":"Has the new Scottish GP contract improved GPs' working lives in deprived areas? A secondary analysis of two cross-sectional national surveys of GPs' views in 2018 and 2023.","authors":"Lauren Ng, Carey J Lunan, Stewart W Mercer","doi":"10.3399/BJGPO.2025.0055","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0055","url":null,"abstract":"<p><strong>Background: </strong>The new 2018 Scottish GP contract aimed to reduce GP workload and address health inequalities in primary care.</p><p><strong>Aim: </strong>To compare the working life experiences of GPs working in affluent and deprived areas in 2023, and assess changes since 2018.</p><p><strong>Design & setting: </strong>Two postal surveys were conducted in 2018 (<i>n</i>=2465, 56% response rate) and 2023 (<i>n</i>=1378, 30% response rate), of all qualified GPs in Scotland.</p><p><strong>Method: </strong>Secondary analysis of GP working life experiences (job satisfaction, job pressures, negative and positive job attributes) in the most affluent and deprived quintiles. ANCOVA was used to adjust mean values for GP and practice characteristics that differed significantly between affluent and deprived settings.</p><p><strong>Results: </strong>In 2023, GPs in affluent areas reported lower job pressures (<i>P</i><0.001) and fewer negative job attributes (<i>P</i><0.001) than GPs in deprived areas in both unadjusted and adjusted analysis. Compared to 2018, GPs in affluent areas in 2023 reported significant improvements in job satisfaction, job pressures, and negative job attributes in unadjusted and adjusted analysis, and positive job attributes in adjusted analysis. In contrast, GPs in deprived areas reported a significant increase in job pressures, with no other changes in working life experiences.</p><p><strong>Conclusions: </strong>Since the implementation of the 2018 Scottish GP contract, stark contrasts continue to exist in the working life experiences of GPs in affluent areas compared with deprived areas. Targeted strategies are required to address the inverse care law in order to achieve the contract's intended goals.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993631","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
Distribution and quality of privately-funded general practices in England: a cross-sectional analysis. 英格兰私人资助的全科医疗的分布和质量:横断面分析。
IF 2
BJGP Open Pub Date : 2025-08-27 DOI: 10.3399/BJGPO.2025.0116
Joseph Hutchinson, Michael Anderson, Harriet Bullen, Zara Kurdo, Matt Sutton
{"title":"Distribution and quality of privately-funded general practices in England: a cross-sectional analysis.","authors":"Joseph Hutchinson, Michael Anderson, Harriet Bullen, Zara Kurdo, Matt Sutton","doi":"10.3399/BJGPO.2025.0116","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0116","url":null,"abstract":"<p><strong>Background: </strong>Public surveys indicate demand for privately-funded general practice services in England has increased. However, little is known regarding the number, location and quality of private general practices.</p><p><strong>Aim: </strong>To examine: 1) the geographical distribution of private general practices across England; 2) the relationships between access, continuity of care and funding of NHS general practices with nearby private practices; and 3) the quality ratings of NHS and private general practices.</p><p><strong>Design & setting: </strong>Cross-sectional analysis of NHS and private general practices in England as of April 2024.</p><p><strong>Method: </strong>We used the Care Quality Commission (CQC) Primary Medical Services Inspectorate to identify all private general practices in England. We used multilevel logistic regression to examine associations between NHS practice characteristics and the presence of a private general practice nearby. We then compared available CQC ratings.</p><p><strong>Results: </strong>As of April 2024, England had 358 private and 5,976 NHS practices. Private general practices are primarily in London and other urban areas. NHS practices with higher patient satisfaction with waits for appointments (odds ratio 1.08 (95% CI: 1.03-1.13)) and more GPs per 10,000 patients (1.04 (1.01-1.06)) were more likely to have a private practice nearby. There was no association with continuity of care or funding. Quality ratings were similar, although 44% of private practices were unrated by the CQC.</p><p><strong>Conclusion: </strong>Private general practices are more common in London, as well as areas with better access to NHS GPs. The growth in private general practices may have widened inequalities in access to primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972586","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
GPs' acceptability and feasibility for using point-of-care tests for cancer in primary care: a qualitative interview study. 全科医生在初级保健中使用即时癌症检测的可接受性和可行性:一项定性访谈研究。
IF 2
BJGP Open Pub Date : 2025-08-26 DOI: 10.3399/BJGPO.2024.0191
Anam A Ayaz-Shah, Richard D Neal, Kelly E Lloyd, Matthew J Thompson, Samuel G Smith
{"title":"GPs' acceptability and feasibility for using point-of-care tests for cancer in primary care: a qualitative interview study.","authors":"Anam A Ayaz-Shah, Richard D Neal, Kelly E Lloyd, Matthew J Thompson, Samuel G Smith","doi":"10.3399/BJGPO.2024.0191","DOIUrl":"10.3399/BJGPO.2024.0191","url":null,"abstract":"<p><strong>Background: </strong>Primary care is the first point of contact for patients with symptoms suspicious of cancer. The availability of reliable, rapid diagnostic cancer tests, at the 'point of care', have the potential to expedite diagnosis, and support timely management of patients.</p><p><strong>Aim: </strong>To explore the acceptability and feasibility of using point-of-care tests (POCTs) for detecting cancer among UK GPs, including barriers and facilitators to uptake.</p><p><strong>Design & setting: </strong>A qualitative semi-structured interview study with 32 UK GPs.</p><p><strong>Method: </strong>Online and telephone interviews guided by the theoretical framework of acceptability were conducted. The data were analysed inductively using framework analysis.</p><p><strong>Results: </strong>GPs found POCTs acceptable if they were accurate, well-designed, and supported by robust evidence. Funding for tests and implementation resources were crucial, with an expectation of remuneration for their time. GPs believed POCTs could improve patient triage, reduce secondary care referrals, and facilitate clearer communication of referral decisions with patients. Concerns included potential workload increase, and overtesting in patients. Facilitators for uptake included recommendations in guidelines, peer acceptance, and comprehensive training. However, low awareness of POCTs among GPs and slow innovation adoption within the NHS were considerable barriers.</p><p><strong>Conclusion: </strong>Most GPs welcome the use of POCTs for cancer detection in primary care; however, this will require substantial system-level changes. We highlight the relevant considerations and challenges that need to be addressed before uptake. This study also calls attention to wider innovation implementation issues that should be considered by GPs, test developers, policymakers, and stakeholders.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755060","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
Saline nasal irrigation for acute sinusitis (SNIFS II): a randomised controlled pilot trial with nested process evaluation. 盐水鼻冲洗治疗急性鼻窦炎(SNIFS II):一项随机对照试验,嵌套过程评估。
IF 2
BJGP Open Pub Date : 2025-08-26 DOI: 10.3399/BJGPO.2024.0307
Roderick P Venekamp, Ben Ainsworth, Tammy Thomas, Beth Stuart, Joanna Slodkowska-Barabasz, Fiona Mowbray, Christopher C Butler, Nick Francis, Samantha Richards-Hall, Anthony Harnden, Alastair D Hay, Claire Hopkins, Michael Moore, Lucy Yardley, Theo Jm Verheij, Shihua Zhu, Paul Little
{"title":"Saline nasal irrigation for acute sinusitis (SNIFS II): a randomised controlled pilot trial with nested process evaluation.","authors":"Roderick P Venekamp, Ben Ainsworth, Tammy Thomas, Beth Stuart, Joanna Slodkowska-Barabasz, Fiona Mowbray, Christopher C Butler, Nick Francis, Samantha Richards-Hall, Anthony Harnden, Alastair D Hay, Claire Hopkins, Michael Moore, Lucy Yardley, Theo Jm Verheij, Shihua Zhu, Paul Little","doi":"10.3399/BJGPO.2024.0307","DOIUrl":"10.3399/BJGPO.2024.0307","url":null,"abstract":"<p><strong>Background: </strong>Despite having marginal beneficial effects, antibiotics are routinely prescribed in adults with acute sinusitis. Alternative interventions for this common condition are urgently needed.</p><p><strong>Aim: </strong>To assess the feasibility and acceptability of saline nasal irrigation for acute sinusitis.</p><p><strong>Design & setting: </strong>Randomised controlled pilot trial with nested process evaluation in 24 English general practices between October 2019 and May 2021.</p><p><strong>Method: </strong>Participants were randomised to advice to high-volume hypertonic saline nasal irrigation with a delayed antibiotic prescription or usual care. Feasibility outcomes included recruitment and follow-up rates, adherence, and acceptability of the intervention.</p><p><strong>Results: </strong>Of those invited, <i>n</i> = 81/107 (76%) consented and were randomised (42 intervention, 39 usual care). Two participants were excluded owing to ineligibility. Antibiotic prescribing strategies were recorded at baseline for <i>n</i> = 79/79 (100%), with no or delayed antibiotics prescribed in 60% (<i>n</i> = 24/40) of the saline group versus 38% (<i>n</i> = 15/39) of the usual care group. At follow-up, 80% (<i>n</i> = 63/79) of participants recorded whether they consumed antibiotics or not. Among those from the intervention group who returned a symptom diary, 96% (<i>n</i> = 22/23) and 65% (<i>n</i> = 15/23) reported using saline nasal irrigation during the first and second week, respectively. Semi-structured interviews with 16 participants revealed that most were positive about trial participation and viewed saline nasal irrigation as acceptable, noting it as an alternative to antibiotics.</p><p><strong>Conclusion: </strong>Saline nasal irrigation is deemed acceptable for adults with acute sinusitis and a trial of such intervention is feasible. A large trial is warranted to assess the effectiveness of this intervention for this common condition.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754694","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
Physical activity support for people with heart failure: mixed-methods study protocol. 心力衰竭患者的身体活动支持:混合方法研究方案。
IF 2
BJGP Open Pub Date : 2025-08-26 DOI: 10.3399/BJGPO.2025.0030
Vincent Singh, John Percival, Olivia Skrobot, Rasha Okasheh, Rachel Johnson, Alyson L Huntley
{"title":"Physical activity support for people with heart failure: mixed-methods study protocol.","authors":"Vincent Singh, John Percival, Olivia Skrobot, Rasha Okasheh, Rachel Johnson, Alyson L Huntley","doi":"10.3399/BJGPO.2025.0030","DOIUrl":"10.3399/BJGPO.2025.0030","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is a common condition affecting 1-2 in every hundred adults in the UK and one in six people aged over 85 years. Physical activity is important for people with heart failure (PWHF) as it can increase exercise capacity and is shown to improve quality of life. We know that PWHF often seek advice from healthcare professionals about participating in physical activity safely, but healthcare professionals are not always sure what physical activity advice is best for their patients. It is also important to understand what physical activity services are available for healthcare professionals to refer patients to and to explore how patients are referred into these physical activity services.</p><p><strong>Aim: </strong>To explore the barriers and enablers to primary and community healthcare professionals (GPs and nurses) referring PWHF to community physical activity services.</p><p><strong>Design & setting: </strong>A mixed-methods study will be conducted across GP practices in England.</p><p><strong>Method: </strong>The following approaches will be used: i) in-depth qualitative interviews with GPs (<i>n</i> = 12) and nurses (<i>n</i> = 12) to understand their experiences of talking to PWHF about referral to physical activity services; ii) finding out what commissioned physical activity services are available to PWHF, and how primary and community healthcare professionals can refer patients to the services; iii) two workshops to examine the findings with our stakeholders.</p><p><strong>Conclusion: </strong>The findings will be used to inform the development of an intervention for healthcare professionals referring to physical activity services and support the community service configuration.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754565","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
Patients' acceptance of a penicillin allergy de-labelling programme in primary care: a qualitative study. 患者在初级保健中接受青霉素过敏去标签规划的情况。
IF 2
BJGP Open Pub Date : 2025-08-26 DOI: 10.3399/BJGPO.2024.0136
Marta Santillo, Caity Roleston, Kelsey Armitage, Catherine Porter, Joanne Fielding, Marta Wanat, Shadia Ahmed, Sinisa Savic, Christopher Butler, Sue Pavitt, Jonathan Sandoe, Sarah Tonkin-Crine
{"title":"Patients' acceptance of a penicillin allergy de-labelling programme in primary care: a qualitative study.","authors":"Marta Santillo, Caity Roleston, Kelsey Armitage, Catherine Porter, Joanne Fielding, Marta Wanat, Shadia Ahmed, Sinisa Savic, Christopher Butler, Sue Pavitt, Jonathan Sandoe, Sarah Tonkin-Crine","doi":"10.3399/BJGPO.2024.0136","DOIUrl":"10.3399/BJGPO.2024.0136","url":null,"abstract":"<p><strong>Background: </strong>About 6% of the UK general practice population has a record of a penicillin allergy but fewer than 10% of these people are likely to be truly allergic. Consequently, a significant portion of the population is denied first-line antibiotics. The ALlergy AntiBiotics And Microbial resistAnce (ALABAMA) trial aimed to determine if a penicillin allergy assessment pathway (PAAP) was safe and effective in de-labelling patients as allergic and improving antibiotic prescribing and patient health outcomes.</p><p><strong>Aim: </strong>To investigate patients' experiences of penicillin allergy testing (PAT) and their acceptance of de-labelling following a negative allergy test.</p><p><strong>Design & setting: </strong>This was a qualitative study using semi-structured interviews with patients who took part in the PAAP intervention arm of the ALABAMA trial.</p><p><strong>Method: </strong>As part of a mixed-methods process evaluation embedded in the ALABAMA trial, we conducted interviews with patients in the PAAP intervention arm. Data from interviews with patients were analysed using thematic analysis.</p><p><strong>Results: </strong>Of the 28 participants interviewed, two received a positive PAT result and 26 received a negative PAT result; of these, 24 accepted and two declined de-labelling. At point of trial recruitment, many patients already doubted that they were allergic to penicillin. Patients were happy to attend PAT and felt cared for and safe at the hospital. These factors led to most people trusting their negative test result and accepting de-labelling.</p><p><strong>Conclusion: </strong>The patients we interviewed engaged with the PAAP intervention and, when testing negative, were predominantly willing to have their allergy record changed and to take penicillin in future. We highlight factors that influenced patients' acceptance of de-labelling to facilitate future adoption of PAAP. These factors, which should be considered when planning for penicillin allergy testing services, were as follows: patients identifying themselves as low risk before the test; PAT being perceived as trustworthy and safe; patients' previous experience of penicillin allergy and reactions; patients' understanding of penicillin reactions; and clear communication after de-labelling.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765201","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
The role of reflexivity in exploring exclusion in GP training: a qualitative study of GP educators. 反身性在全科医生培训排他性探索中的作用:对全科医生教育者的定性研究。
IF 2
BJGP Open Pub Date : 2025-08-22 DOI: 10.3399/BJGPO.2025.0036
Frances Wedgwood, Simon Bailey, Nagina Khan
{"title":"The role of reflexivity in exploring exclusion in GP training: a qualitative study of GP educators.","authors":"Frances Wedgwood, Simon Bailey, Nagina Khan","doi":"10.3399/BJGPO.2025.0036","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0036","url":null,"abstract":"<p><strong>Background: </strong>Reflexivity is an under-researched concept in Primary Care education and educators receive no formal training in reflexivity. Evidence from other disciplines suggests that reflexivity can promote patient safety and inclusivity, making it a potentially valuable tool in medical training.</p><p><strong>Aim: </strong>To examine the use of reflexivity in GP training and how it can be used to explore experiences of exclusion.</p><p><strong>Design & setting: </strong>A qualitative analysis of GP educators' perspectives in London and SE England.</p><p><strong>Method: </strong>Fourteen primary care educators were recruited. Focus groups and semi-structured interviews were conducted. Participants' opinions of reflexivity were explored, focussing on their own reflexivity, and that of their learners and the medical faculty. Data were transcribed verbatim and thematically analysed.</p><p><strong>Results: </strong>Three key themes were identified<b>:</b> the value of reflexivity; revealing unfairness through reflexivity; tokenistic reflection vs creative reflexivity.</p><p><strong>Conclusion: </strong>This study indicates GP educators are not familiar with the concept of reflexivity but are keen to consider how it could impact their learners. Moreover, the research demonstrated how issues of diversity, inclusion and exclusion are brought to light through reflexive practice, and how this affects International Medical Graduates learners. The participants identified a lack of organisational reflexivity as a significant factor affecting inclusion and differential attainment, and it was suggested there was an \"inverse education law.\" The educators called for more diverse leadership, less tokenistic reflection and more reflexive and creative learning tools to address this.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972567","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
Between-practice variation in chronic obstructive pulmonary disease diagnosis guideline compliance: database study. 慢性阻塞性肺疾病诊断指南依从性的临床差异:数据库研究。
IF 2
BJGP Open Pub Date : 2025-08-22 DOI: 10.3399/BJGPO.2024.0263
Alex Bottle, Alex Adamson, Benedict Hayhoe, Jennifer K Quint
{"title":"Between-practice variation in chronic obstructive pulmonary disease diagnosis guideline compliance: database study.","authors":"Alex Bottle, Alex Adamson, Benedict Hayhoe, Jennifer K Quint","doi":"10.3399/BJGPO.2024.0263","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0263","url":null,"abstract":"<p><strong>Background: </strong>Early chronic obstructive pulmonary disease (COPD) diagnosis is vital, but little is known about compliance with relevant diagnostic guidelines or variation in primary care.</p><p><strong>Aim: </strong>To quantify between-practice variations in guideline compliance and over time.</p><p><strong>Design & setting: </strong>observational study in English primary care.</p><p><strong>Method: </strong>The Clinical Practice Research Datalink was used to assess the use of four pre-diagnostic investigations (spirometry, chest X-ray, FBC and BMI) by GP practices for patients with COPD recorded first in primary care, in three time periods: 2006-7 (cohort 1), 2016-7 (cohort 2), and Mar-Aug 2020 (cohort 3). Multilevel logistic regression models quantified the non-random variation between GP practices in spirometry around diagnosis. Funnel plots counted the proportion of outliers.</p><p><strong>Results: </strong>Cohort totals were 31 676 (cohort 1), 37 393 (cohort 2) and 3368 (cohort 3). Overall, the mean age was 68.3 years (SD 12.0), with 47.3% female. The use of pre-diagnosis spirometry improved a little in cohort 2 (74.2%) on cohort 1 (62.8%) but fell back for the COVID-era group (61.1%). In contrast, chest X-ray, FBC and BMI all improved after cohort 1 and were maintained for the COVID cohort; almost all patients received one of these. The proportion receiving all four before diagnosis jumped from 26.6% in cohort 1% to 46.7% in cohort 2 and was maintained in cohort 3 (43.0%). Modelling and funnel plots showed considerable non-random variation in spirometry use by practice, though with some improvement since cohort 1.</p><p><strong>Conclusions: </strong>The recording of spirometry and chest X-rays warrants further and consistent improvement.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972583","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}
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