BJGP Open最新文献

{"title":"Translating in-person care to telehealth: a secondary analysis of GP consultations on musculoskeletal conditions.","authors":"Yifu Li, Simon Chan, Lawrence Lu, Tim M Jackson, Hania Rahimi-Ardabili, Annie Ys Lau","doi":"10.3399/BJGPO.2024.0013","DOIUrl":"10.3399/BJGPO.2024.0013","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to a rapid transition to telehealth, particularly in general practice where continuous care for chronic conditions, such as musculoskeletal (MSK), is provided.</p><p><strong>Aim: </strong>To determine the appropriateness of telehealth for MSK conditions by identifying whether in-person tasks can be supported remotely via telehealth.</p><p><strong>Design & setting: </strong>This study is a secondary analysis of the Harnessing Resources from the Internet (HaRI) dataset. This dataset comprises of 281 videos of recorded GP consultations. The dataset includes 10 GPs, across eight separate clinics, and was collected during 2017 in the UK.</p><p><strong>Method: </strong>Content analysis was conducted to identify the clinical tasks, physical examinations, and physical artefacts used during the consultations. A scoring method applying two key metrics was developed to assess the translatability of clinical tasks to telehealth.</p><p><strong>Results: </strong>Across the 31 MSK consultations analysed, 12 clinical tasks, five physical examinations, and 12 physical artefacts were observed. Of clinical tasks, 17% (<i>n</i> = 2/12) were deemed to be 'easily translatable over telehealth' and 50% (<i>n</i> = 6/12) were deemed 'relatively easy to be translated over telehealth'. Only 17% (<i>n</i> = 2/12) of tasks were rated 'moderately translatable over telehealth', and 17% (<i>n</i> = 2/12) were deemed 'potentially translatable over telehealth'. No clinical tasks in this study were categorised as untranslatable to telehealth. The average telehealth translatability score was 7.1/10.</p><p><strong>Conclusion: </strong>Most clinical tasks observed during in-person GP consultations with patients with MSK conditions are translatable to telehealth. Further research is necessary to investigate the long-term efficacy and safety of telehealth utilisation for MSK conditions in primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082064","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":"Increasing engagement with liver disease management across the UK: a follow-up cross-sectional survey.","authors":"Helen Jarvis, Charlotte Berry, Jonathan Worsfold, Vanessa Hebditch, Stephen Ryder","doi":"10.3399/BJGPO.2024.0142","DOIUrl":"10.3399/BJGPO.2024.0142","url":null,"abstract":"<p><strong>Background: </strong>Liver disease is an increasing cause of premature mortality. Early detection of liver disease in primary care gives opportunity to intervene and change outcomes. Engagement in liver disease care by NHS bodies responsible for primary care pathway development could drive improvements. The formation of integrated care systems (ICS) in England provides an opportunity to reassess engagement with liver disease nationally.</p><p><strong>Aim: </strong>To update the level of engagement with community chronic liver disease management among ICSs and health authorities across the UK.</p><p><strong>Design & setting: </strong>A cross-sectional follow-up survey to ICS and UK health boards.</p><p><strong>Method: </strong>Questions used for a previous survey in 2020 were adapted and sent electronically to NHS bodies responsible for health care across the UK, using a freedom of information request. Quantitative analysis was undertaken using Microsoft Excel.</p><p><strong>Results: </strong>There were 67 responses from 68 possible ICS and health board areas, representing 99% UK coverage. Twenty-seven per cent had a named individual responsible for liver disease. Monitoring of local liver disease health statistics happened in 34% of all UK areas. Comprehensive care pathways were available in <i>n</i> = 24/67 (36%) of areas, an increase from 26% in the 2020 survey. Areas with no liver pathways in place fell from 58% to 36% between the two surveys. Regional variations persist, with Wales and Scotland moving towards comprehensive coverage. Almost double the number of areas were making use of transient elastography within community pathways of care, up from 25% to 46%.</p><p><strong>Conclusion: </strong>The results of this re-survey highlight improvements, but emphasise the need to build on regional success to further reduce inequality in care commissioning.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297462","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' experience of difficult decisions in people with dementia who have an acute illness: a qualitative, semi-structured interview study.","authors":"Samuel Lassa, Chris Burton, Jon M Dickson","doi":"10.3399/BJGPO.2024.0074","DOIUrl":"10.3399/BJGPO.2024.0074","url":null,"abstract":"<p><strong>Background: </strong>GPs are often required to make decisions about the management of acute illness in people living with dementia. These decisions are often complex and involve multiple informants.</p><p><strong>Aim: </strong>We aimed to explore how GPs made decisions about acute illness in people with dementia using a micropolitics approach.</p><p><strong>Design & setting: </strong>Qualitative, semi-structured interviews with 13 GPs with a range of years of experience working in South Yorkshire, UK.</p><p><strong>Method: </strong>Interviews were conducted by phone. Interviews focused on GPs' accounts to reflect their own perceptions and choices as portrayed to the interviewer. The analysis used the lens of micropolitics in the analysis and interpretation of the themes, with a focus on decisions between GP, patient, family and carers, and other health and social care providers about the management of acute illness in a person with dementia.</p><p><strong>Results: </strong>The results showed that GPs act as street-level bureaucrats while carrying out their role, using discretion during decision-making in an environment characterised by uncertainties and work pressures. In addition, GPs use the 'soft power' skills of diplomacy, such as negotiation, persuasion, and engagement, in navigating difficult decision-making situations, while building relationships and partnerships with various actors in the health system.</p><p><strong>Conclusion: </strong>GPs possess and express power, and influence decision-making in people living with dementia when navigating biomedical, social, and psychological factors. This power comes in the form of soft power (street-level diplomacy) and the more formal power of street-level bureaucracy.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297461","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":"Continuity within a community integrated palliative care model and the influence of remote and digital approaches to care: a qualitative interview study.","authors":"Emma Ladds, Malaika Ivey, Katrina Gadsby, Elin Preest, Ffion Samuels, Victoria Bradley","doi":"10.3399/BJGPO.2024.0126","DOIUrl":"10.3399/BJGPO.2024.0126","url":null,"abstract":"<p><strong>Background: </strong>Demand for palliative care is rising. Recent UK policy approaches promote integrated care models - collaborations between GPs and multidisciplinary specialists - and remote and digital practices. The extent to which different forms of continuity are supported within this evolving context is currently unclear.</p><p><strong>Aim: </strong>To explore the experience of continuity and impact of remote and digital practices within an integrated palliative care model.</p><p><strong>Design & setting: </strong>A qualitative interview study of patients and bereaved relatives recruited from a GP practice list and healthcare professionals delivering the integrated palliative care service for that population.</p><p><strong>Method: </strong>Twenty narrative and semi-structured interviews were conducted with 22 patients, relatives, and professionals between May 2022 and November 2023. They explored how care was delivered or received, focusing on coherency and the use of remote and digital practices. Data were theorised using a novel framework that considered psychodynamic, biomedical, sociotechnical, and sociopolitical domains of continuity.</p><p><strong>Results: </strong>The need for human care and connection were of primary importance and affected by intersubjective, biomedical, sociotechnical, and sociopolitical factors that influenced continuity of care. Despite the logistical ease of remote and digital practices, professionals had to work harder or around technologies to provide a 'caring' service. This was exacerbated by a lack of co-localisation, loss of longitudinal relationships, and reduction in tacit knowledge.</p><p><strong>Conclusion: </strong>Numerous complex factors and the exacerbating effects of remote and digital practices influence continuity and coherency within an integrated palliative care model.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308709","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":"'Picking up the pieces': primary care practitioners' experiences of cancer care reviews. A descriptive qualitative study.","authors":"Dipesh P Gopal, Stephanie Jc Taylor, Ping Guo, Nikolaos Efstathiou","doi":"10.3399/BJGPO.2024.0064","DOIUrl":"10.3399/BJGPO.2024.0064","url":null,"abstract":"<p><strong>Background: </strong>The number of people who are living with and beyond cancer is increasing in England. Primary care delivers cancer care via structured proactive conversations which are incentivised through the Quality and Outcomes Framework (QoF): 'cancer care reviews' (CCRs). Declining workforce numbers, increasing patient demand, CCR policy changes in 2020, and the onset of the coronavirus disease 2019 (COVID-19) pandemic motivate exploration of how staff deliver CCRs.</p><p><strong>Aim: </strong>To explore primary care staff's experiences with CCRs, their view of CCRs, how they conduct CCRs, and their perception of the value of CCRs.</p><p><strong>Design & setting: </strong>Descriptive qualitative study in general practices in England.</p><p><strong>Method: </strong>Semi-structured online interviews with 15 primary care staff; data analysis using reflexive thematic analysis.</p><p><strong>Results: </strong>Four themes were identified: varied and evolving perception of cancer; the delivery and impact of CCRs; changes to CCR delivery during the COVID-19 pandemic; and ways to complement CCRs. Primary care staff felt that the way that cancer was perceived by patients, including those from ethnic minority backgrounds, impacted how CCRs were delivered. Cancer care involved acknowledging the challenge of a cancer diagnosis, helping decode jargon, and addressing unmet care needs. The pandemic resulted in remote CCR delivery for some practices. Staff suggested that community cancer teams could provide cancer care alongside existing services.</p><p><strong>Conclusion: </strong>Staff adopted the new 3- and 12-month format CCRs despite the COVID-19 pandemic. Clinical staff may benefit from better training on cancer as a long-term condition and how cancer is perceived by people from diverse ethnic backgrounds.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082063","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":"Translating primary care to telehealth: analysis of in-person paediatric consultations and role of carers.","authors":"Simon Chan, Tasneem Khandaker, Yifu Li, Tim M Jackson, Hania Rahimi-Ardabili, Annie Ys Lau","doi":"10.3399/BJGPO.2024.0030","DOIUrl":"10.3399/BJGPO.2024.0030","url":null,"abstract":"<p><strong>Background: </strong>The usage of telehealth in general practice has risen substantially since the COVID-19 pandemic. Over this time frame, telehealth has provided care for all patient demographics, including the paediatric population (aged ≤18 years). However, the translatability of telehealth (that is, whether in-person tasks can be supported remotely via telehealth) rarely considers the paediatric population or their carers.</p><p><strong>Aim: </strong>To examine the degree of translatability to telehealth for in-person GP consultations on paediatric patients with consideration of the carers' roles.</p><p><strong>Design & setting: </strong>This study screened 281 videos of in-person GP consultations set within UK general practices, and 20 of them were eligible for analysis.</p><p><strong>Method: </strong>A secondary analysis of in-person GP consultations was undertaken to examine tasks, physical artefacts, examinations, and the interaction between carer, patient, and GP. A novel scoring method revolving around two key metrics, taking into consideration the carer, was designed to analyse whether the tasks performed can be supported via telehealth.</p><p><strong>Results: </strong>Analysis of 20 eligible consultations revealed 13 distinct physical examinations, 19 physical artefacts, and 17 clinical tasks. Of these 17 clinical tasks, 41% were deemed 'easily translatable to telehealth,' 29% 'moderately translatable with patient-provided equipment', 12% 'potentially translatable', and 18% 'currently untranslatable'. The average telehealth translatability score was 6.1/10, which suggests possible challenges with telehealth support. Regarding carer involvement, 90% of consultations involved collecting patient history, 70% placation of child, and 40% had physical support during examinations.</p><p><strong>Conclusion: </strong>Tasks performed during paediatric in-person GP consultations may not be easily translatable to telehealth and caution should be exercised when considering their translatability to telehealth.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565119","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":"Emergency admission Predictive RIsk Stratification Models: Assessment of Implementation Consequences (PRISMATIC 2): a protocol for a mixed-methods study.","authors":"Mark Kingston, Helen Snooks, Alan Watkins, Christopher Burton, Jeremy Dale, Jan Davies, Alex Dearden, Bridie Evans, Bárbara Santos Gomes, Jenna Jones, Rashmi Kumar, Alison Porter, Bernadette Sewell, Emma Wallace","doi":"10.3399/BJGPO.2024.0182","DOIUrl":"10.3399/BJGPO.2024.0182","url":null,"abstract":"<p><strong>Background: </strong>Emergency admissions are costly, increasingly numerous, and associated with adverse patient outcomes. Policy responses have included the widespread introduction of emergency admission risk stratification (EARS) tools in primary care. These tools generate scores that predict patients' risk of emergency hospital admission and can be used to support targeted approaches to improve care and reduce admissions. However, the impact of EARS is poorly understood and there may be unintended consequences.</p><p><strong>Aim: </strong>To assess effects, mechanisms, costs, and patient and healthcare professionals' views related to the introduction of EARS tools in England.</p><p><strong>Design & setting: </strong>Quasi-experimental mixed-methods design using anonymised routine data and qualitative methods.</p><p><strong>Method: </strong>We will apply multiple interrupted time-series analysis to data, aggregated at former clinical commissioning group (CCG) level, to look at changes in emergency admission and other healthcare use following EARS introduction across England. We will investigate GP decision making at practice level using linked general practice and secondary care data to compare case-mix, demographics, indicators of condition severity, and frailty associated with emergency admissions before and after EARS introduction. We will undertake interviews (approximately 48) with GPs and healthcare staff to understand how patient care may have changed. We will conduct focus groups (<i>n</i> = 2) and interviews (approximately 16) with patients to explore how they perceive that communication of individual risk scores might affect their experiences and health-seeking behaviours.</p><p><strong>Conclusion: </strong>Findings will provide policymakers, healthcare professionals, and patients, with a better understanding of the effects, costs, and stakeholder perspectives related to the introduction of EARS tools.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297459","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":"Treating the perimenopause in the UK Armed Forces: a mixed-methods review exploring the confidence of GPs.","authors":"Antony Sean Willman, Kate King","doi":"10.3399/BJGPO.2024.0088","DOIUrl":"10.3399/BJGPO.2024.0088","url":null,"abstract":"<p><strong>Background: </strong>Access to high quality perimenopause (PMP) care for UK Armed Forces (UKAF) personnel is crucial, given the increasing proportion of women aged 40-55 in the service. However, owing to the lack of exposure of GPs to the PMP in defence primary health care (DPHC), there are concerns about the confidence in PMP management, particularly in prescribing hormone replacement therapy (HRT).</p><p><strong>Aim: </strong>To assess the confidence of GPs working in DPHC in the management of the PMP.</p><p><strong>Design & setting: </strong>This study employed a mixed-methods approach and included all GPs (uniformed and civilian) working in DPHC.</p><p><strong>Method: </strong>A cross-sectional survey gathered quantitative data on demographics, views on PMP care, and self-rated confidence levels in managing the PMP among defence GPs (DGPs). Semi-structured interviews of purposefully sampled responders were thematically analysed to explore these issues further.</p><p><strong>Results: </strong>There were 164 responses from 542 DGPs (response rate 30.3%). The majority of responders expressed confidence in managing the PMP but reported lower confidence levels in prescribing HRT for younger women and initiating testosterone. Factors influencing confidence included recent PMP continuing professional development (CPD), GP sex, and exposure to PMP cases. Semi-structured interviews provided deeper insights into GP characteristics, CPD, and awareness of the PMP. Women's health hubs providing PMP care and experiential education were strongly supported.</p><p><strong>Conclusion: </strong>The study identified gaps in confidence among DGPs, particularly in certain aspects of PMP management, similar to those found in NHS GPs. CPD and case exposure were important predictors of confidence, with strong support for regional women's health hubs to optimise PMP care. Further research is warranted to explore strategies for bridging confidence gaps and improving PMP care delivery within the UKAF context.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584531","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":"Outcomes for older people with screening-detected versus existing chronic kidney disease: a cohort study with data linkage.","authors":"Anna K Forbes, José M Ordóñez-Mena, Winnie Mei, Clare J Taylor, Nicholas Jones, Jennifer A Hirst, Fd Richard Hobbs","doi":"10.3399/BJGPO.2024.0123","DOIUrl":"10.3399/BJGPO.2024.0123","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a common health problem associated with increased risk of cardiovascular disease (CVD), end-stage kidney disease (ESKD), and premature death. It is estimated that one-third of people aged ≥70 years have CKD globally, many of whom are undiagnosed, but little is known about the value of screening.</p><p><strong>Aim: </strong>To compare the risk of adverse health outcomes between people with an existing diagnosis of CKD and those identified through screening, and identify factors associated with mortality in CKD.</p><p><strong>Design & setting: </strong>Prospective cohort study of 892 primary care patients aged ≥60 years with CKD (existing and screening detected) in Oxfordshire, with data linkage to civil death registry and secondary care.</p><p><strong>Method: </strong>Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models to compare the risk of all-cause mortality, hospitalisation, CVD, ESKD separately, and as a composite between CKD groups, as well as to identify factors associated with mortality.</p><p><strong>Results: </strong>After a median follow-up of 3-5 years, 49 people died, 512 were hospitalised, 78 had an incident CVD event, and none had an ESKD event. There was no difference in the composite outcome between those with existing CKD and those identified through screening (HR 0.94, 95% CI = 0.67 to 1.33). Older age (HR 1.10, 95% CI = 1.06 to 1.15), male sex (HR 2.31, 95% CI = 1.26 to 4.24), and heart failure (HR 5.18, 95% CI = 2.45 to 10.97) were associated with increased risk of death.</p><p><strong>Conclusion: </strong>Screening older people for CKD may be of value, as their risk of short-term mortality, hospitalisation, and CVD is comparable with people routinely diagnosed. Larger studies with longer follow-up in more diverse and representative populations of older adults are needed to corroborate these findings.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297463","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":"Prevalence and predictors of annual asthma reviews in Scottish primary care data: an observational study.","authors":"Holly Tibble, Alexandria Ming Wai Chung","doi":"10.3399/BJGPO.2024.0062","DOIUrl":"10.3399/BJGPO.2024.0062","url":null,"abstract":"<p><strong>Background: </strong>People with asthma are recommended to have regular reviews in primary care, with assessment of symptoms, adjustment of treatment and self-management processes, and the delivery of a written action plan for emergencies.</p><p><strong>Aim: </strong>To investigate the incidence and factors associated with attendance of annual asthma reviews.</p><p><strong>Design & setting: </strong>This observational study used electronic health records for 49 307 patients in Scotland with asthma between 1 January 2000 and 31 March 2017. The analysis population of 13 726 patients had at least five asthma-related encounters between 2008 and 2016.</p><p><strong>Method: </strong>Multivariable logistic regression was employed, using linked primary care prescription data and primary care registration demographic data.</p><p><strong>Results: </strong>There was a median of 381 days between subsequent reviews. Reviews in the index year were strongly associated with reviews in the following year (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.68 to 1.84). In contrast, asthma consultations (excluding reviews) in the index year were associated with lower odds of having a review in the following year (OR 0.48, 95% CI = 0.46 to 0.51). Those aged 18-35 years in the index year or those with missing addresses in the practice registration data were the least likely groups to have an asthma review in the following year.</p><p><strong>Conclusion: </strong>Reviewing the delivery of asthma care identifies patients who may be slipping through the gaps by receiving only reactive asthma care rather than the structured, preventive care that can be delivered through annual reviews. Understanding the risk factors for not receiving an annual review can be leveraged to create more effective review invitations, such as explaining the specific content of reviews, introducing new contact methods to improve health equity, and reviewing the algorithm used to determine who is invited.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366811","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}