BJGP Open最新文献

{"title":"Collecting sociodemographic data in primary care: qualitative interviews in community health centres.","authors":"Rachel Thelen, Sara Bhatti, Jennifer Rayner, Agnes Grudniewicz","doi":"10.3399/BJGPO.2024.0095","DOIUrl":"10.3399/BJGPO.2024.0095","url":null,"abstract":"<p><strong>Background: </strong>Many primary care organisations do not routinely collect sociodemographic data (SDD), such as race, sex, or income, despite the importance of these data in addressing health disparities.</p><p><strong>Aim: </strong>To understand the experiences of primary care providers and staff in collecting SDD.</p><p><strong>Design & setting: </strong>A qualitative interview study with 33 primary care and interprofessional team members from eight Ontario community health centres (CHCs).</p><p><strong>Method: </strong>Semi-structured virtual interviews were conducted between July and August 2021. The interviews were recorded and transcribed verbatim. Content analysis of the transcripts was undertaken.</p><p><strong>Results: </strong>Participants reported using both formal methods of SDD collection, and informal methods of SDD collection that were more organic, varied, and conducted over time. Participants discussed sometimes feeling uncomfortable collecting SDD formally, as well as associated burden and limited resources to support collection. Client-provider rapport was noted as facilitating data collection and participants suggested more training, streamlined data collection, and better communication about purpose and use of data.</p><p><strong>Conclusion: </strong>SDD can be collected informally or formally, but there are limitations to informally collected data and barriers to the adoption of formal processes.</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":"142629634","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":"Exploring the equity of distribution of general medical services funding allocations in Wales: a time-series analysis.","authors":"Jonny Currie, Kathrin Thomas, Anne M Cunningham, Kerry Bailey, Haroon Ahmed, Daniel Farewell, Sally Lewis","doi":"10.3399/BJGPO.2024.0080","DOIUrl":"10.3399/BJGPO.2024.0080","url":null,"abstract":"<p><strong>Background: </strong>Good access to quality primary care in high-income countries can improve population health. Access to primary care is, however, often not equal among socioeconomic groups; our analysis sought to explore whether funding, a determinant of service supply, is equitably distributed among GP practices in Wales.</p><p><strong>Aim: </strong>To explore the relationship between funding and deprivation among GP practices in Wales, to understand the equity of current funding policies.</p><p><strong>Design & setting: </strong>A time-series analysis was undertaken in the primary care setting in Wales.</p><p><strong>Method: </strong>We obtained funding data for general practices in Wales between 2014 and 2022, and explored the equity of distribution using the percentage of practice patients living in the 20% most deprived small areas in Wales. We generated a linear regression model exploring the relationship between practice funding and deprivation, with an interaction term with time in years.</p><p><strong>Results: </strong>Practice funding rose for all practices between 2014 and 2022. Practice deprivation and time in years were both associated with practice funding, with increases in practice deprivation associated with reduced funding allocations, and time being associated with a small increase in funding over the study period. Over the period of analysis of 2014-2022, for every 10% increase in patients living in the most deprived lower layer super output areas, funding per patient decreased on average by 1%.</p><p><strong>Conclusion: </strong>General practices in Wales in more deprived areas receive discernibly less funding per patient than those in less deprived areas. Given the potential and likelihood primary care can affect population health outcomes, this underinvestment may be contributing to existing health inequalities and requires urgent further analysis and action.</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":"142366810","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":"Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study.","authors":"Lucy McDonnell, Mark Ashworth, Peter Schofield, Stevo Durbaba, Patrick Redmond","doi":"10.3399/BJGPO.2023.0248","DOIUrl":"10.3399/BJGPO.2023.0248","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic overuse is associated with antimicrobial resistance (AMR). It is unclear whether community AMR is driven by overall antibiotic use or by high levels of repeated (intense) use by individual patients.</p><p><strong>Aim: </strong>To determine the association between high antibiotic prescribing intensity (all antibiotic prescriptions; any indication), and rates of urinary tract infection (UTI) resistance among patients within small communities.</p><p><strong>Design & setting: </strong>Repeated cross-sectional ecological analysis of geographical areas (population averaging 1500) from 2012-2015 using anonymised primary care data and urine cultures.</p><p><strong>Method: </strong>For each area, we compared the percentage of patients prescribed antibiotics who received≥5 prescriptions over 3 years or≥4 prescriptions over 1 year, with subsequent or same year UTI resistance rates. We also compared Average Daily Quantities (ADQ) of all antibiotics prescribed, with UTI resistance rates, per year, per area. Results were adjusted for covariates and analysed at area level using mixed effects logistic regression.</p><p><strong>Results: </strong>Of 196 513 patients prescribed antibiotics in 69 areas, 16% were prescribed intensively (≥5 prescriptions in 3 years), receiving almost 30% of prescriptions. Of 12 308 confirmed UTI specimens (80% <i>Escherichia coli</i>), 65% were resistant to at least one antibiotic (amoxicillin; cefalexin; ciprofloxacin; trimethoprim; nitrofurantoin). We found no significant association between high intensity 'any' antibiotic prescribing (same year or 2 preceding years) or overall 'any' antibiotic prescribing (same year) and UTI resistance.</p><p><strong>Conclusion: </strong>We found no relationship between concurrent high intensity 'any' antibiotic prescribing, and UTI resistance rates in small urban communities, pre-COVID-19. Individual patient use of multiple antibiotics, even at high intensity, may not be an independent risk factor for community UTI resistance.</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":"142366808","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":"Personalised care planning for older people with frailty: a review of factors influencing implementation.","authors":"Anne Heaven, Marilyn Foster, Robbie Foy, Rebecca Hawkins, Claire Hulme, Sara Humphrey, Jane Smith, Andrew Paul Clegg","doi":"10.3399/BJGPO.2024.0163","DOIUrl":"10.3399/BJGPO.2024.0163","url":null,"abstract":"<p><strong>Background: </strong>Frailty increases vulnerability to major health changes because of seemingly small health problems. It affects around 10% of people aged >65 years. Older adults with frailty frequently have multiple long-term conditions, personal challenges, and social problems. Personalised care planning (PCP) based on 'goal setting' and 'action planning' is a promising way to address the needs of older adults living with frailty.</p><p><strong>Aim: </strong>To identify and explore factors that influence the implementation of PCP-style interventions for older adults.</p><p><strong>Design & setting: </strong>We conducted a scoping review and identified a small number of interventions that explicitly employed goal setting and action planning.</p><p><strong>Method: </strong>We used a range of sources to identify relevant material. We included all interventions inclusive of patients aged ≥65 years and reported in English. We excluded end-of-life care interventions, group education, and/or those that did not involve one-to-one engagement. We explored all related articles that described, examined, or discussed implementation. We constructed a thematic framework in NVivo (version 11). Findings were narratively synthesised.</p><p><strong>Results: </strong>We identified 18 potentially relevant PCP-style interventions and 13 of these met the inclusion criteria. Within these, were seven main categories of potentially modifiable influences relevant to older adults with frailty related to the following: primary care engagement; delivery staff characteristics; training; patient engagement; collaborative working; organisation and management; and systems.</p><p><strong>Conclusion: </strong>Many modifiable factors can influence the implementation of PCP. We identified several influences that have informed the development and implementation of a novel intervention PeRsOnaliSed care Planning for oldER people with frailty (PROSPER).</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":"142928425","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":"Pathways to myeloproliferative neoplasm presentation and time to diagnosis: results from a cross-sectional study.","authors":"Emma-Louise Tarburn, Lisa Iversen, Charlotte Robertson, Charlene McShane, Andrew Duncombe, Mary-Frances McMullin, Claire Harrison, Ruben Mesa, Lesley A Anderson","doi":"10.3399/BJGPO.2024.0068","DOIUrl":"10.3399/BJGPO.2024.0068","url":null,"abstract":"<p><strong>Background: </strong>Early cancer recognition is key to improving patient outcomes. Diagnosis is often delayed in patients with myeloproliferative neoplasms (MPNs), putting them at risk of thromboembolic events and other complications pre-diagnosis. A clear understanding of the barriers to presentation and diagnosis is required.</p><p><strong>Aim: </strong>To explore barriers and factors influencing delayed presentation and diagnosis of MPNs.</p><p><strong>Design & setting: </strong>A cross-sectional study of patients with MPN within the UK and the Republic of Ireland.</p><p><strong>Method: </strong>An online cross-sectional survey of patients with MPN was undertaken. Symptoms and factors influencing patient and GP delay were examined. Adjusted odds ratios (aORs) were calculated to explore the relationship between these factors and patient and GP delay.</p><p><strong>Results: </strong>Most (80.2%) of the 620 patients completing the survey reported symptomatic presentation. The most common symptoms associated with patient delay were pruritus (aOR 1.89, 95% confidence interval [CI] = 1.19 to 3.01), headaches (aOR 1.86, 95% CI = 1.13 to 2.82), and concentration difficulties (aOR 1.75, 95% CI = 1.12 to 2.76). Attributing symptoms to ageing (aOR 1.92, 95% CI = 1.19 to 3.11) and not wanting to burden the GP (2.04, 95% CI = 1.24 to 3.39) were significantly associated with patient delay. Those reporting >3 blood cancer warning signs were more likely to experience GP delay than those experiencing fewer (aOR 3.26<b>,</b> 95% CI = 1.75 to 6.29), and lack of relational continuity of GP care was significantly associated with GP delay (aOR 3.41, 95% CI = 1.65 to 7.28).</p><p><strong>Conclusion: </strong>Debunking misconceptions around ageing, encouraging timely communication with GPs, and improving relational continuity of GP care could assist in reducing diagnostic delays, prevent potentially fatal disease complications, and ultimately improve outcomes for patients with MPN.</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":"141856698","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":"Montreal Cognitive Assessment (MoCA) use in general practice for the early detection of cognitive impairment: a feasibility study.","authors":"Cassandre Carton, Matthieu Calafiore, Charles Cauet, Nassir Messaadi, Marc Bayen, David Wyts, Wassil Messaadi, Teddy Richebe, Sabine Bayen","doi":"10.3399/BJGPO.2024.0039","DOIUrl":"10.3399/BJGPO.2024.0039","url":null,"abstract":"<p><strong>Background: </strong>GPs can detect cognitive impairment (CI) at a very early stage, allowing early support for people and their caregivers. The early onset of CI is between 50 years and 60 years. Currently, in France, the Mini-Mental State Examination (MMSE) remains the most used screening test, although it has a lower sensitivity and specificity than the Montreal Cognitive Assessment (MoCA) for detecting mild CI, taking an average of 15 minutes to complete.</p><p><strong>Aim: </strong>To investigate the feasibility of the MoCA during routine consultations in general practice for the early detection of CI and to determine prevalence of CI in a primary care setting.</p><p><strong>Design & setting: </strong>A quantitative, prospective feasibility study was carried out in real-life working conditions during routine GP consultations in France.</p><p><strong>Method: </strong>GPs performed MoCA on adults aged ≥50 years, without suspected or confirmed CI.</p><p><strong>Results: </strong>Sixty-one GPs performed 221 MoCA with a mean duration of 8 minutes and detected mild neurocognitive impairment in 62% of patients.</p><p><strong>Conclusion: </strong>The MoCA is feasible and easy to perform during routine consultations in general practice by trained and experienced physicians.</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":"142019040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying impaired mental health in patients with type 2 diabetes: a cross-sectional study in general practice.","authors":"Line T Jakobsen, Anne Søjbjerg, Stinne E Rasmussen, Kaj S Christensen","doi":"10.3399/BJGPO.2024.0045","DOIUrl":"10.3399/BJGPO.2024.0045","url":null,"abstract":"<p><strong>Background: </strong>Type two diabetes (T2D) is linked to impaired mental health. International guidelines emphasise the importance of including psychological aspects in diabetes care. Yet, no systematic approach has been implemented to assess mental health in patients with T2D in general practice.</p><p><strong>Aim: </strong>To evaluate the mental health of patients with T2D in general practice, and to investigate the effectiveness of asking patients about their wellbeing by using a single-item question compared with the five-item World Health Organization-Five Wellbeing Index (WHO-5).</p><p><strong>Design & setting: </strong>A cross-sectional study was undertaken, which included 230 patients with T2D in Danish general practice, from 1 May 2023-31 January 2024.</p><p><strong>Method: </strong>Eligible patients were recruited at the annual chronic care consultation. They answered a single-item question on wellbeing and four validated measures of general wellbeing (WHO-5), depression (Patient Health Questionnaire-9; PHQ-9), anxiety (Generalised Anxiety Disorder-7; GAD-7), and diabetes distress (Problem Areas in Diabetes-5; PAID-5).</p><p><strong>Results: </strong>Overall, 32% of patients expressed symptoms of impaired mental health. Notably, the WHO-5 identified 53% of these patients, whereas only 12% of patients were identified through the single-item question. Importantly, among the patients exhibiting symptoms of impaired mental health, those identified by the WHO-5 displayed statistically significantly lower mental health scores across all measures (except PAID-5) compared with those not identified by the WHO-5.</p><p><strong>Conclusion: </strong>A significant proportion of patients with T2D in general practice are affected by mental health issues. Our findings indicate that a single-item question may not sufficiently detect these issues, highlighting the importance of incorporating tools, such as the WHO-5, to offer a more comprehensive approach in diabetes 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":"142005495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerable older people's views on proactive care planning: a qualitative interview study in primary care.","authors":"Lisa Kastbom, Anna Olaison, Annette Sverker, Anna Segernäs","doi":"10.3399/BJGPO.2024.0167","DOIUrl":"10.3399/BJGPO.2024.0167","url":null,"abstract":"<p><strong>Background: </strong>Patients in old age often have complex care needs owing to multimorbidity and polypharmacy. This qualitative study is part of a larger ongoing Swedish intervention trial Secure And Focused primary care for older pEople (SAFE), including shorter care agreements based on person-centred patient goals.</p><p><strong>Aim: </strong>To explore, in a primary care setting, the views of older and vulnerable patients on a more systematic, proactive approach to care planning, including establishing and documenting care agreements based on person-centred goals.</p><p><strong>Design & setting: </strong>Individual semi-structured interviews with patients (<i>n</i> = 25) aged >75 years from 12 intervention primary healthcare centres in two counties in Sweden.</p><p><strong>Method: </strong>Interviews were conducted between June and October 2023. They were digitally recorded and transcribed verbatim. Latent qualitative content analysis was used.</p><p><strong>Results: </strong>The following three categories, with 10 sub-categories, were found: I would like to live in the present, so why plan ahead? Let me decide versus they know best; and Care agreements usually went unnoticed. The latent theme - The ambivalence of care planning in the fourth age - was created to give a deeper meaning to the content of the categories.</p><p><strong>Conclusion: </strong>This study emphasises that older, vulnerable persons have varying attitudes towards participation in proactive care planning. This ambivalence may originate from the individual's desire to have their autonomy respected and express future care preferences on the one hand, and to avoid or postpone end-of-life conversations and care planning on the other hand. Patients also expressed a desire to be more actively involved in care planning. Although care agreements have the potential to increase patient involvement in proactive care planning, they often went unnoticed. The conversation itself was essential.</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":"142366812","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":"Adapting the Primary Care Assessment Tool for sub-Saharan Africa: a validation study.","authors":"Robert Mash, Kefilath Bello, Innocent K Besigye, Anna Galle","doi":"10.3399/BJGPO.2024.0084","DOIUrl":"10.3399/BJGPO.2024.0084","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization's (WHO) measurement framework for primary health care includes the core functions of primary care: first-contact access, comprehensiveness, coordination, continuity, and person-centredness. The Primary Care Assessment Tool (PCAT), originally developed in the USA, was adapted for use by four African countries, and can measure the core functions of primary care.</p><p><strong>Aim: </strong>To face and content validate a PCAT for sub-Saharan Africa that measures the core functions of primary care.</p><p><strong>Design & setting: </strong>Nineteen countries within the Primary Care and Family Medicine (PRIMAFAMED) network for sub-Saharan Africa participated in a validation study.</p><p><strong>Method: </strong>Two stages included a PRIMAFAMED workshop to assess face validity and a Delphi study to reach consensus on content validity among an expert panel as well as key stakeholders.</p><p><strong>Results: </strong>Thirteen countries participated in the workshop and suggested rephrasing 39 items, deleting six and adding four new items. Nineteen countries participated in the Delphi study and all 20 panel members reached consensus (>70%) on including the items as written. Seven experts and stakeholders reviewed the PCAT and suggested rephrasing 23 items, deleting one and adding one. The final PCAT for sub-Saharan Africa (SSA-PCAT) consists of 85 items that measure affiliation with the primary care facility, first-contact access and utilisation, comprehensiveness, continuity, coordination, and person-centredness, as well as health, demographic and socioeconomic status.</p><p><strong>Conclusion: </strong>The SSA-PCAT will now be piloted in Benin, Uganda, and South Africa. Further psychometric evaluation will be possible followed by more widespread use by researchers, district managers, and policymakers in the region.</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":"142019037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lyme disease in UK primary care: a knowledge, attitude, and practice survey.","authors":"Lucy Delaney, Amanda Semper, Neil French, John Sp Tulloch","doi":"10.3399/BJGPO.2024.0092","DOIUrl":"10.3399/BJGPO.2024.0092","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding GP experience with diagnosis and treatment.</p><p><strong>Aim: </strong>This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England.</p><p><strong>Design & setting: </strong>Online KAP survey on LD for UK-based practising GPs.</p><p><strong>Method: </strong>An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK-based research networks, professional societies, and via social media.</p><p><strong>Results: </strong>A total of 191 complete responses were analysed (England <i>n</i> = 130, Scotland <i>n</i> = 61). The Scotland-based responder group had more relevant consultations in the previous 3 years. Responders from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for LD and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with LD by both responder groups for the former and England-based responders for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses.</p><p><strong>Conclusion: </strong>Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based responders' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.</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":"142523272","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}