BJGP Open最新文献

{"title":"Follow-up cancer care in Danish general practice: a questionnaire study.","authors":"Lisa Maria Sele Sætre, Steffi Blach Naamansen, Kirubakaran Balasubramaniam, Jens Søndergaard, Dorte Ejg Jarbøl","doi":"10.3399/BJGPO.2023.0215","DOIUrl":"10.3399/BJGPO.2023.0215","url":null,"abstract":"<p><strong>Background: </strong>The number of patients who have survived cancer has increased substantially owing to improved cancer treatment. This has reinforced the need for effective strategies for follow-up cancer care in general practice.</p><p><strong>Aim: </strong>To investigate the organisation of follow-up cancer care in Danish general practice and to analyse GPs' self-assessment of competences regarding patients who have survived cancer and late effects.</p><p><strong>Design & setting: </strong>A total of 500 Danish general practices were invited to a web-based survey.</p><p><strong>Method: </strong>Questions comprised organisation of follow-up cancer care, and GPs' self-assessment of their competences in follow-up care and evaluation of late effects. Covariates considered included sex, age, seniority, and practice type. Analyses were conducted using descriptive statistics and multivariable logistic regression models.</p><p><strong>Results: </strong>Some 28% of the GPs reported systematic organisation of follow-up cancer care in their clinic. More than half of the GPs assessed themselves as competent in evaluating mental sequelae, existential considerations, and the impact on comorbidities. In contrast, only 19% and 33% of GPs reported competences in sexual and physical sequelae, respectively. Female GPs were less likely to report competences regarding physical and mental sequelae as well as sexual disturbances, and GPs from partnership practices were more likely to report competence in assessing mental sequelae.</p><p><strong>Conclusion: </strong>Fewer than one in three general practices have organised systematic follow-up cancer care and GPs assess their competence as low with respect to physical sequelae and sexual challenges. This emphasises the need for more systematic organisation and focus on knowledge of late effects in general practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GPs' use of video and telephone consultation - implications for physical activity promotion for older adults.","authors":"Christopher Thomas Callaghan, Conor Cunningham, Roger O'Sullivan","doi":"10.3399/BJGPO.2023.0256","DOIUrl":"10.3399/BJGPO.2023.0256","url":null,"abstract":"<p><p>The COVID-19 pandemic led general practitioners (GPs) to adopt video and telephone consultation (VC/TC) as part of routine practice. The potential impact on physical activity (PA) promotion and prescription for older adults, in routine practice, was unknown.</p><p><strong>Aim: </strong>To understand how VC/TC have impacted on the routine promotion of PA to older adults in GPs consultations.</p><p><strong>Design & setting: </strong>A mixed method, cross-sectional study of GPs practice was conducted in Ireland and Northern Ireland in 2020.</p><p><strong>Method: </strong>An online survey and interviews with GPs, explored awareness of PA guidelines, PA promotion during consultations to older adults (65+ years) and the impact on routine practice of moving to VC/TC during the pandemic.</p><p><strong>Results: </strong>GPs from across the Island of Ireland agreed that PA promotion is part of routine practice. Analysis of interviews with GPs highlighted a need to develop practitioners' knowledge of the guidelines and themes emerged around the use of VC/TC In routine practice. Positive themes highlighted that VC/TC enabled GPs to consult with a greater number of patients, thus prioritising face-to-face (FTFCs) consultations where needed. Barriers to using VC/TC included decreased visual assessments of patients FTF.</p><p><strong>Conclusion: </strong>GPs are continuing to use VC/TC at the initial consultation stage, however the broader and longer-term implications on PA promotion with older adults are unknown.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727908","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":"Realities of opioid and gabapentinoid deprescribing in socioeconomically disadvantaged communities: qualitative evaluation.","authors":"Charlotte L Parbery-Clark, Jennie Sofia Portice, Sarah Sowden","doi":"10.3399/BJGPO.2024.0160","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0160","url":null,"abstract":"<p><strong>Background: </strong>Opioid and gabapentinoid prescribing has increased substantially in recent years despite having limited effectiveness in treating chronic primary pain. This is concerning with the prescribing rates and adverse effects of these medications being higher in more socioeconomically disadvantaged groups. Guidance for prescribing and deprescribing these medications exists but the understanding of how deprescribing is operationalised especially in areas of socio-economic disadvantage is limited.</p><p><strong>Aim: </strong>To explore primary healthcare professionals' views and experiences of designing and implementing an intervention to reduce opioid and gabapentinoid prescribing.</p><p><strong>Design & setting: </strong>A qualitative evaluation, using participant observation and semi-structured interviews with primary healthcare professionals working in practices serving areas of substantial socio-economic disadvantage.</p><p><strong>Method: </strong>Interviewees were purposively recruited with subsequent snowballing with participant observation of the peer-support meetings. Interviews transcripts and notes from the participant observation were inductively coded and thematically analysed.</p><p><strong>Result: </strong>Thirteen healthcare professionals from five practices were interviewed. Person-centred care with shared decision-making was strived for which was time consuming due to the complexity of the problem and patients. Where shared-decision making was not possible due to patient refusal or non-engagement, risk was used to determine the appropriate action. This work involved an emotional toll on staff and patients but was at times conversely easier and more rewarding than expected. Ultimately, demedicalising pain with a culture change is required to ensure patients are not prescribed these medications for inappropriate reasons or doses.</p><p><strong>Conclusion: </strong>This study demonstrates key operational aspects to consider when undertaking opioid and gabapentinoid deprescribing in primary care.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761468","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":"Factors influencing multiple non-utilized healthcare appointments from patients' and healthcare providers' perspectives: a qualitative systematic review of the global literature.","authors":"Asrar Aldadi, Kathryn A Robb, Andrea Williamson","doi":"10.3399/BJGPO.2024.0075","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0075","url":null,"abstract":"<p><strong>Background: </strong>The term \"non-utilised appointments\" emerged in 2019 but lacks a clear definition. We focus on multiple non-utilised appointments due to recent advances in understanding 'missingness' in UK healthcare. Studies on missed appointments show conflicting results regarding interventions like text messaging due to oversight of occasional versus repeated missed appointments. Understanding patient and healthcare-related factors in multiple non-utilised appointments is crucial for improving interventions and patient engagement.</p><p><strong>Aim: </strong>To identify factors influencing multiple non-utilised appointments from patients' and healthcare providers' perspectives.</p><p><strong>Design & setting: </strong>A systematic review of qualitative research identifying factors that influence multiple non-utilised appointments across diverse global health care settings.</p><p><strong>Method: </strong>The review employed a qualitative systematic approach, encompassing diverse papers from multiple databases, irrespective of patient or healthcare provider age, location, or setting. Data analysis followed Thomas and Harden's thematic synthesis method. Themes are presented in alignment with both the health service and patient perspective aspects of the Levesque access model.</p><p><strong>Results: </strong>Ten thousand and eighty-six records were retrieved. Five studies met the inclusion criteria and were analysed. Six key themes influenced appointment utilisation. Healthcare system determinants highlighted provider-patient relationship and professionalism, and healthcare organisation factors role in appointments utilisation. Patient experience and decision-making explored personal factors. Additionally, communication, support, and engagement delved into challenges with communication and language, family and social support, and socio-familial barriers to appointment utilisation. Health and well-being factors encompassed medical conditions, mental and emotional factors, and psychosocial determinants affecting appointment utilisation. Moreover, financial constraints and socioeconomic factors were identified as significant contributors. Lastly, healthcare access and barriers addressed transportation challenges, accessibility issues, and geographical barriers impacting healthcare access.</p><p><strong>Conclusion: </strong>The analysis reveals complex factors influencing multiple non-utilised appointments. Strong provider-patient relationships improve care accessibility. Flexible scheduling and patient-centred approaches are pivotal, alongside addressing workplace discrimination. Tailored healthcare services and overcoming geographical barriers are essential. Ensuring safety, accessibility, and communication, while supporting vulnerable groups and mental health needs, are necessary. Equitable access to services and alternative transportation solutions are essential for comprehensive healthcare delivery.</p><p><strong>Systematic review","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761467","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 impact of the COVID-19 pandemic on students' views of a career in general practice.","authors":"Zoe Hook, Ben Jackson, Hugh Alberti, Claire Capper, Fiona Hay, Carly Hire, Hannah Randles, Juliet Zachary, Joanne Protheroe","doi":"10.3399/BJGPO.2023.0257","DOIUrl":"10.3399/BJGPO.2023.0257","url":null,"abstract":"<p><strong>Background: </strong>General Practice (GP) is an essential part of healthcare systems in the UK and internationally but continues to struggle with recruitment. Despite these concerns about GP recruitment, few studies have explored factors that influence medical students' career choices around primary care.</p><p><strong>Aim: </strong>We aimed to re-visit factors previously proposed following new ways of working adopted since the COVID-19 pandemic, including the impact of these changes on learning experiences in primary care.</p><p><strong>Design & setting: </strong>A qualitative study using focus groups across three English medical schools.</p><p><strong>Method: </strong>Eight focus groups involving thirty-three final and penultimate year medical students. Qualitative data analysed using a framework approach. Transcripts coded independently by two researchers from a different institution before themes identified.</p><p><strong>Results: </strong>Six themes were identified: students' prior career aspirations, their experience of the medical school curriculum, conceptualisation of general practice, future career predictions, views on the school's curriculum philosophy and the influence of the COVID-19 pandemic. The curriculum philosophy of each school appeared was important in this journey and changes since the COVID-19 had an impact on all themes.</p><p><strong>Conclusion: </strong>Our study has confirmed previous findings that clinical experiences, the perceived narrative of the school, work-life balance and working environment remain important to students in making career plans. However, in addition, we have found the changing landscape in general practice since the covid pandemic, including remote consulting, workload, continuity of care and team-working are additional factors that concern students.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727909","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":"\"What script am I meant to use?\": a qualitative study in chronic primary pain.","authors":"Niamh Blythe, Carmel Hughes, Nigel D Hart","doi":"10.3399/BJGPO.2024.0101","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0101","url":null,"abstract":"<p><strong>Background: </strong>Chronic primary pain (CPP) as a diagnosis has been introduced in the recent International Classification of Diseases, 11^th Revision (ICD-11). CPP captures the <i>experience</i> of pain as the primary problem, without an underlying attributable cause. Dissemination of UK guidance regarding CPP represents the first time it has been recognised as a condition in its own right. Little is known regarding General Practitioner (GP) views concerning caring for patients with CPP and how related guidance is viewed and applied in practice.</p><p><strong>Aim: </strong>To explore GP perspectives in relation to caring for people with CPP, including challenges encountered and use of related guidelines in practice.</p><p><strong>Design & setting: </strong>A UK-wide qualitative interview study in primary care.</p><p><strong>Method: </strong>Purposive and snowball sampling were used to recruit 15 GP participants from England, Northern Ireland, Wales and Scotland. Semi-structured interviews were undertaken and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Three main themes were generated: (1) \"How to start? Problematic beginnings\" referred to difficulties regarding diagnosis; (2) \"Where to go? Mapping the management challenge\" and (3) \"How to get there? Navigating strategies and response\", explored GP awareness and acceptability of UK guidelines for chronic pain. Areas identified for potential improvement included increased access to NPM and secondary care services, support with de-prescribing and an expanded multidisciplinary team input.</p><p><strong>Conclusion: </strong>CPP is complex to both diagnose and manage. Although guidelines provide a useful framework, they pose challenges when translating into day-to-day practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761465","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 for continuous medical education: a cross-sectional questionnaire study among Danish GPs.","authors":"Helle Ibsen, Linda Juel Ahrenfeldt, Jesper Lykkegaard, Jens Søndergaard, Igor Švab, Niels Kristian Kjaer","doi":"10.3399/BJGPO.2023.0228","DOIUrl":"10.3399/BJGPO.2023.0228","url":null,"abstract":"<p><strong>Background: </strong>GPs' participation in continuous medical education (CME) is essential for patient care, GPs' wellbeing, and healthcare expenditure. However, one-quarter of Danish GPs did not use their reimbursement for CME in 2022. Knowledge of barriers for participating in CME is limited.</p><p><strong>Aim: </strong>To analyse the barriers GPs face to participation in CME, and patterns in perceived barriers.</p><p><strong>Design & setting: </strong>A cross-sectional questionnaire study design was used. The study population comprised all 3257 GPs in Denmark who, in May 2023, were registered as entitled to reimbursement for CME.</p><p><strong>Method: </strong>The response rate was <i>n</i> = 1303/3257 (40%). Based on a question about use of CME, the responders were divided into 'frequent', 'partial', and 'seldom' users. Partial and seldom users answered questions about barriers related to CME (<i>n</i> = 726). The presence of barriers was quantified, and a latent class analysis (LCA) was used to stratify GPs according to their barrier patterns.</p><p><strong>Results: </strong>The most frequent barriers were as follows: too busy (67%); fully booked courses (45%); and no substitute or locum doctor (39%). Based on the LCA, we found three distinctive patterns, clustering around the following: GPs from clinics with no tradition for CME (class 1, 17%); GPs who used time on professional work outside clinic (teaching, organisational work) (class 2, 43%); and GPs who were personally or professionally affected (class 3, 40%). Singled-handed and male GPs were slightly overrepresented among seldom users.</p><p><strong>Conclusion: </strong>We have identified barriers for CME. We found three different profiles of GPs who perceived different patterns of barriers. Identified patterns in barriers should be considered in future CME initiatives.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137294","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":"Effectiveness of smoking cessation interventions in pregnant women attending primary care: a scoping review.","authors":"Niamh Connolly, Dervla Kelly, Patrick O'Donnell, Sarah Hyde","doi":"10.3399/BJGPO.2023.0185","DOIUrl":"10.3399/BJGPO.2023.0185","url":null,"abstract":"<p><strong>Background: </strong>Smoking during pregnancy has many adverse effects for infant and mother. Despite this, many pregnant women continue smoking. Primary care is a suitable area to provide smoking cessation interventions.</p><p><strong>Aim: </strong>To investigate available literature regarding effectiveness of smoking cessation interventions for pregnant women in primary care, the factors contributing to this effectiveness, and to provide suggestions for future research.</p><p><strong>Design & setting: </strong>Systematic scoping literature review.</p><p><strong>Method: </strong>The methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Five electronic databases were searched. Inclusion criteria included original research studies and studies published in English. Data were extracted using a modified Joanna Briggs Institute (JBI) data-charting tool.</p><p><strong>Results: </strong>The initial search yielded 878 articles. Following article screening, 12 studies were included. Five studies found a statistically significant increase in smoking cessation rates or reduction in tobacco consumed in the intervention group. The remaining studies showed no significant difference between the groups. However, 10 studies showed the control group received usual antenatal care involving smoking cessation promotion. An increase in smoking cessation rates was seen in intervention and control groups, demonstrating the effectiveness of these interventions. Interventions included education, counselling, self-help, and financial incentives. They were delivered by GPs, midwives, counsellors, and pregnancy advisers.</p><p><strong>Conclusion: </strong>Primary care is suitable to offer smoking cessation interventions to pregnant women, as it is often the first point of care and more easily accessible than secondary care. Future research is needed to determine the most effective types of interventions.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practitioners' reflections on prescribing addictive hypnotics to elderly: a qualitative study.","authors":"Holgeir Skjeie, Mette Brekke, Trygve Skonnord","doi":"10.3399/BJGPO.2024.0157","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0157","url":null,"abstract":"<p><strong>Background: </strong>The European Guideline for the Diagnosis and Treatment of Insomnia recommends, for all age groups, restrictive, short-term and periodic use of potentially addictive hypnotics. As in other European countries, in Norway, actual practice involving elderly patients differs substantially from this recommendation, as shown by the persistent high frequency of regular prescriptions of addictive hypnotics.</p><p><strong>Aim: </strong>To explore experienced Norwegian general practitioners' (GPs') views of the regular prescription of addictive hypnotics to patients older than 70 years living at home.</p><p><strong>Design & setting: </strong>In-depth individual interviews of a purposive sample of experienced specialists in family medicine at GP offices in Southern Norway.</p><p><strong>Method: </strong>Reflexive thematic cross-case analysis.</p><p><strong>Results: </strong>Most of the 11 GPs interviewed had more than 10 elderly patients who were prescribed hypnotics for daily use and the same number for intermittent prescription. Almost all prescriptions were of z-hypnotics. The GPs knew this was contrary to the guideline. Many were at ease with this fact. They emphasised the need to avoid creating new dependencies. The GPs considered these patients a selected minority within this age group with serious sleep problems, for whom few realistic alternatives were available and whose tolerance over time was better than expected. This logic of pragmatic practice reflected a patient-centred approach and respect for the patients' view in a shared decision-making process combined with challenges of limited alternatives and resources.</p><p><strong>Conclusion: </strong>A zero vision on the prescription of addictive hypnotics to the elderly may neither be prudent nor realistic in the context of general practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727907","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":"Treatment failure of <i>Helicobacter pylori</i> in primary care: a retrospective cohort study.","authors":"Gertrude van den Brink, Lieke M Koggel, Joris Jh Hendriks, Mark Gj de Boer, Peter D Siersema, Mattijs E Numans","doi":"10.3399/BJGPO.2023.0252","DOIUrl":"10.3399/BJGPO.2023.0252","url":null,"abstract":"<p><strong>Background: </strong>Owing to increasing antibiotic resistance, the worldwide efficacy of <i>Helicobacter pylori</i> (HP) eradication treatment has decreased.</p><p><strong>Aim: </strong>To determine antimicrobial resistance of HP in primary care.</p><p><strong>Design & setting: </strong>Retrospective cohort study using real-world routine healthcare data from 80 general practices in the Netherlands.</p><p><strong>Method: </strong>Patients with International Classification of Primary Care (ICPC) codes for gastric symptoms or Anatomical Therapeutic Chemical (ATC) codes for acid inhibition in the period 2010-2020 were selected. Main outcomes were antimicrobial resistance of HP, defined as the prescription of a second eradication treatment within 12 months, and clinical remission of gastric symptoms, defined as no usage of acid inhibition 1 year following eradication therapy.</p><p><strong>Results: </strong>We identified 138 455 patients with gastric symptoms and/or acid inhibition use (mean age 57 years [standard deviation 18.2 years], 43% male). A total of 5224 (4%) patients received an HP eradication treatment. A second treatment was prescribed to 416 (8%) of those patients. From these, 380 patients received amoxicillin-clarithromycin, 16 amoxicillin-metronidazole, and 11 clarithromycin-metronidazole as first regimen and were considered antimicrobial resistant. We observed a 0.8% increment per year of patients requiring a second eradication treatment (<i>P</i> = 0.003, 95% confidence interval = 0.33 to 1.22). After successful eradication, 2329/4808 (48%) patients used acid inhibition compared with 355/416 (85%) patients following treatment failure (<i>P</i><0.001).</p><p><strong>Conclusion: </strong>Antimicrobial treatment is not successful in almost one-tenth of HP infections in primary care after a first treatment containing clarithromycin and/or metronidazole. Although the treatment failure rate is not as high as reported in secondary care, the increasing trend is concerning and may require revision of the current guidelines.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029195","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}