BJGP Open最新文献

{"title":"Cardiovascular risk management in patients using antipsychotics - a qualitative feasibility study.","authors":"Karlijn Joëlle van den Brule-Barnhoorn, Kirstine Marieke Jakobs, Jan van Lieshout, Sietske Grol, Joost Janzing, Wiepke Cahn, Marion Biermans, Erik Bischoff","doi":"10.3399/BJGPO.2025.0014","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0014","url":null,"abstract":"<p><strong>Background: </strong>Patients on antipsychotic medication have an increased risk of cardiovascular disease. In general practice however, there is a lack of solid cardiovascular risk management for this specific group. TACTIC, a person-centred multidisciplinary cardiovascular risk program aimed to decrease cardiovascular risk and review antipsychotic medication use, was piloted in general practice.</p><p><strong>Aim: </strong>To explore barriers and facilitators for delivering the TACTIC intervention, and assess which adjustments have to be made to evaluate its effectiveness and implementability in a future RCT.</p><p><strong>Design & setting: </strong>Qualitative analysis of the feasibility study in three Dutch general practices.</p><p><strong>Method: </strong>We performed 8 individual interviews with patients and 2 focus group interviews with 11 healthcare professionals involved in the study. Interviews were semi-structured and topic guides were informed by the Normalization Process Theory. We used the Framework Method for analysis of our data.</p><p><strong>Results: </strong>Barriers were associated with experienced tension by patients due to participation, the course of the multidisciplinary meeting, and the high workload experienced by general practitioners. Facilitators were associated with the person-centred approach, the clear information meeting and the ability of adjusting roles in the intervention. Valuable suggestions for improvement were introducing a summary report from the psychiatrist, improving expectation management for patients and adjusting the definition of the target group.</p><p><strong>Conclusion: </strong>Several adjustments to the TACTIC intervention are necessary before evaluation in a larger randomised controlled trial can take place. This work underlines the importance of performing a feasibility study prior to a trial to improve its effectiveness and efficacy.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805017","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":"Pharmaceutical company promotional payments to English general practices: longitudinal study.","authors":"Shai Mulinari, Minahil Malik, James Larkin, Mostafa Elsharkawy, Tom Fahey, Frank Moriarty, Piotr Ozieranski","doi":"10.3399/BJGPO.2024.0281","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0281","url":null,"abstract":"<p><strong>Background: </strong>General practices have been a long-standing focus of pharmaceutical promotion, but their financial relationships with pharmaceutical companies remain understudied.</p><p><strong>Aim: </strong>Examine pharmaceutical company payments to general practices in England from 2015-2022, focusing on changing patterns of payments and what this reveals about companies' marketing.</p><p><strong>Design & setting: </strong>Descriptive analysis of pharmaceutical company payments made to practices using data from industry's Disclosure UK database, covering 4430 recipient practices and 54 companies over an eight-year period.</p><p><strong>Method: </strong>Annual Disclosure UK data from 2015-2022 were merged, identifying practices using a novel algorithm-based methodology, and categorising payments by type (eg, donations and grants, event sponsorship). Trends were analysed by company and payment type. The Gini coefficient measured payment concentration, and the persistence of relationships was assessed over time.</p><p><strong>Results: </strong>Pharmaceutical payments to general practices rose from £2.5 million in 2015 to £7.5 million in 2022. While 54 companies made payments, just one company, Chiesi-marketing commonly prescribed respiratory inhalers-accounted for over 50% of the payment value from 2017 onwards. More than 40% of practices received payments from only one company, and 74% of company-practice relationships lasted just one study year. A few companies dominated, with a Gini coefficient of 0.86, driven by Chiesi's payments.</p><p><strong>Conclusion: </strong>The growing scale and concentration of payments and the dominance of one company raise concerns about bias in general practice. Future research should investigate the impact of payments on clinical decision-making, but to do so, payment disclosures need enhanced transparency, particularly through including product-specific payment details.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805018","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":"Rising scabies incidence and the growing burden on general practitioners.","authors":"Saskia C van der Boor, Ines Figaroa, Annemarie A Uijen, Stijn Fh Raven, Cornelia Van Jaarsveld","doi":"10.3399/BJGPO.2025.0037","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0037","url":null,"abstract":"<p><strong>Background: </strong>Scabies cases are rising in several high-income European countries, but its true incidence remains unclear due to its non-notifiable status. General practitioners (GPs) play a key role in managing scabies, yet the impact on primary care is unknown.</p><p><strong>Aim: </strong>To assess the epidemiology and care burden of scabies-related episodes in general practice.</p><p><strong>Design & setting: </strong>A retrospective longitudinal study using pseudonymised data from Dutch GPs.</p><p><strong>Method: </strong>Data from 5 general practices, covering nearly 40,000 patients from 2014 to 2023, were analysed. Scabies-related episode incidence, time between scabies-related symptoms and first GP encounter (patient's delay), time between first GP encounter and scabies diagnosis (doctor's delay), and care burden were compared between two periods: 2014-2020 (low incidence) and 2021-2023 (high incidence).</p><p><strong>Results: </strong>1525 scabies-related episodes including 4555 recorded encounters were included. Between 2014 and 2023, the incidence increased from 99 to 1341 episodes per 100 000 patient-years, with encounters rising from 614 to 2438 per 100 000 patient-years between the two periods. The largest increase in encounters occurred in those aged 17-25 years (<i>P</i><0.001) and in females (<i>P</i>=0.002). Patient delays>28 days decreased from 26.4% to 14.3%. Scabies diagnoses during initial consultations improved from 84.9% to 92.3%. Encounters without interventions declined from 36.9% to 14.4%. Medical prescriptions and referrals per 100 000 patient-years increased.</p><p><strong>Conclusion: </strong>Our findings highlight an exponential increase in scabies-related episodes, significantly increasing the burden on general practices. Regions experiencing rising scabies incidence rates should prioritize public health interventions to curb transmission, which require a coordinated clinical and public health response.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805019","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":"Perceptions and practices of UK general practitioners towards youth vaping: a questionnaire-based study.","authors":"Elika Najafi, Devan Wasan, Yasmin Baker, Kristian Peters, Dhruv Vasooja, Maneth Warnapala, Mario Martínez-Jiménez","doi":"10.3399/BJGPO.2025.0080","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0080","url":null,"abstract":"<p><strong>Background: </strong>E-cigarette use among adolescents and young adults is a growing public health concern. General practitioners (GPs) play a critical role in addressing health behaviours, yet there's limited research on their perceptions and practices towards vaping in young people.</p><p><strong>Aim: </strong>This study aims to explore current perceptions and practices amongst GPs concerning vaping in young people.</p><p><strong>Design & setting: </strong>A quantitative approach was employed through an online, self-administered questionnaire. Respondents included both trainee and qualified GPs from across the UK.</p><p><strong>Method: </strong>The questionnaire consisted of Likert-scale and free-text questions, covering screening, counselling, and demographic information. Participants were recruited through newsletters and social media, with 284 responses collected from March to August 2024. Data was analysed using descriptive statistics. The Kruskal-Wallis test was used to assess for significant differences based on respondents' region of work or level of experience.</p><p><strong>Results: </strong>General practitioners rarely inquire about e-cigarette use (23.9%), despite 85.6% believing it's important to do so. Lack of time, relevance to the presenting complaint, and method for quantifying and documentation were cited as significant causes. Only 27.5% of GPs provide advice to e-cigarette users, likely due to low rates of confidence (12.3%). A lack of time, understanding of health effects, training, and availability of referral services were cited as causes. There were no significant variations in responses based on respondents' location or level of experience.</p><p><strong>Conclusion: </strong>GPs recognise the importance of youth vaping but face barriers to screening and counselling, indicating the need for change in guidelines and policy.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754655","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":"Uptake of video telehealth in general practice: an Australian whole-of-population analysis.","authors":"Danielle C Butler, Hsei Di Law, Christine Phillips, Kirsty A Douglas, Sally Hall Dykgraaf, Jason Agostino, Emily Banks, Rachel Freeman-Robinson, Jane Desborough, Alana Dougherty, Grace Joshy, Nina Lazarevic, Jennifer Welsh, Muhammad-Shahdaat Bin-Sayeed, Dan Chateau, Kay Soga, Anne Parkinson, Sue Trevenar, Rosemary J Korda","doi":"10.3399/BJGPO.2025.0011","DOIUrl":"https://doi.org/10.3399/BJGPO.2025.0011","url":null,"abstract":"<p><strong>Background: </strong>Video use remains low in primary care telehealth consultations. Little is known about patterns of use, or policy levers to promote video.</p><p><strong>Aim: </strong>To investigate use of video telehealth in Australian general practice under permanent telehealth arrangements post-COVID lockdowns, and during a policy change removing reimbursement for long telephone consultations.</p><p><strong>Setting/design: </strong>Whole-of-population analysis of 2022 national healthcare claims linked to 2021 census data.</p><p><strong>Method: </strong>We quantified: proportions of telehealth consultations by video, and of patients and GPs who used video for telehealth consultations; associations between video use and patient characteristics using Poisson regression, and video use in relation to policy changes using interrupted time-series analysis.</p><p><strong>Results: </strong>Of 38 million GP telehealth consultations in 2022, 5.1% were by video; 8.6% of patients and 62% of general practitioners who used telehealth had used video. Patients most likely to use video lived remotely, were frequent GP users, or had multiple health conditions, mental health conditions or dementia. Socioeconomic disadvantage was modestly associated with lower use of video. Over 2022, use of video for telehealth decreased for consultations (6.5% of consultations in January, 4.1% in December), patients (6.7%, 4.4%) and GPs (40%, 26%). Time-series analyses showed downward trends before removal of reimbursement for long telephone consultations, small step increases immediately following, and shallower negative trends thereafter.</p><p><strong>Conclusion: </strong>Use of video telehealth consultations in general practice in Australia is low and declining, more so for disadvantaged groups. Differential financial reimbursement of video and telephone consultations has not substantively increased video use in clinical practice.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754658","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":"Understanding collaborative working between GPs and community pharmacists - systematic review and thematic synthesis of qualitative studies.","authors":"Grace Kng Li Lin, Aleema Sardar, David N Blane","doi":"10.3399/BJGPO.2024.0203","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0203","url":null,"abstract":"<p><strong>Background: </strong>Collaborative working between General practitioners (GPs) and Community Pharmacists (CPs) has led to improvements in management of long-term conditions, and has strong policy backing, yet such joint working remains patchy and under-developed. Understanding the perspectives of GPs and CPs regarding collaboration provides insights for more sustainable collaborative practices.</p><p><strong>Aim: </strong>To understand the perspectives of GPs and community pharmacists concerning collaborative care practices, and to develop a framework of factors that influence this collaborative working relationship.</p><p><strong>Design & setting: </strong>A systematic review of qualitative studies.</p><p><strong>Method: </strong>Five databases were searched from inception to the 22^nd of April 2023 for qualitative studies exploring GP and CP views on collaborative care services. Articles were independently screened by two reviewers at title, abstract and full-text levels. Data extracted from eligible studies were analysed and synthesised thematically.</p><p><strong>Results: </strong>Thirty-six studies met the inclusion criteria. Four main themes were identified: 1) How pre-existing relationships influence mutual understanding of roles, 2) the impact of location and communication on relationship building, 3) analysis of perceived costs and benefits, and 4) the motivation to develop collaborative care practices.</p><p><strong>Conclusion: </strong>A complex interplay of factors influences GP and CP collaborative working, including pre-existing relationships, communication and mutual understanding, and the balance of costs and benefits to further develop these relationships. When planning future collaborative care practices, stakeholders must take the time and initiative to elucidate and understand these factors within their own unique healthcare setting to form lasting working relationships.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754657","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":"Characteristics of patients with frequent contact with general practice: a retrospective study.","authors":"Jesper B Nielsen, Helene S Andersen","doi":"10.3399/BJGPO.2024.0195","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0195","url":null,"abstract":"<p><strong>Background: </strong>Frequent attenders (>11 annual contacts) use more resources than most other patients in general practice.</p><p><strong>Aim: </strong>To study what characterises frequent attenders in relation to age, sex, mode of contact (face to face, email, or phone), and patient contact (GP or GP staff).</p><p><strong>Design & setting: </strong>A retrospective analysis of Danish patient datasets in general practice.</p><p><strong>Method: </strong>We used patient data from 11 Danish GP clinics and 38 874 patients covering a 12-month period. Bivariate as well as regression analyses of patient data were used.</p><p><strong>Results: </strong>Frequent attenders exist in all age groups, but with different frequencies. In the age group 55-64 years, 25% of patients were frequent attenders, this increased to 33% in the next age decade from age 65-74 years and reached 48% among those aged ≥75 years. Frequent attenders have a different user pattern related to physical visits, phone consultations, or email consultations than other patients. In their contact to the GP clinic, the frequent attender is relatively more often in contact with the practice staff than a GP compared with other patients.</p><p><strong>Conclusion: </strong>Within our Danish patient population, 22% had >11 annual contacts to their GP clinic. These frequent attenders are in general terms characterised by being female, aged >65 years, having 20 annual contacts to the GP clinic, and having ≥10 diagnoses. For the entire patient population, the GP handles 36% of the patient contacts (64% by other staff members), and this percentage is lowest among frequent attenders. Email contact is used more often among frequent attenders than other patients.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' reasons for declining a primary care trial online therapy: a mixed-methods study.","authors":"Fiona Fox, Debbie Tallon, Roz Shafran, Paul Lanham, Christopher Williams, Berry Jude, Nicola Wiles, David Kessler, Katrina Turner","doi":"10.3399/BJGPO.2024.0272","DOIUrl":"10.3399/BJGPO.2024.0272","url":null,"abstract":"<p><strong>Background: </strong>Integrating therapist-led sessions and cognitive behavioural therapy (CBT) materials within one online platform may be effective for people with depression. A trial evaluating this mode of delivering CBT is being conducted. To maximise future trial recruitment and understand patients' views of health interventions, it is important to explore reasons for declining to participate.</p><p><strong>Aim: </strong>To explore patients' reasons for declining to participate in a trial of integrated online CBT for depression.</p><p><strong>Design & setting: </strong>A mixed-methods study collecting data from patients via questionnaires and telephone interviews at three UK trial sites.</p><p><strong>Method: </strong>Individuals completed a short questionnaire about their reasons for not taking part in the trial. Telephone interviews further explored these reasons with a subgroup. Quantitative data were summarised using descriptive statistics. Qualitative interviews were analysed thematically.</p><p><strong>Results: </strong>Of 1799 patients who responded to an invitation to participate in the trial, 40.3% declined contact. The most common reasons were not wanting: to take part in research (<i>n</i> = 387); therapy provided online (<i>n</i> = 284); to receive CBT (<i>n</i> = 262). Qualitative interviews with 15 'decliners' highlighted that decisions related to perceptions of eligibility, previous experiences of CBT, and uncertainty about receiving CBT online. Personal circumstances, depressive symptoms, or other mental health issues were also barriers to participation.</p><p><strong>Conclusion: </strong>Reasons given by primary care patients for not taking part in a trial of integrated online CBT suggest that, at the point of recruitment, it is important to discuss the patient's perceptions of their eligibility and whether they would accept the intervention being evaluated.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030017","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":"Patterns and indications for quetiapine prescribing in Dutch primary care: a retrospective database study.","authors":"Büsra G Cinar, Suzanne A Ligthart, Hugo Ajm de Wit, Arnt Fa Schellekens, Hanneke Hwa Fleuren, Cornelis Kramers, Albert Batalla, Gerard A Kalkman","doi":"10.3399/BJGPO.2024.0219","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0219","url":null,"abstract":"<p><strong>Background: </strong>Quetiapine, an antipsychotic, is registered for schizophrenia, bipolar disorder, and as an add-on therapy for major depressive disorder. Its anxiolytic and sedative effects make it attractive for off-label uses like insomnia, despite cardiovascular and metabolic side effects. The global increase in quetiapine use over the past decade warrants an examination of its prescribing patterns, especially off-label.</p><p><strong>Aim: </strong>This study investigated quetiapine prescribing trends in Dutch primary care, with a focus on off-label use.</p><p><strong>Design & setting: </strong>A retrospective database study using national and regional prescribing data from the Netherlands.</p><p><strong>Method: </strong>National prescribing trends from 2003-2022 were analysed using data from the Drug Information Project database, focusing on the top 10 antipsychotics. Regional data from the Radboud University Medical Centre (UMC) Technology Centre Health Database provided detailed quetiapine prescribing patterns from 2012-2021, categorised by daily dose. Indications for quetiapine prescriptions from 2020-2022 were derived from the detailed Radboud UMC Technology Centre patient records, including free-text portions, with specific attention for use in sleep problems.</p><p><strong>Results: </strong>Antipsychotic use increased from 1510 to 2061 per 100 000 population from 2003-2022, largely due to a 13-fold increase in quetiapine (66 to 870 per 100 000 population). Detailed regional data revealed a 3.3-fold increase in quetiapine use from 2012-2021, particularly at doses <100 mg/day. Among new quetiapine users in 2020-2022 from a subset of practices, 76.6% were for off-label indications, and sleep problems were the primary reason for starting quetiapine in 46.9% of cases.</p><p><strong>Conclusion: </strong>Off-label quetiapine prescribing, particulary for sleep problems, is rising in the Netherlands, despite guideline warnings. Further research on the drivers and long-term effects of this practice is needed.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745373","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":"Assessment and treatment of headache in primary care: a scoping review.","authors":"Jon M Dickson, Aneth Kimaro, Cheong Sxe Chang, Daniel Hind","doi":"10.3399/BJGPO.2025.0064","DOIUrl":"10.3399/BJGPO.2025.0064","url":null,"abstract":"<p><strong>Background: </strong>Good quality primary care is essential for the assessment and treatment of headache but there is evidence that primary care for headache is suboptimal.</p><p><strong>Aim: </strong>To identify the international evidence on the assessment and treatment of headache in adults in primary care.</p><p><strong>Design & setting: </strong>A scoping review of the published literature following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR) guidelines, and a narrative review of the evidence.</p><p><strong>Method: </strong>An electronic search of MEDLINE and Embase (1974-2024) was undertaken. Studies meeting the eligibility criteria were included. Results were grouped by study type and were reported narratively.</p><p><strong>Results: </strong>In total, 1125 articles were screened, 43 articles underwent full-text review, and 28 articles were included in the final review. Six studies used comparative methods, of which <i>n</i> = 3/6 investigated educational interventions. The educational interventions found positive effects on learning, and on outcomes such as diagnosis rates, but the only randomised controlled trial (RCT) did not show any benefits of the intervention. Other comparative studies showed satisfaction with GP with an extended role (GPwER) headache services, benefits from direct access to magnetic resonance imaging (MRI), and benefits from a nurse-led headache service. Twenty-two studies used non-comparative methods, such as surveys and interviews, and investigated approaches to assessment, diagnosis, referral rationale, decision making for prescribing prophylactic medications, educational initiatives, direct access to neuroimaging, GPwER, and nurse-led interventions.</p><p><strong>Conclusion: </strong>Despite the availability of high quality clinical guidelines on the assessment and management of headache, the evidence shows that its implementation in primary care is problematic and educational interventions are a common focus of published studies. Further research is required to assess the quality of the current evidence and to develop, refine, and deploy interventions that have a signal of efficacy.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812518","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}